Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RS Pemerintah A di Palembang Tahun 2015

Mardiah, Mardiah
Rivany, Ronnie

Jurnal Ekonomi Kesehatan Indonesia
Vol. 1, No. 4

The difference of cost negative in the case of Coronary Artery Disease (CAD) with Percutaneous Coronary Intervention (PCI), indicate health financing gap between of hospital rates and INA-CBG’s rates. This study aimed to see the difference between the cost recovery rate (CRR) of hospital rates and INA-CBG’s rates for CAD with PCI at A Hospital. The results showed that the cost of treatment based on clinical pathways at the severity level I had a higher CRR Hospital rates compared to INA-CBG’s CRR, whereas at the severity level II, Hospital CRR rate was lower than INA-CBG’s CRR for the utility of less than 2 stents. At severity level III, CRR INA-CBGs’ rates with utilization of 1 and 2 stents performed higher rates than the hospitals CRR. This was related to INA-CBG’s rate that did not take the magnitude of the stentulitizationinto account. It is necessary to improve INA-CBG’s tarif development method from hospital base rate to clinical pathway-based cost of treatment in order to meet hospital operational cost and ensure the best quality of service