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All Journal Jurnal Kesehatan Masyarakat Majalah Kesehatan FKUB Indonesian of Health Information Management Journal (INOHIM) Jurnal Kesehatan Tambusai Sehat Rakyat: Jurnal Kesehatan Masyarakat Jurnal Publikasi Ilmu Manajemen Jurnal Multidisiplin Sahombu Jurnal Ilmu Kesehatan dan Gizi Jurnal Pendidikan Anak Usia Dini Jurnal Kesehatan dan Kedokteran Jurnal ARSI : Administrasi Rumah Sakit Indonesia J-CEKI
Nabila, Anggun
Universitas Esa Unggul
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Journal : Jurnal Multidisiplin Sahombu

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Analysis of the Relationship Between Age and Acute Respiratory Infection Claim Costs in the Health Insurance Program of PT XYZ Anggun Nabila; Dwi Nurmawaty
Jurnal Multidisiplin Sahombu Vol. 6 No. 02 (2026): Jurnal Multidisiplin Sahombu, 2026
Publisher : Sean Institute

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Abstract

The frequency of health insurance claims in corporate insurance systems continues to increase, making the understanding of case characteristics and cost determinants essential for effective health risk management. This study aims to analyze the characteristics of patients with acute respiratory infection (ARI) and to examine the relationship between age and health insurance claim costs, measured by total charges and approved costs. A quantitative approach with a cross-sectional design was applied using secondary data from 401 health insurance claims at PT XYZ, including 46 ARI cases. Data normality was assessed using the Shapiro–Wilk test, and bivariate analysis was conducted using Spearman’s rho correlation. The proportion of ARI cases accounted for 11.5% of all claims, with children representing the largest group of patients. The results indicate a significant negative correlation between age and total claim costs (r = −0.350; p = 0.017) as well as approved costs (r = −0.316; p = 0.032). These findings suggest that younger age groups, particularly children, tend to incur higher claim costs compared to older age groups. However, given the limited number of ARI cases, the results should be interpreted with caution and cannot be broadly generalized. Further studies with larger sample sizes and additional explanatory variables are recommended to strengthen the evidence base for health insurance risk management.
Co-Authors Ade Heryana Astuti, Dita Ayu Devi Angeliana Kusumaningtiar Dwi Nurmawaty Dwi Nurmawaty Eni Widiastuti, Eni Faressa Aurelia Pramudita Ferlina Rizky Indah Nugroho Hasibuan, Rabitha Hernaya, Ade Heryana, Ade Indah Pawitaningtyas Intan Silviana Mustikawati Kevin Antonio Situmeang Khiko Mona Hapsari, Ryan Lubis, Siti Misjelina Br Surbakti Muammar Khaddafi Muslimah, Annisaa Nuur Mutiara Febia Wulandari Namira Wadjir Sangadji Novia Ardana Siregar Nst, Putri Nurholifah, Siti Nurlaela Nurmawaty , Dwi Nurmawaty, Dwi PUTRI HANDAYANI Rozana Ika Agustiya Shorayasari , Susi Shorayasari, Susi Silviana Mustikawati, Intan Susi Shorayasari Susi Shorayasari Yusril Anwar