Cost Effective Analysis on the Implementation of Clinical Pathway in Anwar Makkatutu Hospital, Bantaeng District, South Sulawesi, Indonesia

摘要

Introduction: The National Health Insurance (JKN) has been implemented in Indonesia since 2014 and the dreams for Universal Health Coverage (UHC) by the year 2019. It encourages the need for systems that can reduce losses for patients and hospitals through INA-CBGs. Currently, the participant number and health facilities that cooperate with Social Health Insurance (BPJS) increased significantly, while facts shown the lack of funds for the implementation of JKN during 2014-2015. These situations forced the hospitals to take effective action as quality-cost control by using clinical pathway as a guide of medical treatment for patient. Therefore, this study will analyze comprehensively, about the availability, loyalty, conformity, and cost effectiveness after the implementation of clinical pathway.ududMethod; This study used mix-method approach with sequential explanatory design. Data was collected through observations, in-depth interviews, document reviews, and also Focus Group Discussion (FGD). Respondents were selected purposively, consist of medical and managerial staff, and insured patients. This study was a pilot project which was conducted in Bantaeng district Hospital, one of public hospital in south SulawesiududResults; The early study shown that, Bantaeng District Hospital did not implement the quality-cost control system due to the unavailability of clinical pathway guidance. Therefore, this study encouraged medical and managerial staff to establish clinical pathway guidance and evaluating the implementation (The study is still going on and predicted until July 2017).ududConclusions; Quality-cost control system through clinical pathway implementation can reduce the Medical Errors, Length of Stay, Unnecessary Expenditure, also increasing Satisfaction and Quality of service. Therefore, the hospital need to provide clinical guidance through clinical pathway document to ensure patients to get the required services according to their condition and the cost accordance to the treatment received by the patients.