ANALISIS BIAYA JAMINAN KESEHATAN MASYARAKAT DAN ASURANSI KESEHATAN PADA PASIEN STROKE NON-HEMORAGIK DI RUMAH SAKIT UMUM DAERAH KABUPATEN SLEMAN

Abstract

Background: Non-hemorrhagic stroke causes many deaths.
Its treatment requires long-term care, resulting in very high
cost. Controlinging costs and quality are very important in maintaining
sustainability, however, in reality there are cost sharing
by patients and hospitals outside the insurance coverage.
Aim: This study aims to identify the difference in cost that
must be shared to the patient and the hospital for inpatient
non-hemorrhagic stroke of the Jamkesmas and Askes patients
in Sleman Hospital.
Method: This study used a cross ssectional design. Data
were retrieved retrospectively with a primary diagnosis of
non-hemorrhagic stroke hospitalizations for patients admitted
to the hospital during the period of January 2011 to May 2012.
Data were analyzed using univariate, bivariate correlation,
and multivariate.
Result: The average cost of inpatient care non-hemorrhagic
stroke Jamkesmas patients was Rp3.541.021,00 +
Rp2.609.488,00 and for Askes patients Rp4.678.509,00 +
3.257.816,00. The average cost sharing in Askes patients is
Rp.1.851.536,00 + 1.968.757,00 and Jamkesmas is
Rp405.976,00 +Rp2.303.903,00. Percentage the greatest cost
component in Askes patients is drugs (47%) and accomodation
(44%), while in Jamkesmas is drug (52%) and accommodation
(36%). Components of the cost sharing in Askes patients was
drug (87%). The difference in the cost of hospital rates was
greater than INA-CBGs respectively Rp3.541.021,00 +
Rp2.609.488,00 and Rp3.135.045,00 + Rp727.710,00.
Conclusion: The proportion of costs covered by the insurance
and shared by patient/hospital is 87:13 for Jamkesmas
patient, 55:45 for Askes patients (January 2011-May 2011),
and 59:41 for the Askes patients (June 2011-May 2012). The
proportion of cost sharing of inpatient care non-hemorrhagic
stroke by Askes patients outside the program is greater than
the proportion of costs sharing by the hospital on Jamkesmas
program.
Keywords: cost sharing, Askes costs, Jamkesmas costs,
non-hemorrhagic stroke patient