Development of Cost Analysis Guidance for Indonesian Hospitals

Ragil Setia Dianingati(1), Arthorn Riewpaiboon(2*)

(1) Pharmacy Study Program, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
(2) Social, Economic, and Administrative Program, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
(*) Corresponding Author


Health technology assessment is important in the process of national health insurance system development. On the other hand, health technology assessment study needs a cost analysis as a basic, which is a troublesome if there is not any guidance. To help performing the cost analysis study, this study describes the development of a costing manual book and template as a guide for costing analysis in Indonesian hospitals. This management tool developed in stages, from tool drafting, testing in the real life environment, to approval from stakeholders. Costing templates were developed using Microsoft Excel formulas, such as IF, SUMIF and TRANSPOSE. The costing manual book and template were designed for the Indonesian hospital context. The costing template successfully assessed the unit costs of healthcare services in the study hospital. It can calculate the unit costs of healthcare services for 3 main objectives: hospital internal management, reimbursement rate setting and economic evaluation. The costing analysis tool was reviewed and approved by the study hospital staff and stakeholders. Even the model test was only tested in one district hospital, but it was designed to be flexible enough to adapt to different hospital organization structures. The cost analysis guidance is relevant and applicable to district hospitals in Indonesia. It is well accepted by stakeholders and helpful in calculating the hospital unit costs in a practical way. Hopefully, there will be further hospital cost analyses in the future. These cost analyses can then be used as inputs for universal health coverage development.



cost analysis; costing guidance; indonesian hospitals

Full Text:



1. WHO. Research for Universal Health Coverage. The world health report 2013. Geneva: WHO, 2013.

2. Independent Hospital Pricing Authority of Australia. Australian Hospital Patient Costing Standards. Australia: Independent Hospital Pricing Authority of Australia, 2018.

3. Newbrander W, Lewis E. Hospital Costing Model Manual: Health Reform and Financing Program & APHIA Financing and Sustainability Project, Management Sciences for Health, 1999.

4. Mogyorosy Z, Smith P. The main methodological issues in costing health care services: a literature review. University of York: Centre of Health Economics, 2005.

5. Riewpaiboon A, Malaroje S, Kongsawatt S. Effect of costing methods on unit cost of hospital medical services. Tropical medicine & international health : TM & IH 2007;12(4):554-63 doi: 10.1111/j.1365-3156.2007.01815.x[published Online First: Epub Date]|.

6. Özaltın A, and C. Cashin. Costing of Health Services for Provider Payment: A Practical Manual Based on Country Costing Challenges, Trade-offs and Solutions: Joint Learning Network for Universal Health Coverage, 2014.

7. Clearstate. Universal healthcare coverage in Indonesia—One year on. Indonesia UHC Scheme: The Economist Intelligence Unit, 2015.

8. Marzoeki P, Tandon A, Bi X, Pambudi ES. Indonesia - Universal health coverage for inclusive and sustainable development : country summary report. Washington DC: World Bank Group, 2014.

9. BPJS Kesehatan. Sistem Rujukan Berjenjang (Patient Referral System). Jakarta: BPJS Kesehatan, 2014.

10. Kementerian Kesehatan Republik Indonesia. Petunjuk Teknis Sistem Indonesian Case Base Groups (INA-CBGs). In: Health Mo, ed. Jakarta: Ministry of Health, 2014.

11. Kementerian Kesehatan Republik Indonesia. Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan. In: Health Mo, ed. Jakarta: Ministry of Health, 2016.

12. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes third edition. Oxford: Oxford University Press., 2005.

13. Kementerian Kesehatan Republik Indonesia. Pedoman Penerapan Kajian Farmakoekonomi. In: Indonesia KKR, ed. Jakarta: Kementerian Kesehatan Republik Indonesia, 2013:72.

14. Eryani L. Analisa Biaya Satuan Pelayanan (Unit Cost) dengan Metode Activity Based Costing (ABC) sebagai Pembanding Jasa Sarana Tarif Pelayanan Endoskopi, Studi pada RSUD Kota Yogyakarta. Gadjah Mada University, 2013.

15. Sugiyarti AT, Nuryadi, Sandra C. Unit Cost Analysis (Unit Cost) With Activity Based Costing Method (ABC) (Case Study In Eyes at RSD Balung Jember). Jurnal Pustaka Kesehatan, 2013;1(1)

16. Apriliani VE. Analisis Penentuan Tarif Jasa Rawat Inap Rumah Sakit dengan Menggunakan ABC Sistem. Muhammadiyah Malang University, 2016.

17. Purwanti BM. Analisis Penerapan Penghitungan Unit Cost dengan Metode Double Ditribution pada Unit Radiologi Tahun 2014, Studi Kasus: Rumah Sakit Hana Charitas. Sanata Dharma University, 2016.

18. Puspitasari IF. Analisis Perbandingan Metode Konvensional dengan Metode Activity Based Costing untuk Meningkatkan Akurasi dalam Menentukan Tarif Rawat Inap (Studi Empiris pada Rumah Sakit Queen Latifa). PGRI Yogyakarta University, 2016.

19. Rahmaniar D. Analisis Biaya Satuan Metode Activity Based Costing (ABC) dalam Evaluasi Tarif Pelayanan Rumah Sakit "X" Surabaya. Airlangga University, 2016.

20. Rahmaniar D, Rochmah TN. Analisis Biaya Satuan Metode Activity Based Costing (Abc) Dalam Evaluasi Tarif Pelayanan Di Klinik Spesialis Bedah Saraf Rumah Sakit “X” Surabaya. Jurnal Manajemen Kesehatan Yayasan RS Dr. Soetomo 2017;3(2):76-87

21. Creese A, Parker D. Cost Analysis in Primary Health Care. Geneva: World Health Organization, 1994.

22. Shepard DS, Hodgkin D, Anthony YE. Analysis of hospital costs: A manual for managers. Geneva: World Health Organization, 2000.


Article Metrics

Abstract views : 2881 | views : 2863


  • There are currently no refbacks.

Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

©Jurnal Manajemen dan Pelayanan Farmasi
Faculty of Pharmacy
Universitas Gadjah Mada
Creative Commons License
View My Stats