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Abstract

Tariff of the Caesarean Section (CS) in JKN Program is much different with the CS tariff applicable in hospital. Therefore it needs to be done the research of tariff assignment policy of CS without complications with the method of Activity-Based Costing (ABC) based on ICD-9CM in the implementation of JKN Program in XY hospital Kudus.This is an analytical case studies which has three stages. First, the preparation of Clinical Pathway (CP) CS without complications with a descriptive qualitative approach and methods of FGD and Brainstorming in data collection. Second, the implementation of CP and the calculation of unit cost of the CS without complications with the quantitative approach and methods of observation ctivity Based Costing. Third, analysis of the results and follow-up of the internal hospital policy to face JKN program by qualitative approach and FGD method.Research results generate CP CS without complication adn CP handling New Healthy Baby Born through CS without Complication . The calculation results of the CS without complications unit cost class II is Rp5,320,957 and Rp5,484,564 for class I. When added with the services then cost of CS without complications class II become Rp7,485,745. and Rp8,380,564 for class I. This figureis still above the applicable standard price of JKN which Rp5.306.800 for class II and Rp6.191.300 for class I. All this time, the hospital policy on tariff setting the priority component competitors as a consideration factor

Bahasa Abstract

Tarif Sectio Caesarea (SC) dalam program JKN jauh berbeda dengan tarif di Rumah Sakit. Sehingga perlu dilakukan penelitian tentang kebijakan penetapan tarif seksio sesarea tanpa penyulit dengan metode activity based costing (ABC) berdasarkan ICD9cm dalam program JKN di RS XY Kabupaten Kudus. Studi kasus ini menggunakan pendekatan kuantitatif yang didukung data kualitatif dan terbagi tiga tahap : 1). Brainstorming dan Focus Group Discussion (FGD) untuk penyusunan Clinical Pathway (CP) SC Tanpa Penyulit dan 2). Implementasi CP dan penghitungan unit cost SC Tanpa Penyulit dengan Activity Based Costing serta 3). FGD untuk merumuskan masukan kepada rumah sakit dalam menghadapi program JKN. Penelitian menghasilkan CP SC Tanpa Penyulit dan CP Penanganan Bayi Baru Lahir Sehat melalui SC Tanpa Penyulit. Hasil penghitungan unit cost SC Tanpa Penyulit kelas II Rp 5.320.957 dan kelas I Rp 5.484.564. Bila ditambahkan jasa pelayanan maka biaya yang dikeluarkan RS untuk SC Tanpa Penyulit kelas II menjadi Rp 7.485.745 dan kelas I menjadi Rp 8.380.564. Angka ini masih di atas standar tarif JKN yaitu Rp 5.306.800 (kelas II) dan Rp 6.191.300 (kelas I). Kebijakan penetapan tarif RS hanya mempertimbangkan tarif rumah sakit kompetitor. Perhitungan biaya satuan belum memasukkan biaya gedung. Dalam menghadapi program JKN, rumah sakit akan meninjau kembali struktur tarif, meningkatkan fungsi Tim Kendali Mutu dan Kendali Biaya (TKMKB), serta mengupayakan CoB (Coordination of Benefit) sebagai peluang income generating. Disarankan agar RS segera menerbitkan pedoman CP, meninjau ulang tarif dengan memasukkan biaya gedung, mencari inovasi layanan selain CoB, peningkatan peran Tim Kendali Mutu dan Kendali Biaya (TKMKB) serta mengupayakan SDM RS sadar biaya dalam rangka kendali biaya.

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