ANALISIS PERBEDAAN PEMBIAYAAN BERBASIS TARIF INA-CBG’s DENGAN TARIF RIIL RUMAH SAKIT PADA PASIEN PESERTA JKN KASUS DIABETES MELLITUS TIPE II RAWAT INAP KELAS III DI RUMAH SAKIT KALISAT JEMBER PERIODE JANUARI – JUNI 2015
MAWADDAH, ARIFANDA ILFATUL
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The problem usually found in the BPJS (Society Health Insurance) raising real cost to INA-CBG’s package tariff and the quality of servics, especially in inpatient department. This study was to find out how much the between the real cost and the INA-CBG’s package in diabetes mellitus inpatients using BPJS in RS Kalisat Jember. This study was analytical observation. The data were taken retrospectively from the BPJS claim files and patients medical record. Subjects were patients with diabetes mellitus.The research object included the claim files based on length of stay, room cost, supporting cost, treatment cost, medicine cost, and another cost and medical record of diabetes mellitus patients using BPJS IN RS Kalisat Jember during period of January – June 2015 with diagnosis code INA-CBG’s E-4-10-I, E-4-10-II, and E-4-10-III. The data were analyzed analytical descriptively. Moreover, One sample test statistical analysis was conducted to find difference between real cost and INA-CBGs tariff and difference between hospital length of stay and INA-CBGs package length of stay. The result cost analysis period of January – June 2015 code E-4-10-I real cost lower than INA-CBG’s tariff amount Rp 685,400, code E-4-10-II real cost lower than INA-CBG’s tariff amount Rp 2,263,730 and E-4-10-III real cost greather than INA-CBG’s tariff amount Rp 1,229,940. There is comparison significant between real cost with INA-CBG’s tariff package inpatien department diabetes mellitus in RS Kalisat-Jember (p=0,000). Factors that affect real cost with INA-CBG’s tariff package for service patien hospitalization in RS Kalisat the different standard real cost with with INA-CBG’s tariff package, different length of stay, treatment cost, medicine cost, and RS Kalisat not have clinical pathway.