Cost Analysis of Therapy of Chronic Kidney Disease Inpatient In Indonesia

Abstract

Impaired kidney function is one of the main public health problems in Indonesia. In the era of National Health Insurance (JKN) health financing at Advanced Level Referral Facilities (FKRTL) used the Indonesian Case Based Group (INA-CBGs) rate, but hospital costs were often higher than the costs of INA-CBGs. This study aims to determine the difference in costs. in real terms with INA-CBGs rates for hospitalization in Indonesia. This study used a cross-sectional analytic study design with a hospital perspective. Collecting data using a retrospective method with data collection in the form of medical records of patients with chronic kidney failure on hemodialysis and data on patient treatment costs. The study was conducted in regional I and regional III, each region represented by class A, B, and private hospitals so that a total of 6 hospitals were involved in this study. The data is presented descriptively. The difference between the real cost and the cost of INA-CBGs using the Mann-Whitney test SPSS analysis. The results showed that the average real cost in class A hospitals was higher than the average real cost in class B and private class hospitals. Of the 6 hospitals studied, 5 hospitals showed that the total real cost for treating chronic kidney disease in Indonesia was still higher than the INA-CBGs rates. The highest average real cost for hospitals in regional 1 is in class A hospitals with a value of up to Rp. 13,709,812 per patient/year, these costs are in accordance with the INA-CBGs rates. Meanwhile in regional 3, the highest average real cost of Rp. 33,000,450 patients/year is in a class A hospital. This cost is much higher than the INA-CBGs rate. The results of statistical tests showed that there was a significant difference between the average real cost and the INA-CBGs tariff (p=0.000). The total difference caused is Rp. 13,851,798 so that it becomes a loss and a burden for the hospital.