Inpatient Readmission Insidence of National Health Insurance Patients at Partner Hospitals of BPJS-Health in Sukabumi 2015

Authors

Atmiroseva Atmiroseva, Faculty of Public Health Universitas IndonesiaFollow
Atik Nurwahyuni, Department Health Administration and Policy, Faculty of Public Health Universitas Indonesia, Depok, IndonesiaFollow

Abstract

The INA-CBG payment system in the JKN program allegedly increasing the incidence of readmission. This study aims to map the incidence of readmission in JKN participants admitted to thirteen partner hospitals of BPJS-Health in Sukabumi. The research design is a descriptive study with the unit of analysis is patient. The study used secondary data from inpatient claims in thirteen partner hospitals BPJS-Health Sukabumi which has been verified during 2015. The study found that the number of readmission is 8.81% with the most readmission incidence occurs in the equal CMG category and at the least in the equal severity level category. The cost of inpatient readmission services is more expensive 104-113% of the initial care cost. Moreover, about 15- 16% cases of severity level readmission is increasing and 12-13% of its severity level is decreased. Less than 3% cases of readmission ended not good because they died, were referred, or had to come home forcibly.

References

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Bahasa Abstract

Sistem pembayaran INA-CBG pada program JKN diduga meningkatkan kejadian readmisi. Penelitian ini bertujuan untuk memetakan kejadian readmisi pasien JKN yang dirawat inap di tiga belas rumah sakit mitra kerja BPJS Kesehatan Cabang Sukabumi. Desain penelitian adalah studi deskriptif dengan unit analisis adalah pasien. Penelitian menggunakan data sekunder dari klaim rawat inap dari tiga belas rumah sakit mitra kerja BPJS Kesehatan Cabang Sukabumi yang sudah terverifikasi selama tahun 2015. Penelitian menemukan angka readmisi sebesar 8.81% dengan kejadian readmisi terbanyak terjadi pada kategori readmisi dengan CMG sama dan paling sedikit pada kategori readmisi dengan severity-level sama. Biaya pelayanan readmisi rawat inap lebih mahal 104-113 persen dari biaya rawatan awal dan sekitar 15-16% kasus readmisi severity level-nya naik dan 12-13% severity level-nya turun. Kurang dari 3% kasus readmisi berakhir tidak baik karena meninggal, dirujuk, atau minta pulang paksa.

Recommended Citation

Atmiroseva, Atmiroseva and Nurwahyuni, Atik (2017) "Inpatient Readmission Insidence of National Health Insurance Patients at Partner Hospitals of BPJS-Health in Sukabumi 2015," Journal of Indonesian Health Policy and Administration: Vol. 2: No. 2, Article 4.
DOI: 10.7454/ihpa.v2i2.1909
Available at: https://scholarhub.ui.ac.id/ihpa/vol2/iss2/4