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All Journal PELS (Procedia of Engineering and Life Science)
Dani, Ika Aria
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Computer Science & IT Control & Systems Engineering Electrical & Electronics Engineering Engineering

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Analysis of Differences Between Hospital Rates and INA-CBG's Claim of Sectio Caesarea Hayati, Afriliya; Budi, Savitri Citra; Dani, Ika Aria
Procedia of Engineering and Life Science Vol. 6 (2024): The 3rd International Scientific Meeting on Health Information Management (3rd ISMoHI
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v6i1.1924

Abstract

Hospitals as advanced referral facilities have an important role in implementing the National Health Insurance (JKN) programme. For payment of advanced health services for JKN participants at the hospital, BPJS makes payments based on the Indonesian case-based groups (INA-CBG's) package. However, the problem that is often found in hospitals is the difference between hospital rates and INA-CBG's claim. This study aims to determine and analyse the difference between hospital rates and INA-CBG's claim for sectio caesarea cases at Bhayangkara Polda DIY Hospital. This study was a descriptive quantitative study with a retrospective approach. The object of the study was the BPJS patient's inpatient claim file for sectio caesarea cases at Bhayangkara Polda DIY Hospital in the fourth quarter of 2023. The number of samples was 39 patients using the total sampling technique. The results showed a significant difference (p< 0,05) between hospital rates and INA-CBG’s claim for sectio caesarea cases at Bhayangkara Polda DIY Hospital. The difference between hospital rates and INA-CBG’s claim caused a negative difference of Rp.10,865,028,00. There is a negative difference between the hospital rates and the INA-CBG's claim for sectio caesarea cases at Bhayangkara Polda DIY Hospital, so the hospital suffers a loss.
Co-Authors Hayati, Afriliya Savitri Citra Budi