Abstract
BPJS Health experienced various challenges in achieving Universal Health Coverage / Jaminan Kesehatan Nasional (JKN), including a referral system. According to the 2018 National Health Account, curative spending costs reached 69.1%. The Case Mix Index (CMI) is a benchmark for hospital performance abroad, but Indonesian hospitals have not used it. In 2019, BPJS Health tested CMI in 30 hospitals. The research uses sample data from 2019-2020 based on province, hospital type and ownership. The methods used are anova test, independent T, linear regression and multiple linear regression. The research results show a decrease in cases in 2019-2020. The highest CMI was in region 1, hospital A, and the private sector. The beta coefficient value for the proportion of male gender, elderly age, PBI APBD participants, and class 1 is greater than for CMI. CMI inpatients in 2019 is related to region, type of hospital, hospital ownership, proportion of children, proportion of productive, proportion of elderly, proportion of BP, proportion of PBI APBN, proportion of PBI APBD, proportion of PBPU, and proportion of class 1. CMI of inpatients in 2020 related to region, type of hospital, hospital ownership, proportion of men, proportion of women, proportion of children, proportion of productive, proportion of elderly, proportion of BP, proportion of PBI APBN, proportion of class 1, and proportion of class 3. It is hoped that the government will accelerate the distribution of services health and BPJS Health monitor hospital CMI.
Bahasa Abstract
BPJS Kesehatan mengalami berbagai tantangan dalam pelaksanaan Jaminan Kesehatan Nasional (JKN), termasuk menjalankan sistem rujukan. Menurut temuan National Health Account tahun 2018, biaya belanja kuratif mencapai 69,1%. Case Mix Index (CMI) menjadi tolak ukur kinerja rumah sakit di luar negeri tetapi rumah sakit Indonesia belum menggunakannya. Tahun 2019, BPJS Kesehatan menguji coba CMI pada 30 rumah sakit. Penelitian menggunakan data sampel tahun 2019-2020 berdasarkan provinsi, tipe rumah sakit, dan kepemilikan. Metode yang digunakan yaitu uji anova, T-independen, regresi linear, dan regresi linier berganda. Hasil penelitian menunjukkan penurunan kasus pada tahun 2019-2020. CMI tertinggi berada pada regional 1, rumah sakit A, dan swasta. Nilai koefisien beta proporsi jenis kelamin laki-laki, usia lansia, peserta PBI APBD, dan kelas 1 lebih besar terhadap CMI. CMI rawat inap tahun 2019 berhubungan dengan regional, tipe rumah sakit, kepemilikan rumah sakit, proporsi anak, proporsi produktif, proporsi lansia, proporsi BP, proporsi PBI APBN, proporsi PBI APBD, proporsi PBPU, dan proporsi kelas 1. CMI rawat inap tahun 2020 berhubungan dengan regional, tipe rumah sakit, kepemilikan rumah sakit, proporsi laki-laki, proporsi perempuan, proporsi anak, proporsi produktif, proporsi lansia, proporsi BP, proporsi PBI APBN, proporsi kelas 1, dan proporsi kelas 3. Diharapkan pemerintah mempercepat pemerataan pelayanan kesehatan dan BPJS Kesehatan memonitor CMI rumah sakit.
Recommended Citation
Ambarita, Anna Tirawani and Nurwahyuni, Atik
(2023)
"ANALISIS CASE MIX INDEX PELAYANAN RAWAT INAP RUMAH SAKIT YANG BEKERJA SAMA DENGAN BPJS KESEHATAN TAHUN 2019-2020,"
Jurnal Ekonomi Kesehatan Indonesia: Vol. 8:
No.
2, Article 2.
DOI: 10.7454/eki.v8i2.6883
Available at:
https://scholarhub.ui.ac.id/eki/vol8/iss2/2
