Comparison Analysis of Rates by Unit Cost and INA-CBGs Rates in Hemodialysis Services at Hospital X

Abstract

Hemodialysis is a method of kidney replacement treatment in patients with chronic kidney failure. This treatment is carried out routinely with a frequency of 2-3 times a week. This study aims to develop a pattern of hemodialysis rates based on unit cost calculations using the Activity-based Costing (ABC) method and analyze differences with INA-CBGs rates at X Hospital. This study used a quantitative method with a descriptive-analytical research design, which carried out hemodialysis unit cost analysis based on an Activity-based Costing approach, as well as a comparative study to analyze differences in hemodialysis unit costs and INA-CBGs rates. Sampling in this study used a purposive sampling method with a total sample of 118 hemodialysis measures in December 2021. The data sources used were primary data and secondary data. Data collection used interview and observation methods. The unit cost calculation was carried out using the ABC method, and the different test was carried out using the Wilcoxon Match-Pairs Test. The results showed that the unit cost for hemodialysis services using the ABC method was Rp. 927,554.95. This result is higher than the INA-CBGs rate of Rp. 879,100, - with a negative difference of Rp. 48,454.95 or 5.5% of the INA-CBGs rate for 1 hemodialysis action and Rp. 729,198,542.55 for all hemodialysis actions during 2021. The results of the different tests obtained a p-value lower than 0.05, so that H0 was rejected, and it was concluded that there is a significant difference between hemodialysis rates based on unit cost and INA-CBGs rates. The determinants of the difference in tariffs are the difference in the method of calculation, the amount of employee salary costs, the difference in rates for doctors’ services, the use of consumables, medicines, and supporting examinations, as well as the policy on the use of dialyzer reuse.