Analisis Biaya Pasien yang Menjalani Pengobatan Ablasi Radiofrekuensi Denervasi Sendi Faset di RSUP Dr Sardjito

GALANG MARTIN ADITYO, dr. Calcarina Fitriani R. W., SpAn-TI, Subsp.TI(K); Dr. Diah Ayu Puspandari, Apt, M.Kes, MBA; dr. Mahmud, MSc, SpAn-TI, Subsp.M.N(K), FIPM

2024 | Tesis-Spesialis | S2 Anestesiologi

Latar Belakang: Nyeri tulang belakang merupakan penyebab utama masalah nyeri
kronis dengan prevalensi nyeri di daerah servikal (44%), dengan regio lumbar (56%), dan
regio thorakal (15%). Teknik intervensi ablasi radiofrekuensi sendi faset merupakan
salah satu pilihan utama dalam menangani nyeri tulang belakang tersebut. Analisis biaya
mengenai tindakan intervensi sendi faset masih belum diteliti di Indonesia khususnya
pada evaluasi dengan sistem pembiayaan Jaminan Kesehatan Nasional (BPJS).

Tujuan: Mengetahui analisis biaya menggunakan metode time driven activity based
costing (TDABC) tindakan ablasi radiofrekuensi sendi faset pada tahun 2022 di RSUP
Dr. Sardjito terhadap sistem pembiayaan BPJS.

Metode Penelitian: Rancangan penelitian dengan metode studi deskriptif analisis
dengan menerapkan langkah-langkah analisis time driven activity based costing
(TDABC). Data yang terkumpul dilakukan analisis menggunakan tools TDABC oleh
pusat KPMAK FKKMK UGM. Analisis pembiayaan dibandingkan dengan BPJS
menggunakan analisis cost recovery rate di RSUP Dr. Sardjito.

Hasil: Total layanan intervensi nyeri sendi faset pada tahun 2022 dengan sistem jaminan
BPJS sebanyak 24 kunjungan. Analisis biaya menggunakan metode TDABC didapatkan
hasil total biaya unit tindakan ablasi radiofrekuensi denervasi sendi faset sebesar Rp
8.096.834,93/pasien dengan total alokasi biaya kapasitas personil Rp 2.374.166/pasien
(29,4%) total alokasi biaya ruangan Rp 2.409.837/pasien (30%) total alokasi biaya tidak
langsung sebesar Rp 927.380/pasien (11,1%) dan total alokasi biaya kapasitas obat &
barang habis pakai adalah sebesar Rp 2.385.452/pasien (29,5%). Hasil perhitungan cost
recovery rate didapatkan sebesar 107,99% setiap pasien pada perbandingan dengan
sistem pembiayaan jaminan BPJS (Rp 8.774.050).

Kesimpulan: Analisis biaya menggunakan metode TDABC mampu memberikan
kerangka biaya produksi yang lebih detail dan efektif dalam merancang model inovasi
dan pengembangan produk atau layanan. Evaluasi berkala serta sistem pencatatan data
yang diperlukan dalam analisis biaya dengan metode TDABC diharapkan dapat
diimplementasikan oleh pihak penyedia jasa maupun stakeholder serta pihak pemberi
jaminan khususnya pada era sistem Jaminan Nasional yang bersifat universal health
coverage.

Background: Facet joint pain caused almost 60% incidence of chronic back pain with
the prevalence of pain in the cervical area (44%), the lumbar area (56%), and the thoracic
area (15%). The radiofrequency facet joint denervation technique is standard treatment
of facet joint pain. Cost analysis regarding radiofrequency facet joint denervation service
has not yet been studied in Indonesia, especially in evaluations with the National Health
Insurance (BPJS) financing system.

Objective: To determine the cost analysis using the time driven activity based costing
(TDABC) method for radiofrequency ablation of facet joints service at RSUP Dr. Sardjito
regarding the BPJS financing system.

Methods: The research design used a descriptive analysis study by applying time driven
activity based costing (TDABC) analysis steps. The collected data was analyzed using
TDABC tools by the Center for Health Financing Policy and Health Insurance
Management FKKMK UGM center. Cost recovery rate analysis was used to compare
total cost obtained with BPJS.

Results: The total number of facet joint denervation services in 2022 with the BPJS were
24 visits. Cost analysis using the TDABC method showed that the total unit cost of
radiofrequency ablation facet joint denervation service was IDR 8,096,834.93/patient
with capacity cost rates (CCR) were IDR 2,374,166/patient (29.4%) for personnel, IDR
2,409. 837/patient (30%) for resources, IDR 927,380/patient (11.1%) for indirect cost
and IDR 2,385,452/patient (29.5%) for medical consumables. The cost recovery rate
(CRR) calculation were found to be 107.99% per patient when compared with the BPJS
(total claim IDR 8,774,050).

Conclusions: Cost analysis using the TDABC method is able to provide a more detailed
and effective production cost framework. Periodic evaluation and data recording system
required for cost analysis using the TDABC method can be implemented by service
providers and stakeholders as well as insurance providers, especially in the era of the
national insurance system (BPJS)

Kata Kunci : Time Driven Activity Based Costing, Denervasi Sendi Faset, Analisis Biaya, BPJS