A Comparison of Rate for the Intensive and Non-Intensive Care Units under the Indonesian Case Based Group Scheme at Class B Private Hospitals


Goretty Lusya Angelita, Prastuti Soewondo

 

Hospital Administration Program, Public Health Faculty Universitas Indonesia

 

ABSTRACT

Background: The national health insurance (JKN) of Indonesia has implemented the Indo­nesian Case Base Groups (INA-CBGs) rates for health care payment. The INA-CBGs ta­riff rates are based on tariff on diagnosis grouping by using clinical and homogeneity of re­source uti­lization app­ro­aches. The health care payment follows the CBGs code based on patient’s di­se­ase diagnosis and does not consider the costs based on health services received by each pa­tient. However, there is still problem of difference bet­ween the hospital real cost ofhealthca­re and the INA-CBGs tariff. This stu­dy aimed to compare tariffs for the intensive and non-in­ten­­sive care units under the Indonesian case based group scheme at class B private hos­pitals.

Subjects and Method: This was a descriptive study conducted at a private class B Hospital in Jakarta. The sample for this study included patients who were treated with the non-inten­sive and intensive care room. The data were obtained from November 2017 to October 2018. The data were analyzed descriptively.

Results: Hospital tariff was higher than INA-CBGs tariff, except for CBG N-4-10-2. The hos­pi­tal tariff of the intensive care room was higher than non-intensive care room. There was a ≥10 mi­llion Rupiah difference in rate among CBG G-4-19-III, I-1-15-I and I-4-19-III.

Conclusion: Prospective payment of INACBGs has not been able to address difference in ta­riff for the same CBG cases with different room type.

Keywords: JKN, INACBGs rates, hospital rate, intensive space, private hospital

Correspondence: Goretty Lusya Angelita. Hospital Administration Program, Public Health Faculty, Universitas Indonesia, Depok, West Java. Email: drlusyaangelita@gmail.com. Mobile: 08158102123.

DOI: https://doi.org/10.26911/theicph.2019.04.61

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