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Abstract

Clinical pathway (CP) is a quality and cost control instrument in hospitals designed to ensure service standardization, efficiency of Length of Stay (LOS), and control of healthcare costs. Dengue Haemorrhagic Fever (DHF) in children is an infectious disease that often requires hospitalization, with considerable variation in LOS and treatment costs. This study aimed to assess the effectiveness of CP implementation on LOS and cost of care among pediatric DHF patients at Rumah Sakit Islam Nahdlatul Ulama (RSI NU) Demak. This research applied a quantitative approach using a retrospective descriptive-analytic design. Data were obtained from medical records of 34 pediatric DHF patients hospitalized at RSI NU Demak between January and June 2025. The variables analyzed included LOS and cost of care based on care class. Descriptive analysis was conducted using mean, standard deviation (SD), and the difference between actual costs of care and INA-CBGs tariffs. The results showed that the average LOS for pediatric DHF patients was 4.56 ± 1.07 days, ranging from 2 to 7 days, lower than the CP standard of 5 days. By care class, the mean LOS was 6 days for class I, 4.54 ± 1.15 days for class II, and 4.45 ± 1.01 days for class III. Regarding care costs, the mean cost difference was -IDR 1,605,429 for class I, -IDR 642,372 ± 476,993 for class II, and -IDR 555,046 ± 481,767 for class III. Negative values indicate that the actual hospital costs are higher than the INA-CBGs tariff (deficit). Descriptively, the LOS stay among pediatric DHF patients was lower than the CP standard; however, cost variations were still observed.

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Bahasa Abstract

Clinical pathway (CP) merupakan instrumen kendali mutu dan biaya di rumah sakit yang dirancang untuk memastikan keseragaman pelayanan, efisiensi lama rawat, serta pengendalian biaya pelayanan kesehatan. Penyakit Demam Berdarah Dengue (DBD) pada anak merupakan salah satu penyakit infeksi yang sering menyebabkan rawat inap dengan variasi lama perawatan dan pembiayaan yang cukup besar. Penelitian ini bertujuan mengetahui efektivitas implementasi CP terhadap Length of Stay (LOS) dan biaya perawatan pasien DBD anak di RSI NU Demak. Penelitian menggunakan pendekatan kuantitatif dengan desain deskriptif analitik retrospektif. Data diperoleh dari rekam medis pasien DBD anak yang dirawat di RSI NU Demak periode Januari-Juni 2025 sebanyak 34 pasien. Variabel yang dianalisis meliputi LOS dan biaya perawatan pasien berdasarkan kelas perawatan. Analisis dilakukan secara deskriptif menggunakan nilai rata-rata (mean), standar deviasi (SD), serta perbedaan antara biaya aktual rumah sakit dengan tarif standar INA-CBGs. Hasil penelitian menunjukkan bahwa rata-rata LOS pasien DBD anak adalah 4,56 ± 1,08 hari dengan rentang 2–7 hari, lebih rendah dibandingkan standar CP yaitu 5 hari. Berdasarkan kelas perawatan, rata-rata LOS pada kelas I adalah 6 hari, kelas II 4,77 ± 1,24 hari, dan kelas III 4,35 ± 0,93 hari. Dari sisi biaya perawatan, terdapat selisih terhadap tarif INA-CBGs pada seluruh kelas, yaitu -Rp1.605.429 pada kelas I, -Rp580.239 ± 505.444 pada kelas II, dan -Rp557.267 ± 582.967 pada kelas III. Nilai selisih negatif menunjukkan bahwa biaya aktual lebih tinggi dibandingkan tarif INA-CBGs (defisit). Secara deskriptif, lama rawat inap pasien DBD anak lebih rendah dibandingkan standar CP, namun variasi biaya masih ditemukan.

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