Effectiveness Analysis of Crystalloids and Crystalloid-Colloid Combinations in Hospitalized Dengue Fever Patients Without Shock at RSUD Tangerang City

Helmawati Helmawati; Arrozi Arrozi; Duta Liana

doi:10.55606/innovation.v4i1.8435

Authors

Helmawati Helmawati Universitas Esa Unggul
Arrozi Arrozi Universitas Esa Unggul
Duta Liana Universitas Esa Unggul

DOI:

https://doi.org/10.55606/innovation.v4i1.8435

Keywords:

Average Cost-Effectiveness Ratios (ACER), Cost- Effectiveness, Crystalloid- Colloid Combinations, Crystalloid Solutions, Inpatient Dengue Fever Patients

Abstract

The high cost of colloid fluids and the large number of patients are concerns in determining which treatment standard should be chosen from several treatment alternative, where the total cost for 43 cases with a combination of crystalloid colloid fluids is IDR 209.370.993 while the total cost for 45 cases of crystalloid fluids is only UDR 146.492.268 which causes hospital losses. This study aims to determine the difference in the cost-effectiveness between crystalloid fluids and crystalloid-colloid combinations in hospitalized dengue fever patients without shock at Tangerang City Hospital. The research design used was cross-sectional with a comparative quantitative analysis method, where cost effectiveness was analyzed using the Average Cost Effectiveness Ratios (ACER) method. There were two groups of study samples: the first group, 25 patients who received crystalloid fluids, and the second group, 23 patients who received crystalloid-colloid combination fluids. This study showed a difference in the average hospitalization costs for dengue patients between crystalloid fluid therapy and crystalloid-colloid combination therapy. Hospitalization costs for dengue patients were lower in the crystalloid fluid group, with a significant difference (p=0.000). It was also found that crystalloid fluids were more cost-effective than the crystalloid-colloid combination. The implications of the study results consist of theoretical implications and practical implications. Based on the results of the analysis carried out, the crystalloid solutions are more cost-effective than crystalloid-colloid combinations. This finding can be used as a consideration in making decisions and policies that are in accordance with quality control and cost control for patients covered by the National Health Insurance (BPJS Health insurance).

Downloads

Download data is not yet available.

References

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, A., Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, A., Achadi, E. L., Taher, A., … Khusun, H. (2019). Universal health coverage in Indonesia: Concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7

Bhatt, S., Gething, P. W., Brady, O. J., Messina, J. P., Farlow, A. W., Moyes, C. L., Drake, J. M., Brownstein, J. S., Hoen, A. G., Sankoh, O., Myers, M. F., George, D. B., Jaenisch, T., Wint, G. R. W., Simmons, C. P., Scott, T. W., Farrar, J. J., & Hay, S. I. (2013). The global distribution and burden of dengue. Nature, 496(7446), 504–507. https://doi.org/10.1038/nature12060

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford University Press.

Ghasemi, A., & Zahediasl, S. (2012). Normality tests for statistical analysis: A guide for non-statisticians. International Journal of Endocrinology and Metabolism, 10(2), 486–489. https://doi.org/10.5812/ijem.3505

Gold, M. R., Siegel, J. E., Russell, L. B., & Weinstein, M. C. (1996). Cost-effectiveness in health and medicine. Oxford University Press.

Kalayanarooj, S. (2011). Clinical manifestations and management of dengue/DHF/DSS. Tropical Medicine and Health, 39(4SUPPLEMENT), S83–S87. https://doi.org/10.2149/tmh.2011-S10

Levin, K. A. (2006). Study design III: Cross-sectional studies. Evidence-Based Dentistry, 7(1), 24–25. https://doi.org/10.1038/sj.ebd.6400375

Peraturan Menteri Kesehatan Nomor 69 Tahun 2013 tentang Standar Tarif Pelayanan Kesehatan pada Fasilitas Kesehatan Tingkat Pertama dan Fasilitas Kesehatan Tingkat Lanjutan dalam Penyelenggaraan Program Jaminan Kesehatan.

Probandi, A. (2007). Cost effectiveness analysis dalam penentuan kebijakan kesehatan: Sekedar konsep atau aplikatif? Universitas Sebelas Maret.

Satibi, S., Andayani, T. M., Endarti, D., Suwantara, I. P. T., Wintariani, N. P., & Agustini, N. P. D. (2019). Comparison of real cost versus the Indonesian case base groups (INZ-CBGs) tariff rates among patients of high-incidence cancers under the national health insurance scheme. Asian Pacific Journal of Cancer Prevention, 20(1), 117–122. https://doi.org/10.31557/APJCP.2019.20.1.117

Saurabh, S., & Yadav, R. K. (2020). Recalibration of insecticide-measuring containers could prevent underdosing of insecticide during indoor residual spraying for visceral leishmaniasis (kala-azar) elimination in India. Transactions of The Royal Society of Tropical Medicine and Hygiene, 114(7), 549–552. https://doi.org/10.1093/trstmh/traa026

Song, J. W., & Chung, K. C. (2010). Observational studies: Cohort and case-control studies. Plastic and Reconstructive Surgery, 126(6), 2234–2242. https://doi.org/10.1097/PRS.0b013e3181f44abc

Vassar, M., & Matthew, H. (2013). The retrospective chart review: Important methodological considerations. Journal of Educational Evaluation for Health Professions, 10, 12. https://doi.org/10.3352/jeehp.2013.10.12

Wills, B. A., Dung, N. M., Loan, H. T., Tam, D. T. H., Thuy, T. T. N., Minh, L. T. T., Diet, T. V., Hao, N. T., Chau, N. V., Stepniewska, K., White, N. J., & Farrar, J. J. (2005). Comparison of three fluid solutions for resuscitation in dengue shock syndrome. New England Journal of Medicine, 353(9), 877–889. https://doi.org/10.1056/NEJMoa044057

Witter, S., Bertone, M. P., Baral, S., Gautam, G., Pratap, S. K. C., Pholpark, A., Saputri, N. S., Darmawan, A. B., Toyamah, N., Fillaili, R., de Oliveira Cruz, V., & Sparkes, S. (2025). Political economy analysis of health financing reforms in times of crisis: Findings from three case studies in south-east Asia. International Journal for Equity in Health, 24(1), 34. https://doi.org/10.1186/s12939-025-02395-5