Evaluasi biaya pelayanan rawat inap kamar utama (VIP) Rumah Sakit Umum Daerah Dr. Aloei Saboe Gorontalo

ASWAD, Ahmad, Drs. John Suprihanto, MIM.,Ph.D

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Rumah Sakit Dr Aloei Saboe Gorontalo adalah Rumah Sakit milik pemerintah daerah Kota Gorontalo yang telah berubah menjadi tipe B tahun 2008. Pengembangan Kamar utama (VIP) perlu dilakukan mengingat pangsa pasar yang tersedia yaitu masyarakat ekonomi menengah keatas 39% (data statistik 2007) dan pendapatan VIP sesuai tarif perda yaitu Rp.941.435.725 (Januari-Desember 2007) dengan BOR 94,9%. Setiap hari terdapat 5-11 pasien antri menunggu untuk mendapatkan kamar utama antara 3-7 hari. Data keuangan rumah sakit tahun 2007, biaya operasional termasuk gaji PNS tahun 2007 sebesar 34 milyar sedangkan pendapatan Rumah sakit selama tahun 2007 hanya 18 milyar. Tujuan: Untuk mendeskripsikan proses perhitungan biaya dan penetapan tarif, untuk menghitung besaran biaya langsung aktivitas dan biaya tidak langsung aktivitas rawat inap kamar utama dan Untuk mengusulkan tarif rawat inap kamar utama (VIP) RSUD Dr Aloei Saboe Gorontalo. Metode: Jenis penelitian deskriptif dengan metode Activity Based Costing (ABC), data dalam bentuk kuantitatif. Subjek penelitian adalah anggota tim kelompok kerja (pokja) penyusun tarif pada badan pengelolah RSUD Dr Aloei Saboe, dan objek penelitian adalah biaya langsung aktivitas dan biaya tidak langsung aktivitas ruang rawat inap kamar utama serta biaya penunjang lainnya. Hasil dan pembahasan: Biaya langsung aktivitas kamar utama adalah sebesar Rp.702.455.008 dan biaya tidak langsung aktivitas kamar utama adalah Rp.57.319.324 serta total biaya pelayanan kamar utama sebesar Rp. 759.744.322. Jumlah unit cost kamar utama perhari adalah Rp. 157.000. Setelah menghitung unit cost dan ditambah jasa pelayanan, maka tarif kamar utama adalah VIP B Rp. 213.520, VIP A Rp. 247.839 dan VIP Khusus Rp. 309.520. bila biaya pengembangan SDM dan biaya pembinaan dimasukkan maka tarifnya akan naik menjadi VIP B Rp. 226.331, VIP A Rp. 262.709 dan VIP Khusus Rp. 328.091. Kesimpulan dan saran: Penetapan tarif rumah sakit belum menghitung unit cost tapi melihat tarif rumah sakit sekitar sehingga terdapat kesenjangan biaya operasional dan pendapatan rumah sakit. Untuk menyesuaikan tarif berdasarkan unit cost dan meningkatkan pendapatan, rumah sakit perlu menambah kamar utama (VIP) dan untuk memaksimalkan pendapatan perlu menghitung unit cost disetiap departemen produksi

Background: Dr. Aloei Saboe Hospital is owned by local government of Gorontalo Municipality and has become hospital of type B since 2008. The development of VIP room needs to be made considering the prospective market, i.e. upper middle class people as much as 39% (statistical data of 2007) and VIP income based on local regulation tariff, i.e. Rp 941,435,725 (January – December 2007) with bed occupancy rate as much as 93.9%. Every day as many as 5–11 patients wait for 3 – 7 days to get VIP room. According to financial data of the hospital 2007 the amount of operational cost including salary in 2007 was 34 billion rupiahs whereas hospital revenue in 2007 was only 18 billion rupiahs. Objective: To describe the process of cost calculation and tariff specification in order to be able to calculate activity direct and indirect cost of VIP inpatient service and propose tariff of VIP inpatient service at Dr. Aloei Saboe of Gorontalo. Method: The study was descriptive and used activity based costing (ABC) design and quantitative data. Subject of the study were task force of tariff proposition of Prof. dr. H. Aloei Saboe Hospital. Object of the study were both activity direct and indirect cost of VIP inpatient service as well as other supporting. Result and discussion: The activity direct cost of VIP room was Rp 601,668,769 and the activity indirect cost of VIP room was Rp 159,626,328 and the total cost of inpatient service was Rp 761,295,097. The amount of unit cost of VIP inpatient room was Rp 157,000. After the calculation of unit cost and fee of medical service, the tariff specified for VIP room type B was Rp 213,520, type A was Rp 247,839 and VIP special room was Rp 309,520. When the cost of human resources development and supervision was included the tariff was Rp 226,331 for VIP inpatient room type B, Rp 262,709 for VIP inpatient room type A and Rp 328,091 for VIP special room. Conclusion and Suggestion: The amount of unit cost wich be calculated was more high than the accomodation cost of primary (VIP) inpatient room, for those, each of support service unit and production need to identify and recording all of the activity, so the cost containment be transparent. This calculation be hospital proposal to Regional Government and Regional Public Representative Board, so its need to considering the cost of human resource development and the cost of supervision.

Kata Kunci : Perhitungan biaya,Activity based costing (ABC),Unit cost,Rawat inap,Tarif,cost analysis, activity based costing (ABC), unit cost, tariff, inpatient