The Assessment on the Cost of Illness Among Patients with Chronic Kidney Disease in Stage 3 and 4 at H. Adam Malik Hospital, Medan
DOI:
https://doi.org/10.56338/ijhess.v8i4.12204Keywords:
BPJS Health, Cost of Illness, Indonesian Case-Based Groups, Chronic Kidney DiseaseAbstract
Background: Chronic Kidney Disease (CKD) is a non-communicable disease that imposes a significant economic burden, both on patients and the healthcare system in Indonesia.
Objective: This study aims to describe the Cost of Illness (COI) based on actual hospital costs for patients with stage 3 and 4 CKD at RSUP H. Adam Malik Medan and to examine COI variations according to age, gender, and type of treatment. INA-CBGs tariffs are presented as contextual background only and are not directly compared with hospital costs.
Method: This study used a cross-sectional descriptive analytical quantitative design with total sampling. Data were retrospectively collected from medical records and hospital administrative and financial databases for patients with stage 3 and 4 CKD receiving inpatient or outpatient care at RSUP H. Adam Malik Medan from 2022 to 2025. The analysis focused on the Cost of Illness (COI), calculated from direct medical and direct non-medical costs, and examined according to age, gender, CKD stage, year of visit, and type of treatment. The analysis was conducted from the hospital provider’s perspective, focusing on direct medical costs incurred by the hospital for CKD-related services.
Results: The study results show that patients with stage 3 and 4 CKD were predominantly male 121 (62.37%), adults aged 18-59 years 105 (54.12%), hospitalized 113 (58.25%), and service episodes recorded in 2024 110 (56.41%) from 2022 to 2025. Most CKD patients come from North Sumatra province (90.72%), The most common comorbidities varied by treatment type: diabetes mellitus without complications was the most frequent among outpatients (7.19%), while disorders of plasma-protein metabolism were most frequent among inpatients (10.21%). COI did not differ significantly by age or gender. A significant difference in COI was observed according to treatment type among patients with stage 3 CKD (p = 0.021), but not among those with stage 4 CKD (p = 0.121).
Conclusion: This study describes hospital-based COI for stage 3 and 4 CKD patients and underscores the need for future research that directly compares actual hospital costs with INA-CBGs tariffs to assess financing adequacy. The present analysis did not include such a direct comparison.
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