Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RS Pemerintah A di Palembang Tahun 2015

Authors

Mardiah Mardiah, Program Studi Magister Ilmu Kesehatan Masyarakat Fakultas Kesehatan Masyarakat Universitas IndonesiaFollow
Ronnie Rivany, Departemen Administrasi Kebijakan Kesehatan Universitas IndonesiaFollow

Abstract

The difference of cost negative in the case of Coronary Artery Disease (CAD) with Percutaneous Coronary Intervention (PCI), indicate health financing gap between of hospital rates and INA-CBG’s rates. This study aimed to see the difference between the cost recovery rate (CRR) of hospital rates and INA-CBG’s rates for CAD with PCI at A Hospital. The results showed that the cost of treatment based on clinical pathways at the severity level I had a higher CRR Hospital rates compared to INA-CBG’s CRR, whereas at the severity level II, Hospital CRR rate was lower than INA-CBG’s CRR for the utility of less than 2 stents. At severity level III, CRR INA-CBGs’ rates with utilization of 1 and 2 stents performed higher rates than the hospitals CRR. This was related to INA-CBG’s rate that did not take the magnitude of the stentulitizationinto account. It is necessary to improve INA-CBG’s tarif development method from hospital base rate to clinical pathway-based cost of treatment in order to meet hospital operational cost and ensure the best quality of service

Bahasa Abstract

Adanya selisih negatif pada kasus Coronary Artery Disease (CAD) pada tindakan Percutaneous Coronary Intervention (PCI), mengindikasikan pembiayaan kesehatan masih terdapat kesenjangan antara tarif rumah sakit dengan tarif INA-CBG’s. Penelitian ini bertujuan untuk melihat perbedaan cost recovery rate (CRR) tarif INA-CBG’s dan tarif rumah sakit kasus CAD dengan PCI di RS A Palembang. Hasil penelitian menunjukkan berdasarkan cost of treatment berbasis clinical pathways pada severity level I CRR RS berada diatas CRR tarif INA-CBG’s, sedangkan pada severity level II CRR RS lebih rendah dari CRR tarif INA-CBG’s. Pada severity level III CRR tarif INA-CBG’s dengan utilisasi stent 1 dan 2 lebih tinggi dari CRR RS. Tarif INA CBGs tidak memperhitungkan jumlah stent dalam setiap tindakan PCI. Perlu evaluasi metode penghitungan tarif INA-CBGs dari hospital base rate ke metode perhitungan cost of treatment berdasarkan clinical pathway, sehingga biaya operasional RS dapat dipenuhi dan tetap mampu berikan pelayanan yang bermutu.

Recommended Citation

Mardiah, Mardiah and Rivany, Ronnie (2017) "Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RS Pemerintah A di Palembang Tahun 2015," Jurnal Ekonomi Kesehatan Indonesia: Vol. 1: No. 4, Article 4.
DOI: 10.7454/eki.v1i4.1794
Available at: https://scholarhub.ui.ac.id/eki/vol1/iss4/4