Gambaran Biaya Medis Langsung dan Kesesuaian terhadap Tarif INA-CBG Pasien Kanker Faring di Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito Yogyakarta

SHARON ROSEANNE TJIPTOPUTRI, Dr. apt. Dwi Endarti, M.Sc.

2023 | Skripsi | FARMASI

Angka kasus Kanker faring di Indonesia terus meningkat padahal biaya yang dibutuhkan untuk tatalaksana kanker cukup tinggi. Namun, sudah terdapat sistem dari pemerintah Indonesia yang membantu pembayaran pelayanan kesehatan berdasarkan tarif paket Indonesia Case Base Groups (INA-CBGs), tetapi pada beberapa penelitian masih ditemukan perbedaan pada tarif rumah sakit dengan tarif paket INA-CBGs yang ditentukan. Maka itu, dilakukan penelitian dengan tujuan untuk mengetahui total dan rincian biaya medis langsung untuk pengobatan dan mengetahui perbedaan biaya medis langsung dengan tarif paket INA-CBG pada pasien kanker faring di Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito.     

Metode penelitian yang digunakan adalah metode kuantitatif deskriptif dengan data yang diambil berupa data sekunder retrospektif dari arsip tagihan biaya Rumah Sakit Umum Pusat (RSUP) Dr. Sardjito serta data klaim dengan tarif INA-CBGs. Penelitian ini mengambil jumlah sampel 70 pasien yang memenuhi kriteria inklusi dan eksklusi penelitian. Data kemudia dianalisis dengan perhitungan rata-rata biaya untuk biaya medis langsung terapi, baik pada setiap komponennya, maupun secara keseluruhan. Selain itu juga dilakukan analisis data menggunakan uji normalitas Shapiro-Wilk dan Kolmogorov-Smirnov serta uji beda berupa t-test independent sample dan Mann-Whitney U test untuk mengetahui adanya perbedaan signifikan antara tarif rumah sakit dengan tarif INA-CBG’s. 

Berdasarkan metode tersebut kemudian disimpulkan bahwa total biaya terapi pasien kanker faring berdasarkan perspektif rumah sakit yaitu sebesar Rp 2.252.562.484,00 dari 1735 kunjungan, sehingga rata-rata per episode yaitu sebesar Rp 1.309.587,10 ± 3.027.982,63. Tidak terdapat perbedaan signifikan rata-rata biaya tarif INA-CBG dengan tarif rumah sakit pada 25 kode dan terdapat perbedaan signifikan pada 15 kode dari 40 kode tarif yang dianalisis dengan total selisih sebesar Rp 285.236.521,00 dimana pihak rumah sakit mengalami defisit. 

The number of pharyngeal cancer cases in Indonesia continues to increase while the costs required for cancer treatment are quite high. However, there is already a system from the Indonesian government that helps pay for health services based on Indonesia Case Base Groups (INA-CBGs) package rates. However, in several studies, differences were still found in hospital rates and the specified INA-CBGs package rates. So, it is necessary to compare direct medical costs with the INA-CBGs package rates, especially for pharynx cancer. Therefore, research was conducted with the aim of finding out the total and details of direct medical costs for treatment and knowing the difference between direct medical costs and the INA-CBG package rates for pharyngeal cancer patients at the Central General Hospital (RSUP) Dr. Sardjito.

The research method used is a descriptive quantitative method with data taken in the form of retrospective secondary data from the billing archives of the Central General Hospital (RSUP) Dr. Sardjito and claims data with INA-CBGs rates. This study took a sample of 70 patients who met the study inclusion and exclusion criteria. The data is then analyzed by calculating the average costs for direct medical costs of therapy, both for each component and as a whole. Apart from that, data analysis was also carried out using the Shapiro-Wilk and Kolmogorov-Smirnov normality tests as well as different tests in the form of independent sample t-test and Mann-Whitney U test to determine whether there were significant differences between hospital rates and INA-CBG's rates.

Based on this method, it was concluded that the total cost of therapy for pharyngeal cancer patients based on a hospital perspective was IDR 2,252,562,484.00 from 1735 visits, so the average per episode was IDR 1,309,587.10 ± 3,027,982.63. There is no significant difference in the average cost of INA-CBG tariffs with hospital tariffs in 25 codes and there is a significant difference in 15 codes out of 40 tariff codes analyzed with a total difference of IDR 285,236,521.00 where the hospital is experiencing a deficit. 

Kata Kunci : biaya medis langsung, kanker faring, INA-CBGs