Analisis Klaim Obat Penyakit Kronis Pasien Badan Penyelenggara Jaminan Sosial di Rumah Sakit Pendidikan Prof. Dr. Chairuddin Panusunan Lubis Medan

Abstract

Background: Chronic diseases, such as hypertension, diabetes, and coronary heart disease, have become a major burden on the Indonesian healthcare system. The cost of treating chronic diseases, including medication costs, can be a significant burden for patients, hospitals, and the National Health Insurance (BPJS Kesehatan). Therefore, analyzing chronic disease medication claims is crucial to understanding drug usage patterns and optimizing cost management. Objective: This study aimed to analyze chronic disease medication claims for Social Security Agency (BPJS) patients at Prof. Dr. Chairuddin Panusunan Lubis Education Hospital Medan (RSP CPL Medan) Methods: A retrospective observational study was conducted using a quantitative descriptive approach. Medication claim data of BPJS patients at the RSP CPL Medan from April to June 2023 were analyzed. Data were collected from medical records and medication use data at the Pharmacy Installation. Probability sampling with proportionate stratified random sampling was employed. Data were grouped based on inclusion criteria and then processed and analyzed using the Statistical Product and Service Solution (SPSS) version 22 and Microsoft Excel. The Kruskal- Wallis test and Mann-Whitney test were used for data analysis. Results: A significant difference was found between the number of medications prescribed and the cost difference of chronic disease medications for BPJS patients. The more medications in a prescription, the higher the cost difference. Additionally, significant differences were found between the type of polyclinic and the cost differences for chronic disease medications for BPJS patients, indicating varying medication costs across different polyclinics. However, there were no significant differences between the number of secondary diagnoses and the cost differences for chronic disease medications for BPJS patients. Conclusion: This study demonstrated that several factors influence the cost difference of chronic disease medications for BPJS patients at the RSP CPL Medan, including the number of medications prescribed and the type of polyclinic.