Rokiah Kusumapradja
Universitas Esa Unggul

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Analysis of the Differences in Unit Costs for Bronchopneumonia Services Based on Clinical Pathway with INACBGs Rates and Hospital Rates at Dr. RSAL. Mintohardjo Jack Steven Saripantung; Rokiah Kusumapradja; Intan Silviana
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 1 (2025): Januari : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i1.552

Abstract

Hospital is one of the health service facilities that tries to overcome the health service balance between investment costs and the availability of applicable unit costs. Calculation of unit costs has an important role, including being used for budget planning, cost control, subsidies and as information in decision making. In the era of National Health Insurance (JKN) in Indonesia, Hospitals that cooperate with the Social Security Administering Agency (BPJS) Health are paid using the Indonesian Case Base Groups (INACBGs) package system. The acquisition of claim payments at Dr. Mintohardjo Naval Hospital according to the INACBGs rate compared to Hospital costs has a negative difference value for Bronchopneumonia cases. The purpose of this study was to analyze the difference in unit costs of Bronchopneumonia services based on Clinical Pathway towards the determination of INACBGs Rates and Hospital Rates at Dr. Mintohardjo Naval Hospital. This type of research is quantitative, comparative analytical observation using a cross-sectional research design according to the Hospital perspective. The subjects of the study were Medical Records and BPJS Kesehatan claim files for Bronchopneumonia services for the period April to September 2023, totaling 61 files. The study was conducted from January 2024 to April 2024. Data analysis used the paired t-test statistical method in the statistical test application (SPSS Version 26). The results of the study on calculating unit costs using the Activity Based Costing (ABC) method are as follows: 1) There is a difference between the calculation of unit costs with INACBGs rates of negative 6.2% and unit costs with Hospital rates of positive 11.2%, 2) There is a difference in the unit cost of Bronchopneumonia services based on Clinical Pathway with the Activity Based Costing method against INA-CBGs Rates, 3) There is a difference in the unit cost of Bronchopneumonia services based on Clinical Pathway with the Activity Based Costing method against Hospital Rates. The suggestions in this study are: 1) For the financial management of RSAL Dr. Mintohardjo to improve competence in calculating unit cost rates for services based on clinical pathways with the Activity Based Costing method, one of which is through training, 2) Updating and conducting clinical pathway audits periodically, 3) Re-evaluating hospital rates to increase the margin of each service so that the margin obtained is in accordance with what has been set, 4) Digitizing patient usage data that was previously still written manually to avoid errors in entering details of service costs.
Effectiveness of Emergency Department Patient Services in Terms of Nurse Competence, Team Coordination, and Work Motivation At Graha Juanda Hospital Feby Wulansari; Wahyuni Dian Purwati; Rokiah Kusumapradja
Harmoni Economics: International Journal of Economics and Accounting Vol. 2 No. 3 (2025): August: Harmoni Economics: International Journal of Economics and Accounting
Publisher : International Forum of Researchers and Lecturers

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70062/harmonieconomics.v2i3.316

Abstract

The Emergency Department (ED) plays a pivotal role as the frontline of hospital services, requiring rapid and accurate responses to ensure patient safety and optimal care outcomes. This study aims to analyze the influence of nurse competence and inter-team coordination on the effectiveness of patient transfers from ED to inpatient units, with nurse work motivation as a mediating variable. A quantitative approach was employed with hypothesis testing using path analysis (Structural Equation Modeling - SEM). The study was conducted at Graha Juanda Hospital, Bekasi, involving a sample of 55 nurses selected through total sampling from both the ED and inpatient departments. Primary data were collected through structured questionnaires, and data analysis was performed using SPSS 26. The results demonstrate that nurse competence and team coordination significantly affect service effectiveness, both directly and indirectly through work motivation. Specifically, high levels of nurse competence enhance the ability to assess, monitor, and manage patients efficiently, while effective team coordination fosters a collaborative environment that streamlines patient care transitions. However, work motivation plays a crucial role in mediating these relationships. The findings also indicate that low work motivation—linked to factors such as limited professional development opportunities, high workloads, and lack of recognition—contributes to delays in transferring patients to inpatient care, with the average Length of Stay (LOS) exceeding six hours. The study concludes that improving nurse competence, strengthening inter-team coordination, and enhancing nurse motivation are critical strategies to improve the quality and timeliness of emergency services. By offering continuous professional development, balancing workloads, and creating an environment where nurses feel valued, hospitals can significantly reduce delays in patient transfers. This integrated internal performance approach is vital for reducing LOS in the ED, ensuring timely care, and enhancing patient satisfaction. Furthermore, fostering a positive work environment that prioritizes both individual nurse growth and team collaboration is essential for sustaining high-quality emergency services and seamless, patient-centered care transitions.