Analisis Case Mix Index FKRTL Kerja Sama BPJS Kesehatan di Provinsi Banten Tahun 2019 - 2022

https://doi.org/10.22146/jkki.103784

Yuli Prihastutik(1*), Julita Hendrartini(2)

(1) Universitas Gadjah Mada, Indonesia
(2) Universitas Gadjah Mada, Indonesia
(*) Corresponding Author

Abstract


Dalam rangka menjaga suistanibilitas JKN utamanya kecukupan dana JKN terhadap pembiayaan kesehatan bagi peserta JKN, maka kenaikan pembiayaan pelayanan kesehatan dengan sistem INA CBG yang terus meningkat dari tahun ke tahun tersebut harus dilakukan evaluasi dan monitoring secara berkala oleh seluruh ekosistem yang terlibat dalam JKN salah satunya adalah Rumah Sakit dan BPJS Kesehatan. Evaluasi tersebut salah satunya dapat dilakukan dengan Case Mix Index. Hasil analisa Case Mix Indeks tersebut sebagai evaluasi yang penting artinya bukan hanya bagi rumah sakit namun juga BPJS Kesehatan. Adapun hasil analisa Case Mix Indeks di Provinsi Banten Tahun 2019 – 2022 didapatkan hasil yaitu terdapat perbedaan signifikan antara kelas RS dimana RS dengan tingkatan lebih tinggi memiliki nilai CMI yang lebih tinggi dari pada kelas dibawahnya. Nilai CMI rawat jalan di provinsi Banten tahun 2019 - 2022 dipengaruhi signifikan oleh proporsi kunjungan pasien lanjut usia, segmen kepesertaan PBI , segmen kepesertaan Non PBI hak perawatan kelas tiga dan proporsi kunjungan pasien hak perawatan kelas satu. Sedangkan Nilai CMI rawat inap di provinsi Banten tahun 2019 - 2022 dipengaruhi signifikan oleh proporsi kunjungan pasien lanjut usia


Keywords


Ina CBG, JKN,Case Mix Indeks, Case Mix Index;



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DOI: https://doi.org/10.22146/jkki.103784

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