Perbandingan biaya rawat inap pasien gakin antara tarif paket askes dengan unit cost di RSUD Tani dan Nelayan Kabupaten Boalemo

JAMAL, M, drg. Julita Hendrartini, M.Kes

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Tarif rumah sakit selayaknya diperhitungkan atas dasar unit cost, kemampuan ekonomi masyarakat, tarif rumah sakit setempat lainnya, serta kebijakan subsidi silang dengan tujuan menjadi titik temu demand and supply. Bagi keluarga miskin, biaya pelayanan kesehatan ditanggung pemerintah melalui PT. Askes dengan hak memperoleh pelayanan rawat inap kelas III di rumah sakit. Tarif yang dibayarkan oleh PT. Askes kepada rumah sakit adalah tarif paket. Tujuan: Untuk mengetahui unit cost rawat inap kelas III di RSUD Tani dan Nelayan dan kemudian membandingkan dengan tarif paket Askes. Metode Penelitian: Penelitian ini adalah studi kasus dengan jenis penelitian deskriptif. Objek penelitian adalah tarif paket Askes rawat inap kelas III, catatan administrasi operasional rumah sakit termasuk catatan keuangan serta anggaran Pemda untuk RSUD Tani dan Nelayan. Unit analisis penelitian ini adalah rawat inap kelas III RSUD Tani dan Nelayan. Sedangkan variabel penelitian adalah tarif paket Askes dan unit cost . Unit Cost dihitung dengan menggunakan metode double distribution. Data yang diambil adalah 1 tahun anggaran dari bulan Januari sampai Desember 2007. Data tersebut dianalisis untuk dijadikan perbandingan dengan tarif paket Askeskin. Hasil Penelitian: Unit cost rawat inap kelas III non bedah adalah sebesar Rp 198.933, isolasi Rp 430.581 dan bedah Rp 437.442. Sedangkan unit cost tanpa memperhitungkan biaya investasi, gaji dan insentif pegawai adalah: non bedah Rp 32.791, isolasi Rp 72.618 dan bedah Rp 61.623. Jika rerata unit cost ideal rawat inap kelas III dibandingkan dengan tarif paket Askes, maka selisihnya Rp 18.939 per orang per hari. Sehingga subsidi Pemda untuk menutupi selisih tersebut sebesar Rp 44.127.870 selama setahun. Kesimpulan: Unit cost rawat inap kelas III lebih tinggi 31,57% dari tarif paket Askes.

Background: Hospital tariff should be based on unit cost, economic ability of the community, tariff of nearby hospitals and the policy of cross subsidy for the purpose to find an equilibrium between supply and demand. The cost of health service for poor families is supported by the government through PT. Askes with the right to get inpatient service of class III in hospitals. Objective: To identify the amount of unit cost of inpatient class III in Tani and Nelayan Hospital and compare the cost with tariff of Askes package. Method: This was a descriptive case study. Object of the study were tariff of Askes package of inpatient class III, administrative records of hospitals operation including financial records and the total government budget for Tani and Nelayan Hospital. Analysis unit of the study was inpatient class III of Tani and Nelayan Hospital and the research variables were tariff of Askes package and unit cost. Calculation of unit cost was based on double distribution method. Data collected included one fiscal year, from January to December 2007. The data were analyzed to be compared to tariff of Askeskin package. Result: Unit cost of inpatient class III non surgery was Rp 198,933, isolation was Rp 430,581, and surgery was Rp 437,442, whereas unit cost ignoring cost of investment, salaries and incentives for staff for non surgery was Rp 32,791, isolation Rp 72,681 and surgery Rp 61,623. If average ideal unit cost of inpatient class III was compared to tariff of Askes package, the difference was Rp 18,939 per person/day; therefore the local government gave the subsidy as much as Rp 44,127,870 a year. Conclusion: Unit cost of inpatient class III was 31,57% higher than tariff of Askes package.

Kata Kunci : Tarif paket,Rawat inap,Gakin,Askeskin,Unit cost,double distribution,package tariff,inpatient,poor families