<![CDATA[The National Health Insurance Program (JKN) through BPJS Kesehatan uses the INA- CBGs payment system to improve financing efficiency and the quality of hospital services. However, the increase in service complexity and changes in patient characteristics can affect service efficiency, especially in Ear, Nose, Throat (ENT) specialist services. This study aims to evaluate changes in patient characteristics, distribution of service financing, efficiency of INA-CBGs tariffs, and management of BPJS services for outpatient ENT Poly at Surabaya Islamic Hospital in 2023–2025. The research uses an evaluative method with a descriptive quantitative approach. The research data came from secondary data on TXT BPJS outpatient ENT which included patient characteristics, diagnosis, service cost components, hospital rates, and INA- CBGs rates. The sampling technique used total sampling of all BPJS patients in the outpatient ENT period of the study period. The results showed that patient visits were dominated by women and adult age groups. The most common cases are other minor chronic diseases. Total hospital costs increased from IDR 256,479,954 in 2023 to IDR 369,708,595 in 2025 with the largest cost component coming from consultations and medicines. Although the rate of INA-CBGs is still higher than the cost of hospitals, the difference in profits has decreased significantly. This study concludes that it is necessary to strengthen service efficiency, control costs, and optimize service management to maintain the financial sustainability of hospitals.]]>
