PERSIAPAN RUMAH SAKIT SWASTA DALAM MENERAPKAN TARIF PELAYANAN JAMINAN PERSALINAN: STUDI KASUS DI RUMAH SAKIT KHUSUS IBU DAN ANAK DI KOTAMADIA MALANG

Abstract

Background: High maternal death is mainly caused by limited
access to maternity services due to unaffordable cost of services.
Therefore, a special insurance scheme named Jaminan
Persalinan (Jampersal) was launched and it is expected to be
able to solve this problem.The Muhammadiyah Maternal and
Child Hospital in Malang is a private hospital that offers obstetric
and neonatal emergency service for those with Jampersal.
The Jampersal fee was already set similar to that of Jaminan
Kesehatan (Jamkesmas)scheme, using INA-CBG. Therefore,
it is important to elicit the possibility of Jampersal fees being
accomodated by private hospital.
Objective:This research aimed to compare between Jampersal
and hospital fees and analyse efforts of a private hospital in
accomodating the INA-CBG’s pricing scheme.
Methods:This study was carried out at Muhammadiyah Malang
Maternal and Child Hospital. Unit cost calculation and hospital
pricing were collected using the secondary data available from
the department of finance in the hospital, while Focus Group
Discussion (FGD) was held with the management level to understand
willingness and opportunity of hospital managersto collaborate
with the government in providing Jampersal services.
Results: The results showed that INA-CBG’s tariff was lower
than both unit cost and hospital pricing for normal delivery and
delivery with cesarean section.The unit costand tariff of normal
delivery were Rp1.633.704,00 and Rp2.070.275,00, respectively.
Both of them were higher than the INA-CBG’s tariff
(i.e., Rp1.487.770,00).The INA-CBG’s tariff for cesarean section
(i.e. Rp2.712.943,00) was lower than both the unit cost
and hospital tariff of similar service (i.e. Rp4.782.072,00 and
Rp 5.110.500,-, respectively). From the FGD, it was found that
unlike for cesarean section, efforts to accommodate the Jampersal
pricing for patients with normal delivery are possible.
Conclusions: The findings indicate that Jampersal feesare
lower than both the Muhammadiyah Malang Maternal and Child
Hospital’s pricing and unit cost.Development of clinical
pathwaymay become a solution for the hospital to apply the
INA-CBG’s tariff.
Keywords: fees, Jampersal, private hospital