Beban Ekonomi Transplantasi Ginjal sebagai Terapi Pengganti Ginjal pada Pasien Penyakit Ginjal Kronik Stadium Akhir: Tinjauan Sistematis
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Penyakit ginjal tahap akhir (ESRD) tidak hanya berdampak pada kondisi klinis pasien, tetapi juga menimbulkan tekanan ekonomi yang besar bagi sistem layanan kesehatan di seluruh dunia. Beban ini sebagian besar didorong oleh kebutuhan terapi pengganti ginjal (RRT), dengan transplantasi ginjal sebagai salah satu komponen biaya terbesar dalam perawatan ESRD. Kebutuhan perawatan jangka panjang yang kompleks dan berkelanjutan semakin memperparah tekanan finansial pada sistem kesehatan secara global. Tinjauan sistematis ini bertujuan untuk mengidentifikasi dan mengevaluasi beban ekonomi penyakit ginjal kronis (CKD) berdasarkan berbagai modalitas RRT, yaitu hemodialisis, dialisis peritoneal, dan transplantasi ginjal, dalam berbagai konteks sistem kesehatan. Pencarian literatur dilakukan secara sistematis melalui basis data Scopus, PubMed, SpringerLink, dan ProQuest, mencakup studi observasional dan evaluasi ekonomi berbahasa Inggris yang diterbitkan antara 2015 dan 2025, dengan fokus pada biaya medis langsung, biaya non-medis, kehilangan produktivitas, dan indikator ekonomi terkait. Sebanyak 15 studi dari berbagai negara dianalisis dan menunjukkan pola temuan yang cukup konsisten. Pengeluaran layanan kesehatan meningkat secara signifikan seiring dengan perkembangan stadium CKD dan dimulainya RRT. Berbagai pendekatan evaluasi ekonomi digunakan, termasuk analisis beban penyakit, analisis biaya-manfaat, analisis biaya komparatif, dan analisis biaya-utilitas. Hemodialisis mencatat biaya tahunan tertinggi, diikuti oleh dialisis peritoneal. Meskipun transplantasi ginjal memerlukan investasi awal yang lebih besar, modalitas ini terbukti menghasilkan biaya tahunan jangka panjang yang jauh lebih rendah dibandingkan dengan dialisis. Tinjauan ini menyimpulkan bahwa transplantasi ginjal merupakan strategi yang lebih efisien secara ekonomi dan berpotensi mengurangi beban ekonomi global akibat ESRD.
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