Impact of Comorbidity on Length of Stay of Hospitalized Pneumonia in Children
Abstract: The incidence of
pneumonia in children under-five in West Java is high. The average length of
stay (LOS) often exceeds the standards set by the Indonesia-Disease Related
Group (INA-DRG) because of the comorbidities. It can cause financial loss for
the hospital. This study was conducted to analyze the impact of comorbidity on
LOS.
Methods: Data was collected from medical records of 296 hospitalized
pneumonia under-five children in the Department of Child Health Dr. Hasan
Sadikin General Hospital Bandung in the period from January–December 2012 that
consisted of patient’s identity, LOS, primary diagnosis, and comorbid
diagnosis. Data was selected through inclusion and exclusion criteria and
statistically analyzed using the chi-square and
Spearman correlation test.
Results: Out of 218 subjects, those who had major comorbidities and minor
comorbidities was 79 (36.2%) and 39 (17.9%), respectively. The average LOS of
those who had major and minor
comorbidities was 8.33±8.252 days and 5.95±3.554 days, respectively. Congenital
heart disease had the highest and most significant Risk Ratio (RR) with average
LOS was 8.00±4.889 days with RR: 1.895 (95% CI:1.339–2.682, p=0.001).
Conclusions: Subjects have higher average LOS than the LOS set by the
INA-DRG. Congenital heart disease is the most common comorbidity and has the
highest and the most significant risk ratio.
Keywords: Comorbidity,
Indonesia-Disease Related Group (INA-DRG), length of stay (LOS), pneumonia,
under-five children
Author: Nur Mala Il A'la, Adi
Utomo Suardi, Dewi Kartika Turbawati
Journal Code: jpkedokterangg170082
