Cost Analysis of Indonesia Case Based Groups (INA-CBGs) Tariff for Stroke Patients

https://doi.org/10.22146/jmpf.46720

Ingenida Hadning(1*), Fitriannisa Fathurrohmah(2), Muhammad Ridwan(3), Bangunawati Rahajeng(4), Pinasti Utami(5), Indriastuti Cahyaningsih(6)

(1) Universitas Muhammadiyah Yogyakarta
(2) Universitas Muhammadiyah Yogyakarta
(3) Universitas Muhammadiyah Yogyakarta
(4) Universitas Muhammadiyah Yogyakarta
(5) Universitas Muhammadiyah Yogyakarta
(6) Universitas Muhammadiyah Yogyakarta
(*) Corresponding Author

Abstract


The INA-CBG’s (Indonesia Case Based Groups) package rate implementation for National Health Insurance Program member since 1st January 2014 suffering from stroke has forced all hospitals in Indonesia to do a quality control and efficient service cost. Stroke, one of the catastrophic diseases often accompanied with some of its comorbid factors, requires high treatment cost. Thus, a cost analysis study is needed to prevent hospital loss. This study was aimed at determining the suitability of cost between the real cost of stroke therapy and the Indonesian Case-Based Groups (INA-CBG) rate according to the Ministry of Health Decree number 69 of 2013. This study was an observational study with a cross-sectional design. Data collection was done retrospectively. Study subjects were all that hospitalized strokes of patients who were members of the National Health Insurance and also met the inclusion and exclusion criteria registered between January to June 2014. The study data were in real direct medical costs analyzed for its suitability with the INA-CBG's rate. Descriptive statistical tests and t-tests were used to analyze the data. The results showed that the average real cost of the first-class hospitalization was higher than INA-CBG's rate for cerebral infarction and for unspecified stroke, with insignificant discrepancies. The average real cost of second class hospitalization was lower than INA-CBG's rate for cerebral infarction, otherwise the average cost was higher than INA-CBG's rate for unspecified stroke, with insignificant discrepancies. The average real cost of third class hospitalization was lower than INA-CBG's rate for cerebral infarction and for unspecified stroke, with significant discrepancies. Most of the average costs were higher than the INA-CBG rate. Thus, the hospital is not capable of managing a stroke of cost-based treatment on INA-CBGs. The hospital has suffered losses. INA-CBG's rate of stroke treatment needs to be evaluated.


Keywords


stroke; cost analysis; INA-CBG’s

Full Text:

PDF


References

  1. Goldstein, L.B., et al., 2006, Primary Prevention of Ischemic Stroke: A Guideline From The American Heart Association / American Stroke Association Stroke Council. Stroke, 37: 1583-1633.
  2. Lloyd-Jones, D., et al., 2010, Heart Disease and Stroke Statistics 2010 Update: A Report From American Heart Association. Circulation 121; e16-e25.
  3. Riskesdas, 2013, Riset Kesehatan Dasar. Badan Penelitian dan Pengembangan Kesehatan, Jakarta.
  4. Fagan S.C, Hess D.C, 2005, Pharmacotherapy: A Pathophysiologic Approach : Stroke, 6th ed, McGraw-Hill, Medical Publishing Division, New York.
  5. Kasper D.L, Braunwald E, Fauci A.S, Hauser S.L, Longo D.L, Jameson J.L, 2005, Harrison’s Manual of Medicine, 16th ed, McGraw-Hill, Medical Publishing Division, New York.
  6. Lumbantobing SM, 2003, Stroke Bencana Peredaran Darah di Otak, Medical Faculty Universitas Indonesia, Jakarta.
  7. Ministry of Health, 2013, Buku Pegangan Sosialisasi Jaminan Kesehatan Nasional Dalam Sistem Jaminan Sosial, Ministry of Health Republic of Indonesia, Jakarta.
  8. Dwiprahasto, I., 2011, Diskusi Penatalaksanaan dan Pembiayaan Kanker di Indonesia, Faculty of Public Health Universitas Indonesia and Roche Indonesia, Jakarta, Indonesia, 11 Mei 2011.
  9. Hadning, I., Ikawati, Z., Andayani, T.M., 2015, Stroke Treatment Cost Analysis for Consideration on Health Cost Determination Using INA- CBGs at Jogja Hospital, International Journal of Public Health Sciences, Vol.4 No.4, December 2015, 288-293.
  10. Sugiyanto, 2009, Analisis Biaya Pengobatan Stroke Iskemik Sebagai Pertimbangan Dalam Penetapan Pembiayaan Kesehatan Berdasar INA-CBG’s di RSUP Dr. Sardjito, Thesis, Master of Pharmacy Universitas Gadjah Mada, Yogyakarta.
  11. Gupta, S. K., Gupta, A., Gondhotra, D., Gupta, A., Gupta, S., 2008, Role of Citicoline in Ishaemic Stroke, Department of Neurology and G Medicine, Govt, Medical College Jammu-J&K, India, Vol 10 no 4, Otober-December 2008, 160-162.
  12. Armilawaty, Amalia, H., Amiruddin, R., 2007, Hipertensi dan Faktor Risikonya dalam Kajian Epidemiologi, [Online], Scientific Article, Faculty of Public Health Universitas Hassanuddin, www.jurnalpembahasan/hipertensi dan faktor risikonya dalam kajian epidemiologi ”New Paradigm for Public Health”.htm, [2012, Desember 20].
  13. Ayala, D.E., Crespo, J.J., Dominguez-Sardiña, M., Moya, A., Otero, A., Rios, M.T., Castiñeira, M.C., Sineiro, E., Gomara, S.M., Callejas, P.A., Pousa, L., Mojon, A., Fernandez, J.R., Hermida, R., Invest, Hygia Project, 2015, Prognostic Value of Different Ambulatory Blood Pressure Parameters As Predictors of Stroke: The Hygia Project, Journal of Hypertension, 33:PP.3403.
  14. Simona L., MD, Claudia C., MD, Leandro P., MD, Mauro S., MD, Blood Pressure Variability and Clinical Outcome in Patients with Acute Intracerebral Hemorrhage, Journal of Stroke and Cerebrovascular Diseases, Vol 24 Issue 7: 1493–1499.
  15. Handayani, F., 2013, Angka Kejadian Serangan Stroke pada Wanita Lebih Rendah Daripada Laki-Laki, Jurnal Keperawatan Medikal Bedah, Universitas Diponegoro, 1, 75-79.
  16. Sitorus, R.J., 2008, Faktor-Faktor Risiko Yang Mempengaruhi Kejadian Stroke Pada Usia Muda Kurang Dari 40 Tahun (Studi Kasus Di Rumah Sakit di Kota Semarang), Jurnal Epidemiologi: Universitas Diposengoro.
  17. Ministry of Health, 2014, Ministrial of Health Decree number 27 of 2014 on Technical Instructions of INA-CBGs, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.
  18. Ministry of Health, 2014, Ministrial of Health Decree number 59 of 2014 on Rate of National Health Insurance, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.
  19. Ministry of Health, 2014, Ministrial of Health Decree number 28 of 2014 on Guidelines for the Implementation of the National Health Insurance Program, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.
  20. Huang Y. C., Hu C. J., Lee T. H., Yang J. T., Weng H. H., Lin L. C., Lai S. L., 2012, The Impact Factors on the Cost and Length of Stay among Acute Ischemic Stroke, [Online], http://www.ncbi.nlm.nih.gov/pubmed, (2013, Januari 31).
  21. Jorgensen H.S., Nakayama H., Raaschou H.O., Olsen T.S., 1997, Acute Stroke Care and Rehabilitation: an Analysis of The Direct Cost and Its Clinical and Social Determinants: The Copenhagen Stroke Study, Stroke, 28: 1138–1141.
  22. Misbach J, Hamid A.B., Mayza A., Saleh M.K., 2006, Buku Pedoman Standar Pelayanan Medis (SPM) dan Standar Prosedur Operasional (SPO) Neurologi, Association of Indonesian Neurologist, Jakarta, Indonesia.
  23. Chassin M. R., 1983, Health Technology Case Study 24 : Variations in Hospital Length of Stay: Their Relationship to Health Outcomes,U.S. Government Printing Office, Washington, D.C., 49-50.
  24. Chang K.C., Tseng, M.C., Weng, H.H., Lin, Y.H., Liou, C.W., Tan, T.Y., 2002, Prediction of Length of Stay of First-Ever Ischemic Stroke, Stroke; 33:2670-2674.
  25. Holloway R.G., Witter D.M. Jr., Lawton K.B., Lipscomb J., Samsa G., 1996, Inpatient Costs of Specific Cerebrovascular Events at Five Academic Medical Centers, Neurology, 46: 854–860.
  26. Misbach J, Tobing S.M.L., Ranakusuma T.A.S., Suryamiharja A, Harris S, Bustami M, 2007, Guideline Stroke 2007 (Revised Edition), Association of Indonesian Neurologist, Jakarta, Indonesia.
  27. Ministry of Health, 2014, Ministrial of Health Decree number 71 of 2014 on
    Health Services On National Health Insurance, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.



DOI: https://doi.org/10.22146/jmpf.46720

Article Metrics

Abstract views : 4849 | views : 3424

Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 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