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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi
Sulchan Sofoewan, Sulchan
Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Health Professions Medicine & Pharmacology Public Health

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BIAYA PASIEN JAMINAN KESEHATAN NASIONAL YANG MENJALANI SEKSIO SESAREA DI RSUP DR. SARDJITO YOGYAKARTA Rahmawan, Adi; Nurdiati, Detty Siti; Sofoewan, Sulchan
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : IPAKESPRO

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.299 KB)

Abstract

Adi Rahmawan1, Detty Siti Nurdiati2, Sulchan Sofoewan3 ABSTRACT Background: Ease of access and timeliness in reaching emergency obstetric care is necessary to save the mother and newborn. Delivery by emergency caesarean section aims to save the mother and newborn. The amount of cost from the emergency obstetric care particularly caesarean section, was significantly higher compared to childbirth without complications. The implementation JKN (Jaminan Kesehatan Nasional) aims to overcome this programs. Government hospitals have a dilemma between the mission of serving the lower middle class society and the limited financial resources, as well as a variety of rules and bureaucracy. Casemix system on INA-CBG’s (Indonesian Case Base Groups) is grouping similar patient characteristics. Hospital will receive payments based on the average amount of cost by a group of diagnosis. Objective: Knowing the cost of the JKN patient who underwent cesarean section in Dr. Sardjito Hospital. Method: The study design is a descriptive. JKN patients undergoing Caesarean section in January-July 2014 at the Hospital Dr. Sardjito included in the study. Patients who moved to the VIP, VVIP, and suites classes are excluded. Patient cost data will be averaged and be detailed by characteristics. Result: A total of 136 patients underwent Caesarean section with JKN during January-July 2014. Average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Patient with severe preeclampsia had average cost of 3,050,776 rupiahs higher than patients without severe preeclampsia. Patients with 4 disesases and complications had the difference in cost 16,995,952 rupiahs higher than patients without the disease. Patients with ICU care had higher average cost than non-admission to the ICU in the amount of 3,340,288 rupiahs. Difference in the higher average costs also occur on length of stay. Class treatment, duration stay in the delivery room, the induction or stimulation in the delivery room. History of cesarean section was not the leading cause of higher cost.Conclusion: The average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Complications of the disease and the patient’s condition, severe preeclampsia, long hospitalization, ICU care, led to high costs in patients underwent Caesarean section.Keyword: seksio sesarea, cost, JKN, INA-CBG’ABSTRAKLatar belakang: Kemudahan akses dan ketepatan waktu dalam menjangkau pelayanan kegawadaruratan obstetri sangat diperlukan demi menyelamatkan ibu dan neonatal. Persalinan dengan seksio sesarea pada kedaruratan obstetrik bertujuan untuk menyelamatkan ibu dan neonatal. Biaya yang dihabiskan dari pelayanan kedaruratan obstetri operasi sesar, secara signifikan lebih tinggi dibandingkan dengan persalinan tanpa penyulit. Terselenggaranya program Jaminan Kesehehatan Nasional (JKN) mempunyai tujuan untuk mengatasi hal tersebut. Rumah sakit pemerintah menghadapi dilema antara misi melayani masyarakat kelas menengah ke bawah dengan adanya keterbatasan sumber dana, serta berbagai aturan dan birokrasi yang harus dihadapi. Sistem casemix pada INA-CBG’s merupakan pengelompokan karakteristik pasien yang sejenis. Rumah Sakit akan mendapatkan pembayaran berdasarkan rata-rata biaya yang dihabiskan oleh suatu kelompok diagnosis.Tujuan: Mengetahui besarnya biaya pasien Jaminan Kesehatan Nasional (JKN) yang menjalani operasi seksio sesarea di RSUP Dr. Sardjito Metode: Rancangan penelitian yang akan digunakan adalah deskriptif. Pasien JKN yang menjalani seksio sesarea pada Januari-Juli 2014 di RSUP Dr. Sardjito diikutsertakan dalam penelitian ini. Pasien yang pindah perawatan ke kelas VIP, VVIP, dan suite di eksklusi. Data biaya pasien akan dirata-rata dan dirinci besarnya berdasarkan karakteristik Hasil & Pembahasan: Sebanyak 136 pasien JKN menjalani seksio sesarea selama Januari-Juli 2014. Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. Pasien preeklamsia berat mempunyai ratas-rata biaya yang lebih tinggi 3.050.776 rupiah dibandingkan pasien tanpa preeklamsia berat. Pasien dengan 4 penyakit dan komplikasi mempunyai selisih biaya 16.995.952 rupiah lebih tinggi dibandingkan pasien tanpa penyakit. Pasien dengan perawatan ICU mempunyai rata-rata biaya yang lebih tinggi dibanding yang tidak dirawat di ICU yaitu sebesar 3.340.288 rupiah. Selisih rata-rata biaya yang lebih tinggi juga terjadi pada lama rawat inap. Kelas perawatan, lama perawatan di kamar bersalin, tindakan induksi atau stimulasi di kamar bersalin, riwayat seksio sesarea saat ini tidak menyebabkan semakin tingginya biaya seksio sesarea.Kesimpulan: Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. kondisi penyakit dan komplikasi pasien, preeklamsia berat, lama rawat inap, dan perawatan ICU menyebabkan tingginya biaya pada pasien yang menjalani seksio sesarea. Kata kunci: seksio sesarea, biaya, JKN, INA-CBG’s1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Metode persalinan dan hubungannya dengan inisiasi menyusu dini di RSUP Dr. Sardjito Yogyakrta Virarisca, Sheilla; Dasuki, Djaswadi; Sofoewan, Sulchan
Jurnal Gizi Klinik Indonesia Vol 7, No 2 (2010): November
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.927 KB) | DOI: 10.22146/ijcn.17744

Abstract

Background: The 2002-2003 IDHS shows that the presentation of breastfeeding within an hour after birth or early initiation in Indonesia is still low (38%). According to some studies, early initiation plays an important role in reducing infant mortality rate, determining the success of exclusive breastfeeding, preventing pre-lactation feeding, creating more intensive bonding between mother and baby. Some earlier studies state that delivery methods are related with early initiation. However, there have been some studies whose results are in contrast with those previous studies.Objective: To study the relationship between delivery methods and early initiation in Dr. Sardjito hospital, Yogyakarta.Method: This was an observational study with a cross-sectional study design through quantitative and qualitative approaches. Samples were postpartum women in Dr. Sardjito hospital as many as 100 respondents. Data were analyzed with univariable analysis using frequency distribution table, bivariable analysis using chi-square, and multivariable analysis using binary regression.Results: The proportion of early initiation of breastfeeding was three times greater in women who gave birth with normal delivery methods than women who gave birth with cesarean section (RR=3.1; 95% CI=1.42-6.89). Another factor that was related with early initiation of breastfeding was the support from health providers (RR=2.3; 95% CI=1.36-3.78). Meanwhile, women’s age, knowledge, parity, economic status, and mother’s disease were insignifcantly related with early initiation.Conclusion: The proportion of early initiation of breastfeeding  was three times greater in women who gave birth with normal delivery methods than women who gave birth with cesarean section. Another factor that was related with early initiation of breastfeeding was the support from health providers. Meanwhile, women’s age, knowledge, parity, economic status, and disease were insignifcantly related with early initiation of breastfeeding.
Perbandingan hasil stimulasi ovarium dengan kombinasi klomifen sitrat gonadotropin dan klomifen sitrat pada inseminasi intra uteri Indriani, Farida; Widad, Shofwal; Sofoewan, Sulchan
JURNAL KESEHATAN REPRODUKSI Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.019 KB) | DOI: 10.22146/jkr.35939

Abstract

Background: Infertile couple with the cause of unexplained infertility and male factor can follow intrauterine insemination (IUI) program as a cheap and easy method for infertility therapy. Ovarian stimulation by combination of clomiphene citrate and gonadotropin and also clomiphene citrate alone was done as a superovulation mode to get higher number of mature follicle to gain higher pregnancy rate. Objective : To compare the amount of mature follicles and  endometrial thickness as an outcome of ovarian stimulation between combination drug of clomiphene citrate and gonadotrophin with clomiphene citrate alone.Methods: Observational retrospective cohort. Subject is one cycle intrauterine insemination stimulated either by combination CC gonadotrophin or CC alone, eligible in inclusion criteria and exclusion criteria. Statistic test used was independent t-test, chi-square and logistic regression.Location of study: Infertility Clinic of  Permata Hati, dr. Sardjito Hospital, Yogyakarta.Result: A total of 142 cycle from 98 couples followed IUI and stimulated by combination CC gonadotrophin (n=72) or CC alone (n=70). Multiple mature follicle number was different and statistically significant 77% vs 54%, RR 1,433 (IK95% 1,118-1,836), p=0,005, while endometrial thickness > 7mm was more frequent in combination group but not statistically different with percentage 81,9% vs 74,3%, RR 1,103 (CI95% 0,926-1,315), p=0,367.Conclusion: Ovarian stimulation by combination CC gonadotropin resulting of more multiple mature follicle number while  good endometrial thickness was more in combination group but not statistically significant.Keywords: ovarian stimulation, clomiphene citrate, gonadotrophin, multifollicular, endometrial thickness
BIAYA PASIEN JAMINAN KESEHATAN NASIONAL YANG MENJALANI SEKSIO SESAREA DI RSUP DR. SARDJITO YOGYAKARTA Rahmawan, Adi; Nurdiati, Detty Siti; Sofoewan, Sulchan
JURNAL KESEHATAN REPRODUKSI Vol 2, No 1 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (216.299 KB) | DOI: 10.22146/jkr.7115

Abstract

Adi Rahmawan1, Detty Siti Nurdiati2, Sulchan Sofoewan3 ABSTRACT Background: Ease of access and timeliness in reaching emergency obstetric care is necessary to save the mother and newborn. Delivery by emergency caesarean section aims to save the mother and newborn. The amount of cost from the emergency obstetric care particularly caesarean section, was significantly higher compared to childbirth without complications. The implementation JKN (Jaminan Kesehatan Nasional) aims to overcome this programs. Government hospitals have a dilemma between the mission of serving the lower middle class society and the limited financial resources, as well as a variety of rules and bureaucracy. Casemix system on INA-CBG’s (Indonesian Case Base Groups) is grouping similar patient characteristics. Hospital will receive payments based on the average amount of cost by a group of diagnosis. Objective: Knowing the cost of the JKN patient who underwent cesarean section in Dr. Sardjito Hospital. Method: The study design is a descriptive. JKN patients undergoing Caesarean section in January-July 2014 at the Hospital Dr. Sardjito included in the study. Patients who moved to the VIP, VVIP, and suites classes are excluded. Patient cost data will be averaged and be detailed by characteristics. Result: A total of 136 patients underwent Caesarean section with JKN during January-July 2014. Average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Patient with severe preeclampsia had average cost of 3,050,776 rupiahs higher than patients without severe preeclampsia. Patients with 4 disesases and complications had the difference in cost 16,995,952 rupiahs higher than patients without the disease. Patients with ICU care had higher average cost than non-admission to the ICU in the amount of 3,340,288 rupiahs. Difference in the higher average costs also occur on length of stay. Class treatment, duration stay in the delivery room, the induction or stimulation in the delivery room. History of cesarean section was not the leading cause of higher cost.Conclusion: The average cost of patients underwent Caesarean section was 10,337,411 rupiahs. Complications of the disease and the patient’s condition, severe preeclampsia, long hospitalization, ICU care, led to high costs in patients underwent Caesarean section.Keyword: seksio sesarea, cost, JKN, INA-CBG’ABSTRAKLatar belakang: Kemudahan akses dan ketepatan waktu dalam menjangkau pelayanan kegawadaruratan obstetri sangat diperlukan demi menyelamatkan ibu dan neonatal. Persalinan dengan seksio sesarea pada kedaruratan obstetrik bertujuan untuk menyelamatkan ibu dan neonatal. Biaya yang dihabiskan dari pelayanan kedaruratan obstetri operasi sesar, secara signifikan lebih tinggi dibandingkan dengan persalinan tanpa penyulit. Terselenggaranya program Jaminan Kesehehatan Nasional (JKN) mempunyai tujuan untuk mengatasi hal tersebut. Rumah sakit pemerintah menghadapi dilema antara misi melayani masyarakat kelas menengah ke bawah dengan adanya keterbatasan sumber dana, serta berbagai aturan dan birokrasi yang harus dihadapi. Sistem casemix pada INA-CBG’s merupakan pengelompokan karakteristik pasien yang sejenis. Rumah Sakit akan mendapatkan pembayaran berdasarkan rata-rata biaya yang dihabiskan oleh suatu kelompok diagnosis.Tujuan: Mengetahui besarnya biaya pasien Jaminan Kesehatan Nasional (JKN) yang menjalani operasi seksio sesarea di RSUP Dr. Sardjito Metode: Rancangan penelitian yang akan digunakan adalah deskriptif. Pasien JKN yang menjalani seksio sesarea pada Januari-Juli 2014 di RSUP Dr. Sardjito diikutsertakan dalam penelitian ini. Pasien yang pindah perawatan ke kelas VIP, VVIP, dan suite di eksklusi. Data biaya pasien akan dirata-rata dan dirinci besarnya berdasarkan karakteristik Hasil & Pembahasan: Sebanyak 136 pasien JKN menjalani seksio sesarea selama Januari-Juli 2014. Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. Pasien preeklamsia berat mempunyai ratas-rata biaya yang lebih tinggi 3.050.776 rupiah dibandingkan pasien tanpa preeklamsia berat. Pasien dengan 4 penyakit dan komplikasi mempunyai selisih biaya 16.995.952 rupiah lebih tinggi dibandingkan pasien tanpa penyakit. Pasien dengan perawatan ICU mempunyai rata-rata biaya yang lebih tinggi dibanding yang tidak dirawat di ICU yaitu sebesar 3.340.288 rupiah. Selisih rata-rata biaya yang lebih tinggi juga terjadi pada lama rawat inap. Kelas perawatan, lama perawatan di kamar bersalin, tindakan induksi atau stimulasi di kamar bersalin, riwayat seksio sesarea saat ini tidak menyebabkan semakin tingginya biaya seksio sesarea.Kesimpulan: Rata-rata biaya pasien yang menjalani seksio sesarea adalah 10.337.411 rupiah. kondisi penyakit dan komplikasi pasien, preeklamsia berat, lama rawat inap, dan perawatan ICU menyebabkan tingginya biaya pada pasien yang menjalani seksio sesarea. Kata kunci: seksio sesarea, biaya, JKN, INA-CBG’s1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
Comparison of Serum Interleukin-6 (Il-6) Levels Between Patients With HELLP Syndrome Versus Normotensive Pregnant Ganap, Eugenius Phyowai; Sofoewan, Sulchan; Siswosudarmo, Risanto
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 9, No 2 (2018): July-December 2018
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (727.341 KB) | DOI: 10.30659/sainsmed.v9i2.3630

Abstract

Background: Interleukin-6 (IL-6) has been known associated with oxidative stress and endothelial dysfunction, and also has important roles in pathogenesis of preeclampsia. Several studies have demonstrated that there was a significant increase of serum IL-6 levels in preeclamptic compared to normotensive pregnant women. However, study to evaluate serum IL-6 level in pregnant women with HELLP (hemolysis, elevated liver enzyme, and low platelet) syndrome is not well documented yet. This study aims to evaluate serum IL-6 levels between women with HELLP syndrome compared to normotensive pregnant.Methods: The research design was observational cross-sectional study. Samples were recruited consecutively using inclusion and exclusion criteria from emergency department and inpatient wards at Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Serum IL-6 were collected from venous blood sample and measured by enzyme-linked immunoassay (ELISA) method. Independent-samples t-test or Mann-Whitney test was used to compare serum IL-6 values between women with HELLP syndrome and normotensive pregrnancy. A statistical measurement conducted using SPSS IBM Statistics 19® and considered significance when p<0,05.Results: There were 46 subjects, consisted of 23 women with HELLP syndrome and 23 women with normotensive pregnancy. Serum IL-6 level was a mean of 0,11±0,08 pg/mL and 0,15±0,20 pg/mL in women with HELLP syndrome compared to normotensive pregnancy respectively. There was no significant statistical difference between both groups (p=0,17).Conclusion:.The result of this study has shown that no significant difference of serum IL-6 level in HELLP syndrome women compared to normotensive pregnant women. 
Co-Authors Adi Rahmawan, Adi Detty Siti Nurdiati, Detty Siti Djaswadi Dasuki Elisa Christiana Farida Indriani Ganap, Eugenius Phyowai Herlin Fitriani Kurniawati Risanto Siswosudarmo Shofwal Widad Virarisca, Sheilla