PERBANDINGAN BIAYA PELAYANAN TINDAKAN MEDIK OPERATIF TERHADAP TARIF INA-DRG PADA PROGRAM JAMKESMAS DI RSUP DR. MOHAMMAD HOESIN PALEMBANG

Abstract

Background and Goal: The concept of Indonesian Diagnosis
Related Group (INA-DRG) formerly purposed to gain both quality
and efficiency of the health services. By using this packet rate
hopefully it could minimize the medical cost rate, where there
surgical operation is one of the most expensive medical
services. The present study is aimed to investigate the
comparison between surgical operations to the INA-DRG’s
tariff of JAMKESMAS in RSUP Dr. Mohammad Hoesin Palembang
in quartal I 2009.
Method: This study was observational with the cross sectional
approach. The population study used Jamkesmas patients as
the samples who got the surgical operation treatment since
January up to April 2009, the approximately 232 people.
Samples consists of 70 patients have been taken by using
proportional stratified sampling method. Type of the data that
have been analyzed were primary data included stay care
rate of the patients that collected by using observation method
helped with the check list instrument. The analysis of this
study aimed to highlight the distribution of rupiahs rate circulation
toward services cost rate and descriptively to produce a
picture of rupiah value distribution of the cost of medical
services operative actions which are categorized into three
groups: a special operation, Operation large and medium
operations. Then done with cross tabulated both two variables
and the results were shown in form of narration and table of
distribution.
Results: The results of this study show that 98.6% of the
surgical operations rates were not relevant to INA-DRG’s tariff.
If viewed from the component costs, the costs of operating
the actions of special operations have a tendency to lose
money because most of the cost (55.6%) in excess of average
cost. In the cost component of nursing care was found that
the cost is greater than the average cost at most at the special
operations (41.2%). In supporting service cost component is
known that the cost is higher than average costs at most
operations moderate (50%). At the component cost of
medicines is known that the cost of drugs is greater than the
average cost of most numerous in a major operation around
40%. Therefore, when viewed from the total cost is calculated
based on the sum of four components above cost is found
that the total cost of surgery which is smaller than the average
cost at most at the special operations (72.2%), while the cost
of surgery is greater than the cost average at most at the
operating medium (45.5%). This shows that the total cost of
surgery is being issued to patients in RSMH Jamkesmas greater
than the cost which is generally on the operation.
Conclusion: In conclusion, this present study indicates that
there is a tendency to lose the service of the operative
procedure in patients Jamkesmas in RSMH surgical operations
cost rate were not relevant and more than INA-DRG’s tariff.
Proposed that a clinical pathway must be constructed based
on INA-DRG’s regulation soonly in order to be guidance for
hospitals in giving their medical services mainly to the
Jamkesmas’s patients.
Keywords: health services rate, INA-DRG’s tariff, Jamkesmas