PENGARUH FAKTOR KOMORBIDITAS TERHADAP BIAYA TERAPI SUBYEK HIPERTENSI DI RUMAH SAKIT DI YOGYAKARTA
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Abstract
Aim: to evaluate the effect of comorbidity factor on the change of medication cost among the hypertensive subjects in hospitals in Yogyakarta. Methods: sub-analysis of the non-randomized study on the patients of the physicians received 4 times blood pressure feedback intervention. The study was done in 2 hospitals. Subjects criteria were >18 years, out-patients, covered with Askes insurance, hypertensive and/or received hypertensive medicine, but not in the hemodialysis procedure. The effect of comorbidity factor on the systolic blood pressure (SBP) and medication cost were analyzed with T-test and followed by the scatter plot of the correlation between the change of SBP (X) and the change of cost (Y) of the comorbid subjects minus the mean values of the without comorbid subjects. Results: subjects consisted of without (n=82) and with (n=303) comorbid. The comorbid subjects had older age, less hypertensive medicine, but more cardiovascular medicine, and worse mean SBP reached to the target vs. without comorbid subjects (p<0.05). Comorbidity increased the CVD medicine and total medication cost but had lower hypertensive medicine cost. Based on the scatter plot, comorbid subjects had the proportion of subjects with better SBP (18.4%), subjects with the increased hypertensive medicine cost (31.4%) and with the increased CVD medicine cost (60.4%) compared without comorbid subjects. Conclusion: comorbidity factor significantly increased the CVD medicine and total medication cost of the hypertension subjects in the hospitals in Yogyakarta.
Keywords: Hypertension, Cardiovascular comorbidity, Medication Cost.
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WHO 2009a. Global Health Risks, Mortality and burden of disease attributable to selected major risks, WHO Geneva. Diunduh dari h t t p : / / w w w . w h o . i n t / h e a l t h i n f o /global_burden_disease/GlobalHealthRisks_report_full.pdf, tanggal 22 Februari 2010.
Saseen JJ., MacLaughlin EJ. 2008. Hypertension in Pharmacotherapy, a Pathophysiologic Approach 7th Ed., Mc Graw Hill Co. New York. p.139-171.
Rahajeng E, Tuminah S. 2009. Prevalensi Hipertensi dan Determinannya di Indonesia. Maj Kedokt Indon. 59:12, Des.2009.
Chobanian AV., Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. 2003. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42: 1206-1252.
Wright JM, Musini VM. 2009. First-line drugs for hyper tension. Cochrane Database of Systematic Reviews, Issue 3. Ar t. No.: CD001841. DOI: 10.1002/14651858. CD001841.pub2.
Ogedegbe G. 2008. Barriers to Optimal Hypertension Control. J Clin Hypertens. 10(8): 644-6.
Robertson TA, Cooke CE, Wang JS, Shaya FT, Lee HY. 2008. Effect of Medication Burden on Persistent Use of Lipid-Lowering Drugs
Among Patients with Hypertension, Am J Manag Care.14(11): 710-716.
Vigen R, Shetterly S, Magid DJ, OConnor PJ, Margolis KL, Schmittdiel J, Ho PJ. 2012. A Comparison Between Antihyper tensive Medication Adherence and Treatment Intensification as Potential Clinical Performance Measures. Circ Cardiovasc Qual Outcomes, 5: 276-282.
Rose AJ, Berlowitz DR, Manze M, Orner MB, Kressin NR. 2009. "Comparing Method of Measuring Treatment Intensification in
Hypertension Care. Circ Cardiovasc Qual Outcomes, 2: 385-391.
Smith KJ and Rober ts MS. 2010. Cost Effectiveness Analysis in Pharmacoeconomics from Theory to Practice. Editor Arnold RJG, Boca Raton: CRC Press.
American College of Phycisian (ACP). 2010. Primer on Cost-Effectiveness Analysis. Diunduh dari http://www.acponline.org., tanggal 11 Desember 2010.
Wagner AK, Valera M, Graves AJ, Lavina S, Ross-Degnan D. 2008. Costs of Hospital Care for Hypertension in an Insured Population without an Outpatient Medicines Benefit; an Observational Study in Philippines. BMC Health Services Research, 8:161.
Rose AJ, Berlowitz DR, Manze M, Orner MB, Kressin NR. 2009. Intensifying Therapy for Hyper tension Despite Suboptimal Adherence. Hypertension, 54: 524-9.
Maddox TM, Ross C, Tavel HM, Lyons EE, Tillquist M, Ho M, Rumsfeld JS, Margolis KL,
OConnor PJ, Selby JV, Magid D J. 2010. Blood Pressures Trajectories and Association with Treatment Intensification, Medication Adherence, and Outcomes among Newly Diagnosed Coronar y Ar ter y Disease Patients. Circ Cardiovasc Qual Outcomes, 3: 347-57.
van Bruggen R, Gorter K, Stolk R, Klungel O, Rutten G. 2009. Clinical inertia in general practice: widespread and related to the outcome of diabetes care. Fam. Pract., 26: 42836.
Musini VM, Wright JM, Bassett K, Jauca CD. 2009. Blood pressure lowering efficacy of loop diuretics for primary hypertension. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD003825. DOI: 10.1002/14651858. CD003825.pub2.
Yoon J., Ettner SL. 2009. Cost-Sharing and Adherence to Antihypertensives for Low and High Adherers, Am J Manag Care. 15(11): 833-40.
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