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Abstract

Total knee replacement (TKR) is one of the most economical and frequently successful orthopedic procedures. Cost-of-illness studies of TKR in Indonesia are scarce and lack an analysis of the relationship between characteristics and costs. This study aims to examine the cost-of-illness of TKR from a social perspective and explore the relationship between the characteristics and the cost of TKR. This is an observational cross-sectional study of all patients who underwent TKR from 1st January 2022-31 st December 2023. The characteristics were collected from the medical records. Cost of illness was conducted from a social perspective with a bottom-up approach. Hospital cost on the JKN ECLAIM System was obtained as direct medical cost. Direct non-medical and indirect costs were collected through a phone interview with the patient or caregiver. Indirect cost was defined as income loss from the patient and caregiver. The relationship between characteristics and cost was analyzed bivariately using the Mann–Whitney U test and Kruskal–Wallis test. Of a total 54 patient were obtained. Median direct medical cost was 51,769,675 IDR; direct non-medical cost was 850,000 IDR; and indirect cost was 750,000 IDR. None of the characteristics had a direct relationship with medical cost. Age (p = 0.043), Caregiver (p <0.001), and distance traveled (p <0.001) were known as characteristic related to direct non-medical costs. Indirect cost was related to age (p = 0.053) and employment status (p = 0.005). This study only examined the cost of TKR in the hospital. Costs of post-surgery recovery steps, including costs for revisit consultations, wound care, and physiotherapy, need to be carried out in the future.

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Bahasa Abstract

Prosedur ortopedi yang paling ekonomis dan memiliki tingkat keberhasilan yang tinggi adalah prosedur penggantian lutut total (Total Knee Replacement - TKR). Di Indonesia, eksplorasi studi mengenai biaya penyakit (cost-of-illness) TKR dan analisis karakteristik yang memengaruhinya masih jarang dilakukan. Penelitian ini bertujuan untuk menelaah biaya penyakit TKR dari perspektif sosial dan mengetahui hubungan karakteristik pasien dengan biaya TKR. Studi ini adalah studi observasional (cross-sectional) dari semua pasien yang menjalani TKR pada periode 1 Januari 2022 hingga 31 Desember 2023. Karakteristik dikumpulkan dari rekam medis. Biaya penyakit dihitung dari perspektif sosial dengan pendekatan bawah ke atas (bottom-up). Biaya rumah sakit pada Sistem E-Klaim JKN (Jaminan Kesehatan Nasional) dihitung sebagai biaya medis langsung. Biaya nonmedis langsung dan biaya tidak langsung dikumpulkan melalui wawancara dengan pasien atau pemberi perawatan (caregiver) via telepon. Biaya tidak langsung dihitung sebagai kehilangan pendapatan dari pasien dan pemberi perawatan. Total 54 pasien diperoleh. Median biaya medis langsung adalah Rp 51.769.675; biaya nonmedis langsung Rp 850.000; dan biaya tidak langsung Rp 750.000. Tidak ada karakteristik yang memengaruhi biaya medis langsung. Usia (p = 0.043), pemberi perawatan (caregiver) (p <0.001), dan jarak tempuh (p <0.001) diketahui sebagai karakteristik yang memengaruhi biaya nonmedis langsung. Usia (p = 0.053) dan pekerjaan (p = 0.005) diketahui sebagai faktor yang memengaruhi biaya tidak langsung. Studi ini hanya menelaah biaya TKR di rumah sakit. Biaya pemulihan pascaoperasi, termasuk biaya untuk konsultasi, perawatan luka, dan fisioterapi, perlu dilakukan di masa mendatang.

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