The Implementation of INA-CBGs System Impact on Financial Performance of Public Hospital, the Indonesia Case: A Systematic Review

Abstract

Indonesia started the national health insurance system on 1 January 2014. In this system, there is only one insurer institution, BPJS Kesehatan, a social security agency established by the government to provide health insurance for Indonesian people. This new national health insurance system pays all claims based on package system called Indonesia Case-Based Groups (INA-CBGs). The aim of this review is to describe the application of the INA-CBGs system and its effect on financial performance of the public hospital and helping them in identifying and anticipating problems in implementation of the INA-CBGs system. This review shows prism flowchart using Proquest and Portal Garuda with INA-CBGs, public hospital finance performance, universal health coverage, and Indonesia as the keywords. From the 15 selection research journals, we found that the implementation of the INA-CBGs system with the prospective payment system can provide a positive impact on the financial performance in public hospital, when the hospital could reduce inefficient cost of treatment. Furthermore, public hospitals achieve a surplus since they receive a donation from the government for salary expenses and investment-related expenses. Public hospital management in Indonesia should consider the competence of their accounting and financial managers so they can manage their hospitals properly. Each public hospital management must have a strategy and innovation to improve the quality of service so they can compete with other hospitals and financial performance can be improved in this JKN era.

Toward Hospital Resilience: a Qualitative Study on the identification of Hospital Shocks during Disruption era in Indonesia

“…Hospitals, which initially played a major role in determining prices, have completely changed based on the Indonesia Case-Based Groups (INA-CBGs) system. Hospital income changes, and hospital managers begin to estimate the resources needed to treat the disease and predict the required medical expenses (35). The hospital's focus has changed to e ciency gains and cost containment in providing services.…”

Excess mortality attributable to antimicrobial-resistant bacterial bloodstream infection at a tertiary-care hospital in Indonesia

“…Nasional) [28]. It is still unclear how low blood culture utilization rate or delayed blood culture could impact the comparison of mortality between patients with AMR BSI and AMS BSI, and between patients with AMR BSI and non-infection [29].…”

Peritoneal dialysis in Indonesia: Current status, challenges and prospects

“…3 This policy pays all claims based on a fixed rate to specific diagnoses and procedures depending on hospital classes. 10,11 Since these changes, the number of kidney centres has increased from 315 in 2013 to 797 in 2018, with 91% of dialysis care being government-funded. Both public and private hospitals (national and international chains) provided dialysis in collaboration with private providers such as Fresenius Medical Care and Baxter.…”