ABSTRAK
Nama : Taufiqurrahman
Program Studi : Kajian Administrasi Rumah Sakit
Judul Tesis : Analisis Variasi Biaya Apendiktomi Pasien Jaminan
Kesehatan Nasional Sebelum Dan Sesudah Implementasi
Clinical Pathway Di RSI Ibnu Sina Pekanbaru
Pembimbing : Dr. drg. Mardiati Nadjib, MS
Clinical Pathway (CP) Apendisititis Akut (AA) memberikan gambaran secara rinci
tahap-tahap pelayanan yang akan diberikan kepada pasien. Implementasi CP AA di RSI
Ibnu Sina Pekanbaru diharapkan dapat mengendalikan variasi proses perawatan dalam
upaya meningkatkan kendali mutu dan kendali biaya. Tujuan penelitian ini adalah untuk
melihat peran implementasi CP AA dalam meningkatkan efisiensi biya apendiktomi
pasien JKN di RSI Ibnu Sina Pekanbaru. Desain penelitian ini adalah cross sectional
menggunakan pendekatan kuantitatif dengan menghitung tagihan biaya pasien yang
menjalani apnediktomi sebelum dan sesudah implementasi CP AA dan diolah dengan
uji statistik. Pendekatan kualitatif melalui wawancara mendalam dengan informan yang
terkait dalam implementasi CP AA. Hasil penelitian terjadi pemendekan Length of Stay
(LOS) secara bermakna (P<0.001) pada kelompok pasien sesudah implementasi CP
dibandingkan sebelumnya. Terjadi penurunan rata-rata total biaya apendiktomi sebelum
dan sesudah implementasi CP (Rp. 5.214.188.02 vs Rp. 4.436.438.37) yang bermakna
(P<0.001) dengan persentase selisih 17,5%. Penurunan varian pelayanan berupa
utilisasi alat kesehatan (Alkes), obat dan pemeriksaan laboratorium mempengaruhi
peningkatan efisiensi biaya apendiktomi. Adanya varian dalam implementasi CP AA
menjadi masukan untuk mencapai implementasi CP yang ideal. Varian berupa
pengurangan pelayanan yang seharusnya diberikan kepada pasien harus ditinjaklanjuti
dengan melakukan penilaian outcome pasien seperti tingakat kejadian readmission dan
kondisi pasien ketika melakukan kontrol setelah pulang dari Rumah Sakit (RS).
Kata kunci :
Implementasi Clinical Pathway, Rumah Sakit, Biaya, Apendiktomi

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ABSTRACT
Name : Taufiqurrahman
Study Program : Hospital Administration
Title : Cost Variance Analysis of Appendectomy in the
Indonesian National Health Insurance (JKN) Patients
Before and After Clinical Pathway Implementation at Ibnu
Sina Islamic Hospital Pekanbaru.
Counsellor : Dr. drg. Mardiati Nadjib, MS
Clinical pathway for acute appendicitis provides a detailed description of the steps of
healthcare to be given to patients. Implementation of clinical pathway for acute
appendicitis at Ibnu Sina Islamic Hospital Pekanbaru is expected to be able to control
variations in the treatment process in an effort to improve quality and cost control.The
purpose of this study aimed to see the role of implementation of clinical pathway for
acute appendicitis in improving appendectomy cost efficiency in The Indonesian
National Health Insurance patients at Ibnu Sina Islamic Hospital Pekanbaru. The study
design was cross sectional with a quantitative approach through calculating the cost bills
of patients who underwent appendectomy before and after the implementation of
clinical pathway and processed with statistical tests. Qualitative approach through indepth
interviews with informants who were involved in the implementation of CP. The
results of the study showed shortening length of stay statistically significant as (P
<0.001) in the patient group after the implementation of the clinical pathway compared
to before. There was a decrease in average total costs of appendectomy before and after
the implementation of clinical pathways (IDR.5.214.188.02 vs IDR.4.436.438.37)
statistically significant as (P <0.001) with a percentage difference of 17.5%. Decreasing
service variants in the form of the utilization of medical equipment, drug, and laboratory
test affected the increase in appendectomy cost efficiency. The existence of variants in
the implementation of CP can be used as input to achieve the ideal CP. Variants in the
form of reducing services that should be given to patients must be followed up by
evaluating patient outcomes such as readmission rates and the patient's condition when
controlling after returning from the hospital.
Keywords:
Clinical pathway implementation, Hospital, Cost, Appendectomy