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