Difference analysis of National Health Assurance (JKN) claims based on Hospital Rates and INA-CBGS rates at Dr. Soekardjo Hospital Tasikmalaya

Abstract

Cost Containment Program is one of hospital management efforts that need to conduct. One early step in the Cost Containment program in hospotal is analyzing the differences of JKN claims based on INA-CBGs rates and Hospital rates of Dr. Soekardjo Hospital Tasikmalaya. The objective is to analyze the differences of JKN Claim based on INA-CBGs rates and Hospital rates of Dr. Soekardjo Hospital Tasikmalaya. The research method is quantitative, which non-intervention research, and the study design was observational analytical survey. Researchers used analysis of mean different test. The population in this study is JKN claims data and Rates Hospital Dr. Soekardjo Tasikmalaya by 1^st January - 31^st December 2015. The sample in this study is total population. Research was conducted for 6 months during May to October 2016.

The survey resulted that the entire variable had significant difference with p value = 0.000, it can be concluded that there are differences in the JKN claim average based on INA-CBGs rates and hospital rates as a whole; there are differences in the JKN claim average of  patients at Obstetrical and gynecology Departement , Pediatric  Departement , surgery Departement , and Internal MedicineDepartement  ; There is a difference in the JKN Claim average of outpatient claims and inpatients; There is a difference in the JKN claim average of in patients who received surgery services/procedures and patients who received Non surgery services/procedures at Hospital.

 Keywords: Difference, Hospital, Rate, INA-CBGs, DRGs.