Predicting the Out-of-Hospital Status Based on Cost

Driver of Treatment for HIV AIDS Patients

Nuzulul Kusuma Putri, Ernawaty

Faculty of Public Health, Universitas Airlangga, Surabaya
Lilis Masyfufah
STIKES Dr. Soetomo, Surabaya
 BACKGROUND
• HIV AIDS patient tend to seek treatment in the
phase of AIDS rather than in its early diagnosis
• Eventhough the treatment cost already
covered by insurance, the effeciency of
treatment cost could be strengthen when it is
still in initial phase
 AIM
• This study aimed to describe the possibility of
efficiency through comparing the out-of-
hospital status based on its cost driver when
treated in hospital
 METHOD
• Data are collected through secondary data
analysis of financial report in the biggest HIV
AIDS referal hospital in the highest number of
HIV AIDS patient in Indonesia
 Financing Source of HIV/AIDS Patients

Financing Source n %
National Health Insurance 22 39.3
Poor Certificate from District
6 10.7
Government
Out of Pocket 14 25.0
Social Insurance from District 5 8.9
Total 47 83.9
Unknown 9 16.1
56 100.0
 RESULTS
• This study revealed that most of patient that
covered by the health insurance will be out
the hospital until the last treatment, while the
out-of-pocket patient remain stay until the last
treatment only when there is financial supply
 Admission Point of HIV/AIDS Patients

Admission Point n %
Emergency Room 35 62.5
Non Emergency Room 20 35.7
Total 55 98.2
System 1 1.8
56 100.0
 Admission Point to Its Out-of-hospital Status
Out-of-Hospital Status
Death Recover Total
Emergency Room 10 24 34
29.4% 70.6% 100.0%
Non Emergency Room 7 13 20
35.0% 65.0% 100.0%
17 37 54
31.5% 68.5% 100.0%
 Cost Drivers
Cost Drivers N Minimum Maximum Mean Std. Deviation
Total Tarif 56 649,000.00 29,087,400.00 4,298,284.64 4,499,578.27
Non-operative medical treatment 56 - 4,774,000.00 913,482.14 801,820.18
Laboratory 56 - 995,000.00 583,500.00 217,943.03
Radiology 56 - 2,053,000.00 538,071.43 730,649.15
Medical Gas 56 - 4,307,640.00 505,062.14 836,487.66
Operative Treatment 56 - 22,000,000.00 392,857.14 2,939,873.66
Blood Tranfusion 56 - 6,140,000.00 370,250.00 919,569.39
Acomodation 56 55,000.00 2,006,000.00 359,928.57 364,527.48
Non-operative 56 39,000.00 1,273,100.00 271,089.29 172,119.69
Clinical Pathology 56 - 1,747,000.00 172,519.64 338,188.51
Microbiology 56 - 1,560,000.00 47,696.43 228,829.58
Medical support 56 - 1,483,000.00 45,589.29 202,935.26
Retribution 56 - 25,000.00 24,107.14 4,681.41
Nutrition 56 - 585,000.00 23,571.43 89,893.44
Administration 56 15,000.00 15,000.00 15,000.00 -
Radiology 56 - 25,000.00 3,214.29 6,496.75

Length of stay 55 -
18.00 6.05 3.93
 Recover Death
Cost Driver Mean Cost Driver Mean
Total Tarif 4569909.7297 Total Tarif 3692676.6667
Tarif Tindakan Medis Non
Operatif 939486.4865 Tarif Tindakan Medis Non Operatif 840055.5556
Tarif Tindakan Operasi 594594.5946 Tarif Pemeriksaaan Lab 682388.8889
Tarif Pemeriksaan Radiologi 563783.7838 Tarif Gas Medis 585260.0000
Tarif Pemeriksaaan Lab 533000.0000 Tarif Pemeriksaan Radiologi 505333.3333
Tarif Gas Medis 457886.4865 Tarif Akomodasi 351388.8889
Tarif Labu Darah 399972.9730 Tarif Non Operatif 314644.4444
Tarif Akomodasi 367864.8649 Tarif Labu Darah 238055.5556
Tarif Non Operatif 251629.7297 Tarif Pemeriksaan Patologi Klinis 103800.0000
Tarif Pemeriksaan Patologi
Klinis 210613.5135 Tarif Tindakan Penunjang Irna Medik 30555.5556
Tarif Pemeriksaan
Mikrobiologi dan
Penyegeraan 70567.5676 Tarif Karcis 25000.0000
Tarif Tindakan Penunjang Irna
Medik 54135.1351 Tarif Administrasi 15000.0000
tarif Instalasi Gizi 33000.0000 Tarif Kartu Berobat 5000.0000
Tarif Pemeriksaan Mikrobiologi dan
Tarif Karcis 23648.6486 Penyegeraan 3333.3333
Tarif Administrasi 15000.0000 tarif Instalasi Gizi 0.0000
Tarif Kartu Berobat 2432.4324 Tarif Tindakan Operasi 0.0000
Valid N (listwise) Valid N (listwise)
 RESULTS
• Patient that cost more in laboratory and
radiology tend to out-of-hospital with death
condition
• In other hand, patient with high cost in
examination of clinical pathology and
microbiology tend to out-of-hospital with
better condition
 CONCLUSION
• This result show that the early diagnosis and
prompt treatment of HIV AIDS should be
consider when efficiencing the HIV AIDS
financing