ANALISIS BIAYA DAN KESESUAIAN DENGAN KLAIM INA-CBGS PENYAKIT KANKER PARU DENGAN PROSEDUR KEMOTERAPI PASIEN JKN RAWAT INAP DI RSUD Dr. MOEWARDI SURAKARTA PERIODE 2015
Abstract
Lung cancer is cancer with the highest prevalence in Indonesia especially in male
population. Ever since the Rates program which applied in National Health
Assurance program (JKN) refers to the Indonesian-Case Base Group system (INACBGs). Health care providers find the cost of INA-CBGs‟s claims given by the
government is still lower than the real cost of treatment. The study aims to determine
the difference between the real cost and INA-CBGs‟s claims costs in the treatment of
lung cancer patients hospitalized at Dr. Moewardi Hospital Surakarta with
chemotherapy treatment during 2015 period JKN program. The study was
observational with cross sectional design. Data were collected retrospectively from
medical records and cost data of JKN treatment of lung cancer patients with
chemotherapy treatment at Dr.Moewardi Hospital Surakarta in 2015 period whom
met the inclusion criteria. The average real cost were analyzed and compared with the
basic rate of INA-CBGS that has been added to the cost of chemotherapy drugs based
on the e-catalogs price in 2015. Statistics analysis was carried out using Independent
Sample T-test in normally distributed data and the Mann-Whitney test on not
normally distributed data. Chemotherapy regimens which used by most lung cancer
patients are Paclitaxel-Carboplatin with a percentage of 29.55%. The largest direct
medical average cost of hospitalized JKN participating patients with lung cancer
whom underwent chemotherapy procedures are in treatment class II with heavy
severity (C-4-13-III), which was Rp. 9,275,687 ± 3,931,156. The results of the
analysis which is statistics, showing that in every classes of treatment and severity of
hospitalized lung cancer patients there are no significant difference between the real
cost and claim‟s cost, except in class III treatment with moderate severity (C-4-13-II)
there is a significant difference between the real cost and claim‟s cost
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