Expense of INA CBGS Claim and Real Expense of Catastropic Diseases Inpatient Jamkesmas Participant at Hospital Study in 10 Ministry of Health Hospital of January to March 2012

摘要

Background:The implementation of INA-CBGs system on hospital financing of catastropic diseases (heart, cancer, stroke) to Jamkesmas members at inpatient hospital, giving consequences catastropic diseases represent threat to more expense of Jamkesmas financing period of coming, while other side hospital feel that INA-CBGs claim that lower of hospital tariff. The purpose of this research is to conduct expense of medication of catastropic disease anf comparison of INA CBGs claim with real expense based on hospital tariff. Methods: Research type is observational with research cross sectional layout is according to hospital perspective. Data taken by using retrospective method taken away by medical record document. The research subjects are lodging patient at 10 Ministry of Health hospital within periode January–March 2012. Data analysis conducted descriptively. Results:The result of this strudy indicate that inpatient hospital of Jamkesmas members by catastropic disease is heart disease 37.11%, cancer 23.54% and stroke 39.35%. Conclusion: The average real expense inpatient hospital in A class much more compared to class of B and special hospital. Expense of INA CBGs claim much more of A class hospital compared to B class and special hospital. Component of many expense is accomodation cost, room action, laboratory, non surgical operation for the heart, surgical operation for cancer and the medicine expense. Expense of disease catastropic pursuant to compared to bigger claim based on INA-CBGs of real expense to hospital tariff, so that for hospital catastropic disease not lose. So, the policy of ladder refferal to Jamkesmas participant have to observe tightly so that health services to poor community become more well quality guaranted, exepense and sustainability