The case of expensive artificial heart valve in developing countries Profesional dilemma in facing limitation of health valve in developing countries The case of expensive artificial heart valve in developing countries

D1 Adhiwinata Aman (130110100004) Natanael Parningotan (130110100085) Ade Triyadi (130110100039) Okky Husain (130110100056) Rahmia Lenisa (130110100218) Yunitasari (130110100007) Sofwah Nisana (130110100186) Cindy Regina Putri (130110100174) Ignatia Ratna (130110100148) Sheila Sumargo (130110100156)

Overview Heart Valve Replacement Heart valve surgery → used to repair or replace diseased heart valves. HOW? Before your surgery you will receive general anesthesia. In open surgery, the surgeon makes a large surgical cut in your breastbone to reach the heart and aorta. Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped.

If your valve is too damaged, you will need a new valve If your valve is too damaged, you will need a new valve. This is called valve replacement surgery. Your surgeon will remove your valve and put a new one in place.  The main types of new valves are: Mechanical → made of man-made materials Biological → made of human or animal tissue. In some cases, surgeons can use your own pulmonary valve to replace the damaged aortic valve. The pulmonary valve is then replaced with an artificial valve (this is called the Ross Procedure).

The need of heart valve replacement in developing country Tingkat kebutuhan operasi penggantian katup jantung di negara berkembang cukup tinggi dibanding negara maju, karena pemenuhan nutrisi yang masih belum baik, tingginya angka penyakit jantung rematik, dan kurangnya kualitas kesehatan pada masa tua.

The cost of artificial heart valve replacement biaya operasi penggantian katup jantung di US sekitar $14000 sampai $20000, tergantung rumah sakitnya. di India biayanya bisa sekitar $9500. di Indonesia sendiri, biaya penggantian katup jantung berkisar antara 60 sampai 75 juta rupiah. Tapi tergantung masing- masing rumah sakit. Bisa juga mencapai diatas 150 juta rupiah.

What a doctor should say and do when facing patient who need artificial heart valve but facing financial difficulty? Dalam Kode Etik Kedokteran Indonesia dijelaskan pedoman imbalan jasa dokter. Sebelumnya dokter harus melakukan informed consent terlebih dahulu (menjelaskan kepentingan tindakan operasi, alternatif tindakan, dll.). Selanjutnya diskusikan masalah pembiayaan dengan pasien sebelum dilakukan tindakan, agar pasien tidak bingung dan tidak cemas. Pada kasus ini, pasien memiliki masalah finansial, dokter bisa meringankan biaya jasa atau menghilangkan sama sekali. Untuk biaya alat dan perawatan rumah sakit menjadi kebijakan RSnya masing –masing. Beritahu juga bahwa pasien bisa menggunakan bantuan jaminan kesehatan yang disediakan pemerintah untuk meringankan biaya perawatan.