scholarly journals Tarif Pelayanan Pembedahan Katarak Pasien Jaminan Kesehatan Nasional dengan Teknik Fakoemulsifikasi dan Small Incision Cataract Surgery

2020 ◽  
pp. 193-202
Author(s):  
Riris Dian Hardiani ◽  
Tris Eryando
Keyword(s):  
Cataract Surgery ◽  
National Health ◽  
Social Insurance ◽  
Claim Data ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Average Hospital ◽  
Small Incision ◽  
Case Base

Abstrak Prevalensi kebutaan di Indonesia karena katarak pada penduduk berusia ≥ 50 tahun sebesar 3% dan salah satu biaya kesehatan terbesar di tahun 2017 adalah untuk pembedahan katarak. Untuk melakukan pembandingan tarif rumah sakit serta tarif Indonesian Case Base Groups (INA-CBG) pelayanan pembedahan katarak dengan teknik fakoemulsifikasi dan Small Incision Cataract Surgery (SICS) dilakukan penelitian potong lintang menggunakan data klaim Jaminan Kesehatan Nasional (JKN) Rumah Sakit “X”. Perbedaan tarif fakoemulsifikasi dan SICS dianalisis secara bivariat dengan Mann-Whitney. Dari 1278 pasien katarak, terbanyak adalah pasien laki laki, berumur ≥ 60 tahun, 84,7% pembedahan menggunakan teknik fakoemulsifikasi, dan 77,2% pembedahan dilakukan di rawat jalan. Untuk pelayanan rawat inap, fakoemulsifikasi terbanyak di ruang perawatan kelas 1 (50,0%) dan SICS di kelas 3 (65,4%). Rerata tarif rumah sakit untuk rawat jalan fakoemulsifikasi Rp 9.536.041,- ±1.336.734,03 dan SICS adalah Rp 7.438.924,- ±1.160.666,63 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 9.355.253,- ±2.288.647,36 dan SICS Rp 6.078.391,- ±1.854.308,65 (p<0,05). Rerata tarif INA-CBG fakoemulsifikasi rawat jalan adalah Rp 8.809.191,- ±218.193,55 dan SICS Rp 4.410.000 (p<0,05) sedangkan untuk rawat inap fakoemulsfikasi Rp 10.834.039,- ±2.019.676,19 dan SICS Rp 9.074.188 ±1.638.329,7 (p<0,05). Rerata tarif rumah sakit dan tarif INA-CBG untuk teknik pembedahan katarak dengan SICS baik rawat jalan maupun rawat inap lebih rendah dibandingkan dengan teknik fakoemulsifikasi. Tarif INA-CBG yang dibayarkan Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan untuk kedua metode pembedahan katarak pada pelayanan rawat jalan lebih rendah sedangkan untuk rawat inap lebih tinggi dibandingkan dengan tarif rumah sakit. Kata kunci: Fakoemulsifikasi, SICS, Katarak, JKN Abstract The prevalence of blindness in Indonesia due to cataracts in the population aged 50 years and above is 3%. However, one of the highest health costs in 2017 was on cataract surgery. To compare hospital tariff and Indonesian Case Base Groups (INA-CBG) tariff of phacoemulsification and Small Incision Cataract Surgery (SICS), a cross-sectional study was conducted using National Health lnsurance claim data at Hospital “X”. The differences between phacoemulsification and SICS tariff were analyzed using the Mann-Whitney test. From a total of 1278 patients, majority were males, aged 60 years and above. 84.7% of the patients went through a phacoemulsification procedure, 77.2% were outpatients. Most inpatients that went through a phacoemulsification were admitted to class 1 wards (50.0%) while a majority of those went through a SICS procedure were admitted to class 3 wards (65.4%). There were significant differences in the average hospital tariff between phacoemulsification and SICS for both outpatients’ (IDR 9,536,041 ±1,336,734.03 vs IDR 7,438,924 ±1,160,666.63;p<0.05) and inpatients’ (IDR 9,355,253 ±2,288,647.36 vs IDR 6,078,391 ±1,854,308.65; p<0.05) care. The average INA-CBG tariff also had significant differences between both procedures for outpatients’ care (phacoemulsification vs SICS: IDR 8,809,191 ±218,193.55 vs IDR 4,410,000;p<0.05) and inpatients’ care (IDR 10,834,039 ±2,019,676.19 vs IDR 9,074,188 ±1,638,329.7; p<0.05). The average hospital and INA-CBG tariff of SICS, for both outpatients and inpatients were lower than that of phacoemulsification. Although INA-CBG tariffs paid by the Social Insurance Administration Organization for Health or BPJS Kesehatan for both phacoemulsification and SICS procedures in outpatients was lower, the INA-CBG inpatients’ tariff was higher than the hospital tariff. Keywords: Phacoemulsification, SCIS, Cataracts, National Health Insurance (NHI)

scholarly journals Comparison of the Outcomes of Manual Small Incision Cataract Surgery (MSICS) and Phacoemulsification (PHACO) in Ghana

2021 ◽  
Vol 18 (3) ◽  
pp. 143-149
Author(s):  
Samuel Kyei ◽  
Ebenezer Zaabaar ◽  
Frank Assiamah ◽  
Michael Agyemang Kwarteng ◽  
Kofi Asiedu
Keyword(s):  
Visual Acuity ◽  
Postoperative Complications ◽  
Cataract Surgery ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Uncorrected Visual Acuity

Background: The growing middle-class population of Ghana has seen more people being employed in visually demanding occupations  and hence there is an increased desire for quality post-cataract surgical visual outcomes. This study aimed at comparing the outcomes of manual small incision cataract surgery (MSICS) and phacoemulsification (PHACO) among Ghanaians. Methods: This was a retrospective cross-sectional study in which records of patients who underwent MSCIS or phacoemulsification by the same surgeon were reviewed. Results: Medical records of 248 eyes were reviewed, out of which 132 underwent PHACO and 116 had MSICS. A significant number of the  PHACO group had good (6/6–6/18) uncorrected visual acuity (UCVA) compared to the MSICS group at 1–2 weeks follow-up (p = 0.003) and 4–6 weeks follow-up (p = 0.002). MSICS resulted in a higher total astigmatic change compared to PHACO (p < 0.001). The PHACO grouphad a higher number of postoperative complications compared with the MSICS group (p <0.001). Postoperative borderline and poor  uncorrected visual acuity were associated with age, total astigmatic change, and postoperative complications. Conclusion: The postoperative UCVA outcomes at 4–6 weeks’ follow-up indicates that PHACO resulted in noticeably less spectacle dependency when compared to MSICS.

A Descriptive Study of Intraoperative Complications in Manual Small Incision Cataract Surgery

2021 ◽  
Vol 8 (2) ◽  
pp. 75-79
Author(s):  
Dr. Divya Khatwani ◽  
Dr. Ajay Tammewar ◽  
Dr. Sneha Murade ◽  
Dr. Roopa Naik
Keyword(s):  
Developing Countries ◽  
Cataract Surgery ◽  
Intraoperative Complications ◽  
Cataract Extraction ◽  
Cross Sectional Study ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Study Results ◽  
Developed World

Background: Senile cataract is the most common cause of reversible blindness in India and other developing countries. It is one of the significant social problem. Though phacoemulsification has become a routine procedure for cataract extraction in most parts of the developed world, it is not always appropriate either for its cost or the density of cataract involved in developing nations like India. Small incision cataract surgery is commonly performed surgery in developing countries. This procedure is safe, effective to increase the surgical outcome, reduces surgical time, easier to maintain instrumentation and at the same time affordable. The present study is undertaken to study the intraoperative complications and how best these complications can be minimized and managed. Methods: A total of 50 cases were studied from October 2020-January 2021. It is a hospital based, descriptive cross sectional study. Results: Intraoperative complications occurred in 10 cases (20%). It included iris prolapse in 3 cases (6%), tunnel related complications in 3 cases which included premature entry in 2 cases (4%) and button holing in 1 case (2%), Descemet membrane detachment in 1 case (2%), intraoperative miosis in 1 case (2%), intraoperative hyphema in 1 case (2%), capsule related complications in 1 case (2%) and PC rent in one case (2%). Conclusion: Over all the intraoperative complications of manual small incision cataract surgery are less and the procedure is well suited in our country, where there is a large number of backlog of cataract cases.

scholarly journals Cross-sectional study of the association between cataract surgery and age-related macular degeneration in the era of phacoemulsification in the national health and nutrition examination survey 2005–2008

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e032745
Author(s):  
Zhuoting Zhu ◽  
Wei Wang ◽  
Huan Liao ◽  
Stuart Keel ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Degeneration ◽  
National Health ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Nutrition Examination Survey ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Age Related

ObjectiveTo determine the association between cataract surgery and age-related macular degeneration (AMD) in a representative US sample.DesignPopulation-based, cross-sectional study.SettingThe US National Health and Nutrition Examination Survey 2005–2008.ParticipantsA total of 5401 participants aged ≥40 years had information in cataract surgery status and gradable retinal photographs for right eyes.MethodsCataract surgery status was obtained from questionnaire. Non-mydriatic fundus photographs were collected and AMD status was assessed. The associations between AMD and cataract surgery were evaluated in right eyes using logistic regression models.ResultsOf 338 right eyes with any AMD, 107 right eyes (28.9%) had cataract surgery. After adjusting for multiple variables, there were significant associations between cataract surgery and any AMD (OR 1.36; 95% CI 1.03 to 1.81) or late AMD (OR 2.48; 95% CI 1.01 to 6.09). No significant association was found between cataract surgery and early AMD after adjusting for multiple covariates (OR 1.20; 95% CI 0.91 to 1.59).ConclusionOur results suggest that cataract surgery is associated with the presence of AMD, particularly for late AMD. Longitudinal studies investigating the risk and progression of AMD after cataract surgery are needed in the era of phacoemulsification.

scholarly journals Risk factors of death among children hospitalized with social insurance (BPJS): a cross sectional study using hospital claim data

2020 ◽  
Vol 11 (2) ◽  
pp. 115-120
Author(s):  
Cicih Opitasari ◽  
Rossa Avrina ◽  
Anggita Bunga Anggraini
Keyword(s):  
Risk Factors ◽  
Death Rate ◽  
Social Insurance ◽  
Perinatal Period ◽  
Claim Data ◽  
Cross Sectional Study ◽  
Hospital Death ◽  
Sectional Study ◽  
Cross Sectional ◽  
Severity Level

Latar belakang: Angka kematian di rumah sakit merupakan salah satu indikator yang digunakan untuk mengukur kinerja dan kualitas pelayanan. Tujuan penelitian ini untuk menganalisis  faktor risiko kematian pada anak yang dirawat dengan BPJS kesehatan di satu rumah sakit di Jakarta. Metode: Penelitian potong lintang pada satu rumah sakit pemerintah di Jakarta. Sampel menggunakan semua data klaim pasien BPJS selama periode Januari - Desember 2017. Semua pasien BPJS  berusia di bawah 18 tahun yang dirawat dimasukkan dalam analisis. Regresi logistik digunakan untuk menganalisis faktor risiko kematian anak. Hasil: Dari total 18,941 jumlah pasien BPJS yang dirawat, sebanyak 3689 data anak yang dianalisis. Proporsi angka kematian anak selama satu tahun sebesar 7,3%. Kasus dengan tingkat keparahan derajat II memiliki risiko kematian 11,51 kali lipat [rasio odds suaian (ORa) = 11,51; IK=7,45-17,78; P = 0,000] dibandingkan tingkat keparahan penyakit derajat I, sedangkan kasus dengan tingkat keparahan derajat III beresiko terhadap kematian 33,97 kali lipat (ORa = 33,97;IK=19,93-57,91; P = 0,000). Selain itu, anak yang memiliki indikasi dirawat di ICU meningkatkan risiko kematian  14,21 kali lipat (ORa = 14,21; IK=9,15-22,08; P= 0,000) dibandingkan yang tidak ada indikasi ICU. Kondisi tertentu yang timbul pada  periode perinatal meningkatkan risiko kematian anak 7,65  kali lipat (ORa = 7,65  ; IK=1,81-32,35;P = 0,006) dibandingkan penyakit pada sistem muskuloskeletal dan jaringan ikat. Kesimpulan: Tingkat keparahan penyakit, indikasi ICU dan kondisi tertentu yang timbul pada  periode perinatal adalah faktor risiko kematian anak yang paling sering di rumah sakit Kata kunci: Faktor risiko, kematian, anak, BPJS   Abstract Background: Hospital death rate is one of the indicators used to measure hospital performance and quality of care, especially the overall hospital death rate. This study aims to analyze the risk factors of death among children hospitalized with social insurance (BPJS) in one hospital in Jakarta. Methods: This was a cross-sectional study conducted in one government hospital in Jakarta. The sample was all individual claim data of BPJS patients who were hospitalized during the period of January to December 2017. All BPJS patients aged below 18 years admitted into the pediatric wards were included in the analysis. The logistic regression was used to analyze the risks of children death Results: A total of 18.941 BPJS inpatients in the hospital was identified, out of them 3689 met the inclusion criteria. The proportion of death in children during one year was 7.3%. Illness severity level II had 11.51-fold [adjusted odds ratio (ORa)=11.51;CI=7.45-17.78; P=0.000]] meanwhile severity level III had 33.97-fold higher risk of children death (ORa=33.97; CI=19.93-57.91;P=0.000) compared to children with severity level I. Children who had ICU indicator increase risk of children death at 14.21 -fold (ORa=14.21;IK=9.15-22.08;P= 0.000) compared to those who did not have. Furthermore the risk of children death in certain conditions originating in the perinatal period increases by 7.65–fold (ORa=7.65 ;IK=1.81-32.35;P=0.006) compared to diseases of the musculoskeletal system and connective tissue. Conclusion: Illness severity level, ICU indicator and diseases in certain conditions originating in the perinatal period are the most common risk factors for children death in the hospital Keywords: Risk factors, death, children, BPJS  

scholarly journals Outcomes of manual Small Incision Cataract Surgery (mSICS) compared with phacoemulsification from population based outreach eye camp, in Yogyakarta and Southern Central Java Region, Indonesia

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Indra Tri Mahayana ◽  
Reny Setyowati ◽  
Tri Winarti ◽  
Suhardjo Prawiroranu
Keyword(s):  
Visual Acuity ◽  
Adverse Events ◽  
Cataract Surgery ◽  
Visual Outcome ◽  
High Volume ◽  
Outreach Program ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
Surgical Adverse Events

In this study, we compared the effectiveness (comparison of post-operative visual acuity/VA) of phacoemulsification by ophthalmologists versus manual small incision cataract surgery (mSICS) by residents in a mass cataract surgery setting. This research was a cross-sectional study of 1137 cataract patients who underwent cataract surgery by ophthalmologists and residents in outreach eye camps during 2015-2017 (3 years). There were 554 patients who underwent phacoemulsification by ophthalmologists and 583 patients who underwent mSICS by residents. Basic patient characteristics data, such as: age, sex and pre-surgical VA were recorded and we compared pre- versus post-operative VA (best corrected VA/BCVA) and surgical adverse events in 4 weeks post-operative follow-up. In basic subject characteristics, there were no differences in age and sex between the 2 groups, in which 602 (52.9%) were men and 535 (47.1%) were women. Overall 583 (51.3%) eyes received mSICS and 554 (48,7%) eyes received phacoemulsification. Visual acuity improvement (≥6/18) was achieved in 59.61% of eyes after phacoemulsification and 53.5% eyes after mSICS. There were no statistical differences in visual outcome results between both groups (p=0.10). Severe surgical adverse events (nucleus drop and endophthalmitis) were found in 3 cases (0.26%) and choroidal bleeding in 1 eye (0.08%). The effectiveness of phacoemulsification and mSICS in improving visual acuity was found similar between ophthalmologists and residents. mSICS should be considered for more frequent use in high volume mass cataract surgery.KEYWORDS cataract surgery; phacoemulsification; manual small incision cataract surgery; outreach program; community ophthalmology

scholarly journals EVALUATION OF CAUSES OF EARLY POSTOPERATIVE HYPHEMA IN MANUAL SMALL INCISION CATARACT SURGERY.

2020 ◽  
pp. 18-20
Author(s):  
Gayatri Ravulaparthi ◽  
Sravanthi Singarapu ◽  
Sathya Vattikonda
Keyword(s):  
Surgical Technique ◽  
Cataract Surgery ◽  
Medical Records ◽  
Demographic Data ◽  
Complication Rates ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Small Incision ◽  
The Common ◽  
Wound Construction

Background: Cataract surgery is the most commonly performed surgery in the world. Manual small incision cataract surgery (MSICS) is principally employed in resource poor settings and bulk of cataract surgeries are performed by this technique in the developing world. Results achieved by MSICS is comparable with phacoemulsification in achieving excellent visual outcomes with low complication rates. Hyphema is one of the common postoperative complication of MSICS. Aim: To estimate the incidence and evaluate the causes of early postoperative hyphema in MSICS. Design: Cross sectional observational study done on hospital based patients who underwent manual small incision cataract surgery between August 2019 and July 2020. Material and methods: The demographic data, operation notes and details of clinical examination done using slit lamp bio microscopy on the first postoperative day of 341 patients who underwent MSICS between August 2019 and July 2020 were obtained from the hospitals clinical medical records section. Surgical technique of wound construction and its relevance to the incidence of postoperative hyphema on the first postoperative day was analysed. Results: Out of 341 patients, 26 (7.6%) had hyphema on first postoperative day. The variation in the surgical technique and other causes that was frequently associated with postoperative hyphema were in the order as extension of the wound, deep tunnel, posterior incision site, premature entry and iridodialysis. In 3 patients we could not attribute hyphema to any known cause. Conclusion: A proper technique of wound construction helps avoid this potential complication and thus refinement goes a long way in keeping up the morale of the MSICS surgeon.

scholarly journals Cross-sectional study of the association between age-related macular degeneration and arthritis in the National Health and Nutrition Examination Survey 2005–2008

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e035805
Author(s):  
Zhuoting Zhu ◽  
Huan Liao ◽  
Sen Liu ◽  
Jian Zhang ◽  
Yifan Chen ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
National Health ◽  
Logistic Models ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Nutrition Examination Survey ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Age Related

ObjectiveTo explore the association between age-related macular degeneration (AMD) and arthritis in a representative sample of the US population.DesignPopulation-based, cross-sectional study.SettingThe National Health and Nutrition Examination Survey (NHANES) 2005–2008.ParticipantsA total of 4813 participants aged 40 years and older with available information on AMD and arthritis in the 2005–2008 NHANES.MethodsThe status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected. The types of AMD were assessed using the modified Wisconsin Age-Related Maculopathy Grading Classification Scheme. The association between arthritis and AMD was evaluated using logistic regression models.ResultsAfter adjusting for covariates, participants with any or early AMD had significantly lower odds of having any type of arthritis (any AMD: OR=0.56, 95% CI: 0.36–0.86; early AMD: OR=0.55, 95% CI: 0.34–0.88) or osteoarthritis (OA) (any AMD: OR=0.43, 95% CI: 0.26–0.71; early AMD: OR=0.44, 95% CI: 0.25–0.76) compared with those without AMD. When considering AMD as the outcome, significant negative associations were also found between any arthritis or OA and any (any arthritis: OR=0.64, 95% CI: 0.43–0.94; OA: OR=0.52, 95% CI: 0.33–0.82) or early AMD (any arthritis: OR=0.61, 95% CI: 0.40–0.93; OA: OR=0.51, 95% CI: 0.31–0.86) in the multivariable logistic models. There was no significant association between different types of arthritis and late AMD.ConclusionsPeople with arthritis, especially those with OA, were less likely to have AMD compared with those without arthritis and vice versa. Further studies are needed to confirm this potential protective effect of arthritis and/or arthritis treatment on AMD and to explore the underlying mechanisms.

Safety and Efficacy of Temporal Manual Small Incision Cataract Surgery in India

2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Corneal Edema ◽  
Posterior Chamber ◽  
Small Incision Cataract Surgery ◽  
Safety And Efficacy ◽  
Excellent Outcome ◽  
Sutureless Technique ◽  
Small Incision ◽  
Sandwich Method

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.

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