Cost analysis of congenital heart disease patients who underwent diagnostic catheterization

Main Article Content

Ni Putu Wirantari
Eka Gunawijaya
Ni Putu Veny Kartika Yantie

Abstract

Background Cardiac catheterization has developed into an important technique for diagnosis and management of congenital heart disease (CHD) patients. Catheterization is expensive and almost all patients who undergo the procedure at Sanglah General Hospital are participants of the Social Insurance Administration Organization (Badan Penyelenggara Jaminan Sosial/BPJS) that uses the Indonesian Case-Based Groups (INA-CBGs) payment system.


Objective To determine the characteristics and analyze costs of CHD patients who underwent diagnostic catheterization.


Methods This retrospective study used patient medical record data from March 2009 - July 2018 in Sanglah Hospital, Bali. Data collected included CHD type, age, sex, weight, height, nutritional status, length of procedure, complications, hospital rates, and INA-CBG rates. Data analysis was done with SPSS software.


Results Of 219 CHD patients who underwent non-intervention catheterization, most had cyanotic CHD. Catheterization intervention in 2018 showed a discrepancy between the INA-CBG rate and hospital rate. The biggest difference was 107%, in patients who underwent mild heart intervention with class 3 of treatment.


Conclusion Most subjects are diagnosed with cyanotic CHD especially tetralogy of Fallot and most has already received intervention. There are negative differences between the INA-CBG rates and the hospital real rates for catheterization.

Article Details

How to Cite
1.
Wirantari NP, Gunawijaya E, Kartika Yantie NP. Cost analysis of congenital heart disease patients who underwent diagnostic catheterization. PI [Internet]. 7Aug.2020 [cited 27Oct.2020];60(5):244-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2343
Section
Pediatric Cardiology
Received 2019-11-12
Accepted 2020-08-07
Published 2020-08-07

References

1. Ismail MT, Hidayati F, Krisdinarti L, Noormanto, Nugroho S, Wahab AS. Epidemiology profile of congenital heart disease in a national referral hospital. Acta Cardiologia Indones. 2015;1:66-71. DOI: https://doi.org/10.22146/aci.17811.
2. Allen HD, Shaddy RE, Penny AJ, Feltes TF, Cetta F. Development of the heart. In: Sizarov A, Baldwin HS, Srivastava D, Moorman AFM, editors. Moss and Adams heart disease in infants, children, and adolescents. 9th ed. Baltimore: Williams & Wilkins; 2016. p.657-64.
3. Yun SW. Congenital heart disease in the newborn requiring early intervention. Korean J Pediatr. 2011;54:183-91. DOI: 10.3345/kjp.2011.54.5.183
4. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics 2013 update: a report from the American Heart Association. Circulation. 2013;127:e6-e245. DOI: 10.1161/CIR.0b013e31828124ad.
5. Phillips BL, Cabalka AK, Hagler D, Bailey KR, Cetta F. Procedural complications during congenital cardiac catheterization. Congenit Heart Dis. 2010;5:118-23.
6. Moustafa GA, Kolokythas A, Cahritakis K, Avgerinos DV. Diagnostic cardiac catheterization in the pediatric population. Curr Cardiol Rev. 2016;12:155-62. DOI: 10.1111/j.1747-0803.2010. 00385.x.
7. Kumar P, Joshi VS, Madhu PV. Diagnostic pediatric cardiac catheterization: experience of a tertiary care pediatric cardiac centre. Med J Armed Forces India. 2014;70:10-6. DOI: 10.1016/j.mjafi.2013.01.002.
8. Aulia S, Supriadi, Sari DK, Mutiha A. Cost recovery rate program jaminan kesehatan nasional BPJS kesehatan. Akuntabilitas. 2015;8:111-20. DOI: 10.154 08/akt.v8i2.2767
9. BPJS Kesehatan. Info BPJS kesehatan. Cited 17th 2019 May 17. Available from: http://www.bpjs-kesehatan.go.id.
10. Wijayanti AI, Sugiarsi S. Analisis perbedaan tarif riil dengan tarif paket INA-CBG pada pembayaran klaim Jamkesmas pasien rawat inap di RSUD Kabupaten Sukoharjo. JMIKI. 2013;1:1-10. DOI : 10.33560/.v1i1.56
11. Komaryani K. Kebijakan penentuan besaran biaya CBG. Tim teknis INA-CBG’s Kementerian Kesehatan RI. Accessed: 17th May 2019. Available from: http://www.inahea.org.
12. Djer MM, Madiyono B. Tata laksana penyakit jantung bawaan. Sari Pediatri. 2000;2:155-62. DOI: http://dx.doi.org/10.14238/sp2.3.2000.155-62
13. Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman Laboratorium Kateterisasi Jantung dan Pembuluh Darah. Jakarta: PERKI; 2018. p. 1-53.
14. Ikatan Dokter Anak Indonesia (IDAI). Rekomendasi ikatan dokter anak Indonesia: asuhan nutrisi pediatrik (pediatric nutrition care). Jakarta: Ikatan Dokter Anak Indonesia; 2011
15. Mehta R, Lee KJ, Cahturvedi R, Benson L. Complications of pediatric cardiac catheterization: a review in the current era. Catheter Cardiovasc Interv. 2008;72:278-85. DOI: 10.1002/ccd.21580.
16. Vitiello R, McCrindle BW, Nykanen D, Freedom RM, Benson LN. Complications associated with pediatric cardiac catheterization. J Am Coll Cardiol. 1998;32:1433-40. DOI: 10.1016/s0735-1097(98)00396-9.
17. McPhee SJ, Papadakis MA. Heart disease. In: Basgore TM, Granger CB, Jackson KP, Patel MR, editors. Current medical diagnosis & treatment. 56th ed. New York City: McGraw-Hill; 2017. p. 322-438.
18. Mullins CE. Cardiac catheterization in congenital heart disease: pediatric and adult. Massachusetts: Blackwell Futura; 2006. p. 25-73.
19. Papadopoulou D, Yakoumais E, Sandilos P, Thanopoulos V, Makri T, Gialousis G, et al. Entrance radiation doses during paediatric cardiac catheterisations performed for diagnosis or the treatment of congenital heart disease. Radiat Prot Dosimetry. 2005;117:236-40. DOI: 10.1093/rpd/nci755. Epub 2006 Feb 3.
20. Phillips BL, Cabalka AK, Hagler DJ, Bailey KR, Cetta F. Procedural complications during congenital cardiac catheterization. Congenit Heart Dis. 2010;5:118-23. DOI: 10.1111/j.1747-0803.2010.00385.x.
21. Yuniarti E, Amalia, Handayani TM. Analisis biaya terapi penyakit diabetes melitus pasien Jaminan Keshatan Nasional di RS PKU Muhammadiyah Yogyakarta - perbandingan terhadap tarif INA CBGs. JKKI. 2015;4:43-56. DOI: 10.22146/jkki.v4i3.36108.