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All Journal Jurnal Manajemen Pelayanan Kesehatan (The Indonesian Journal of Health Service Management)
Arrus Ferry
Minat Manajemen Rumah Sakit, Fakultas Kedokteran, UGM UGM Yogyakarta,
Health Professions Public Health

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RESPON RUMAH SAKIT SWASTA SOSIAL KEAGAMAAN TERHADAP ASURANSI SOSIAL: STUDI PENANGANAN KASUS MATERNAL DI RUMAH SAKIT NUR HIDAYAH BANTUL, YOGYAKARTA Arrus Ferry; Mubasysyir Hasanbasri; Mohammad Hakimi
Journal of Health Service Management Vol 19 No 1 (2016)
Publisher : Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta Jl. Farmako Sekip Utara Yogyakarta 55281 Telp 0274-547490

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (515.72 KB) | DOI: 10.22146/jmpk.v19i1.1835

Abstract

Background: The difference between the hospital real cost andthe tariff of INA-CBGs has negative impact on hospital causesfinancial losses, especially private hospital. The potential for thisloss is likely to encourage hospitals to establish a strategy tominimize losses. There are some distortions induced by theprospective payment system i.e. up-coding, cream skimming,readmission, and unbundling. Objective: The aim of this study was to determine Nur Hidayahhospital behaviour in response to INA-CBGs practice inmaternal management. Methods: This study was a quantitative research uses a casestudy approach. Secondary data from medical records, socialinsurance claim documents, records or reports regardingmaternal care and the regulation of social insurance services inthe period of January-June 2014 were use as the data sourcesof this study. Results: There was no evidence to support the practice of upcoding,cream skimming, readmission and unbundling inmaternal care at Nur Hidayah Hospital. Nur Hidayah Hospitalimplemented efficiency strategies and anti-fraud & abuse todeal with social insurance schemes. Conclusion: The INA CBGs-based payment resulted inincreased efficiency of the maternal care in Nur HidayahHospital.
Co-Authors Mohammad Hakimi Mubasysyir Hasanbasri