Real Cost of Analysis of INA CBGs Rates on Caesaean Section at Mother and Child Hospital Restu Ibu Sragen

Abstract

This study aimed to analyze the difference between real cost and INA CBGs rates for caesarean section at Mother and Child Hospital Restu Ibu Sragen. This study applied a mixed method (quantitative and qualitative) with variables focusing on the INA CBGs rates and hospital real cost. The population in this study were all caesarean section patients in 2021, while the samples used in this study were 538 patients or the entire population included in the inclusion criteria, namely patients in 2021, patients using BPJS Health Insurance, and patients with complete medical record data. The real cost consisted of the cost of drugs or medical goods, medical treatment, medical services, and medical support. Qualitative data were collected by interviewing five research respondents, namely three from management, one from the case-mix team, and one from medical records. The results showed that the ratio of calculations in Class 3 patients so as not to experience losses could be done with a balance of mild to moderate patients, namely 1:1,75, while in patients overall type, a comparison of 1:3:8 or 1:3:9 could be made to improve hospital benefits. The statistical analysis showed a difference between real cost and INA CBGs rates for caesarean section at Mother and Child Hospital Restu Ibu Sragen. The determinants are the adherence of doctors and medical personnel to clinical pathways, the condition of medical personnel not too concerned about claim rates, the length of time for patient care, the form of action given to patients, and the presence of complications in patients. There are five strategies produced in this analysis: calculating unit costs for caesarean section in each class and level of severity, considering rates per patient based on the results of data analysis in 2021, monitoring and evaluating caesarean section, monitoring and evaluating clinical pathway compliance, and increase the promotion of the hospital. The results of this study produce strategies and compare patient ratios to minimize losses at RSIA Restu Ibu Sragen.