Background: Dengue Hemorrhagic Fever (DHF) has a high cost burden. Payment for hospital treatment was paid by Health insurance (BPJS) with a case based payment method in the era of the National Health Insurance. This method allowed the hospital to gain profit or loss. This study aimed to analyze the factors that influence the differences in Indonesian Cased Based Groups (INA CBGs) with the medical service costs for DHF in Dr. Soeroto hospitals, Ngawi Regency. Subjects and Method:This study used an observational analytic study with a cross-sectional approach conducted at Dr. Soeroto Hospital, Ngawi Regency, East Java in September -October 2019. A sample of 200 subjects was selected by using simple random sampling. The dependent variable was the difference in rate. The independent variables were class of care, length of stay, age, blood transfusion, comorbidity and complications. Data analysis was using multiple linear regression with Stata 13.Results: INA CBG rates (mean= Rp 6,120,000; SD= Rp 2,330,000) was lower than the cost of hospital treatment (mean= Rp 7,070,000; SD= Rp 4,650,000). There is a negative relationship between the difference in rates and it was statistically significant on the length of stay (b= 0.73; 95% CI= -1,131,915 to -329,501; p= <0.001), patients' age (b= 0.41; 95% CI= -707,099 to -110,293; p= 0.008), blood transfusion action (b= 0.79; 95% 549,190; p= 0.041), and comorbidity (b= 1.14 ; 95% CI= -1,817,112 to -474,641; p= 0.001). While there was a statistically insignificant relationship between classes of care (b= 0.42; 95% CI = -931,443 to 82,607; p= 0.100) and complication (b= 0.34; 95% CI= -1,093,208 to 408,223; p= 0.369). Conclusion:Difference in INA CBG rates and hospital medical service costs were affected by the class of care, length of stay, age, blood transfusion, comorbidity and complications.

Background: Hospitals are demanded to be more efficient and effective in providing medical services to avoid losses in the era of National Health Insurance. The increase in cases of dengue hemorrhagic fever (DHF) is a burden on the cost of medical services in Indonesia. This study aimed to examine the determinants of hospital lost under Indonesia Case-Based Groups (INA-CBGs) reimbursement for patients with dengue hemorrhagic fever (DHF). Subjects and Method: A cross-sectional study was carried out at dr. Soeroto hospital, Ngawi, East Java, from September to October 2019. A sample of 200 in-patients was selected by simple random sampling. The dependent variable was tariff difference between INA-CBGs and hospital cost. The independent variables were class of treatment, length of stay, blood transfusion, co-morbidity, and complication. The data were obtained from DHF in-patients’ medical record. The data were analyzed by path analysis model run on Stata 13. Results: Tariff difference was directly and positively affected by length of stay (b= 2.77; 95% CI= 1.78 to 3.75; p<0.001), blood transfusion (b= 2.95; 95% CI= 0.36 to 5.54; p= 0.025), patients age (b= 0.09; 95% CI= -1.52 to 1.71; p= 0.907), co-morbidity (b= 0.58; 95% CI= -1.07 to 2.22; p= 0.491), and complication (b= 0.34; 95% CI= -1.69 to 2.36; p= 0.743). Tariff difference was directly and negatively affected by type of treatment (b= -0.81; 95% CI= -2.02 to 0.40; p= 0.191). Tariff difference was indirectly affected by co-morbidity, complication, class of treatment, and patient age. Conclusion: Tariff difference is directly and positively affected by length of stay, blood transfusion, patient age, co-morbidity, and complication. Tariff difference is directly and negatively affected by type of treatment. Tariff difference is indirectly affected by co-morbidity, complication, class of treatment, and patient age. Keywords: INA CBGs, hospital tariff, care cost, dengue hemorrhagic fever Correspondence: Betty Nurizky Ariwardani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: bettyna175@-gmail.com. Mobile: 082233243164. DOI: https://doi.org/10.26911/the7thicph.04.35