Disparities in hospital cost and INA-CBGs tariff with unit cost analysis of inpatient services

Warsi Maryati (Universitas Duta Bangsa Surakarta)
Muhammad Faiz Othman (Universiti Teknologi MARA Malaysia)
Siti Musyarofah (STIKES Kendal)
Puguh Ika Listyorini (Universitas Duta Bangsa Surakarta)
Fhahrul Dwi Aryanti (Universitas Duta Bangsa Surakarta)
Miftakhul Jannah (Universitas Duta Bangsa Surakarta)

Proceeding of International Conference Health, Science And Technology (ICOHETECH)
2021: Proceeding of the 2nd International Conference Health, Science And Technology (ICOHETECH)

The National Health Insurance Program, a form of health insurance that has been implemented since 2014, which uses the Indonesian Case Based Groups (INA-CBGs) system. The implementation of this system ensures that patients get good service and hospitals get standard tariff. The intended tariff is in the form of a package which includes all components of hospital costs. This study aims to determine the relationship between the unit cost of all health service cost components and the INA-CBGs tariff and how the gap is. The research sample was taken from the INA-CBGs claim document in the second quarter of 2020 as many as 4,833. Data were analyzed using linear regression to find a relationship between hospital health service costs and the INA-CBGs tariff. Hospital service costs are calculated based on unit cost analysis. The average unit cost of laboratory was IDR 853,500 (7.91%), radiology IDR 366,198 (3.39%), treatment IDR 2,031,850 (18.82%), Examination IDR 4,205,745 (38.95%), Consumables IDR 345,092 (3.17%), and Drugs IDR 3,022,694 (27.76%). The results of the analysis showed Laboratory (b = 1.639; 95% CI = 1.177 to 2.100; p <0.001), Treatment (b = 0.915; 95% CI = 0.852 to 0.978; p <0.001), Examination and Accommodation (b = 1.211; 95% CI = 1.138 to 1.285; p <0.001), and Drug (b = 0.015; 95% CI = 0.007 to 0.024; p <0.001) had a significant relationship with the INA-CBGs tariff. Other variables such as Radiology (b = -0.141; 95% CI = -0.629 to 0.347; p <0.001) and Consumable Costs (b = -0.343; 95% CI = -696 to 0.009; p <0.001) had no significant relationship with INA-CBGs Tariff. However, all cost components have a significant effect (p <0.001) of 42.7% on the INA-CBG tariff with a strong influence category (R = 0.654). Hospitals must be wiser in managing finances with the INA-CBGs pattern, because the tariff may look small because there are some treatment that are not cost effective or there are still unnecessary treatment for patients taking a large portion of the cost of the package.