N0 Tindakan Biaya

1 Prosedur Pencegahan ( perpatient )

Intermittent pneumatic compression of the legs 33

Leg scanning with iodine -125 labelled fibrinogen 85

Intravenous administration of dextran 103

Subcutaneous administration of heparin in low doses 20

2 Prosedur Pengobatan
Venography 88
NAMA : RUSNIATI
NIM : 0024.10.14.2020
KELAS : AKK.2

N0 Tindakan Biaya

3 Full – dose anticoagulant therapy ( per patient )

Hospitalization cost ( for 7 extra days at $ 290 per 2030
day
Intravenous Heparin therapy 30
Laboratory tests 104
Warfarin Therapy 10
Physician fees 35
Total 2209

N0 Tindakan suspek
1 Pendekatan sekarang ( no program )
N0. of patients with clinical suspected deep vein 50
N0. of patients with clinical suspected 30
pulmonary embolism
N0. of positive venograms 23
N0. of positive lung scans 18
N0. of Deaths 8

N0 Tindakan suspek
2. Pemberian Heparin Subcutan
N0. of patient with suspected deep vein 16
thrombosis
N0. of patient with suspected pulmonary 16
embolism
N0. of positive venograms 8
N0. of positive lung scans 8
Death 1

N0 Tindakan suspek
3 Pemberian Dextran , intravena
N0. of patient with suspected deep vein 24
thrombosis
N0. of patient with suspected pulmonary 16
embolism
N0. of positive venograms 13
N0. of positive lung scans 8
Death 1

N0 Tindakan suspek
5. Scan kaki
N0. of positive scans 139
N0. of patients with suspected pulmonary 21
embolism
N0. of positive venograms 109
N0. of positive lung scans 9
Deaths ( not known , although it is thought that
leg scanning is
effective in preventing fatal pulmonary embolism
)
 16x 88 =
-8
1000 x 20 =
$ 1.408 +8 16 x 2.209 = $35.334
$20.000
Venography
Low dose Susp. DVT
heparin Anti Coagulant
DVT Theraphy
+8
Susp. PE
16x 117=
20.000+1.408+1.872+35.334=58.624
Lung Scanning -8
$ 1.872
=$59.000

24x 88 = -11
$ 2.112 +13 21 x 2.209 = $46.389
Venography
High 1000 x 103
= $103.000
Susp. DVT Anti Coagulant
Risk +8 Theraphy
Dextran DVT
Surgical
$20.000
Patients Susp. PE

16x 117= -8 103.000+2.112+1.872+46.389= 153.373

Lung Scanning
$ 1.872 =$154.000

16x 88 = -8
$ 1.408 16 x 2.209 = $35.344
+8
1000 x 33 = Venography
Susp. DVT Anti Coagulant
Intermitent $33.000
Compression DVT Theraphy
$20.000 +8
Of Legs
Susp. PE

16x 117= -8 33.000+1.408+1.872+35.344= 71.624

Lung Scanning
$ 1.872 =$72.000
 139x 88 =
-34
1000 x 85 =
$ 12.232 +105 110 x 2.209 = $242.990
$85.000
Venography
Leg Susp. DVT
Scanning Anti Coagulant
DVT Theraphy
+5
Susp. PE
21x 117= -16 85.000+12.232+2.457+242.990=342.679
Lung Scanning
$ 2.457
=$343.000

-27

50 x 88= Venography +23

High Susp. DVT 41 x 2.209 = $90.569
Risk Traditional 4.400
Surgical “No
Patients Programme DVT 30x 117 =
Anti Coagulant
” $3.510
+18 Theraphy
Approach
Susp. PE

Lung Scanning -12

4.400+3.510+90.569= 98.479

=$99.000
 STRATEGI DATA BIAYA TAMBAHAN
BIAYA/1000 MATI/1000 BIAYA TERSELAMATK C/E
(S) AN RATIO
COST/
LIFE
SAVED
NO PROGRAM 99.000 8 - - -
INTRAVENOU 154.000 1 55.000 7 7.900
S DEXTRAN
LOW DOSE 59.000 1 -40.000 7 ≤0
SUBCUTAN
HEPARIN
INTEMITTERT 72.000 2 -27.000 6 8
PNEUMATIC
COMPARISON
OFLEGS
LEG 343.000 3 244.000 5 54.000
SCANNING
WITH 125
LFIBRINOGEN

1. No Program :
- Venograf : 50 x $ 88 = $ 4.400
- Lung Scanning : 35x $ 117 = $ 3.510
85  41 Positiv
Therapy 41 x $ 2209 = $ 90.569
Total = $ 4.400 + $ 3.510 +$90.569 = $ 98.479 $ 99 000
2. Intravenous Dextran :
Dextran 1000 x $ 103 = $ 103 000
Venografi : 24 x $ 88 = $ 2.112
Lung Scanning : 16 x $ 117 =$ 1.872
Pengobatan = 40  21 x $ 2209 = $ 46.389
= $ 153.373 $ 154. 000
3.Low –dose subcutaneous heparin
Heparin  1000 x $ 20 = $ 20 000
Venografi 16x $ 88 =$ 1.408
Lung Scanning 16 x $ 117 =$ 1.872
Pos 16 x $ 2209 = $ 35.344
Total = $ 58.624$59.000

4. Intermittent compression of the legs

Intermittent Compression 1000 x $ 33 = $ 33000

Venography 16x $ 88 = $ 1.408
Lung Scanning 16 x $ 117 =$ 1.872
Positive 16 x $ 2209 = $ 35.344
 Total = $ 71.624  $ 72.000

5. Leg Scanning

- Leg scan 1000 x $ 85 = $ 85 000

- Venography 139 x $ 88 = $ 12.232
- Lung Scanning 21 x $ 117 = $ 2.457
- Full Dise Therapy 41 x $ 2209 = $ 90.569
Total = $ 190.258  $ 191.000

Yang paling efektif dari kelima di atas adala LOW DOSE

SUBCUTAN HEPARIN dimana angka untuk leg scanning $ 59. 000,