Determinants of Cost Differences Between Indonesian- Case Based Groups Tariff and Hospital Tariff for Stroke Patients: A Path Analysis Evidence from UNS Teaching Hospital Sukoharjo, Central Java

Dewi Wulandari, Dono Indarto, Didik Tamtomo


Background: In the scheme of the National Health Insurance System, the hospital must adapt to the newer financial system by regularly doing quality and cost assurance. Stroke, a catastrophic disease, has a high financial impact on hospital cost. This study aimed to examine the determinants of cost differences between Indonesian Case-Based Groups (INA-CBGs) dan hospital tariff for stroke patients in UNS Teaching Hospital, Sukoharjo.

Subjects and Method: An analytic observation was performed in this study from April to May 2019 by with used the cross-sectional design. Recruitment of 113 stroke patients was determined using a fixed disease sampling. The dependent variable was the cost difference. The independent variables were the length of stay, intensive care use, medicine tariff, severity level, and type of class treatment. The data were obtained from the hospital medical record and analyzed by path analysis.

Results: Medicine tariff was the strongest factor that influenced the difference of tariff (r=-0.65; p<0.001). Medicine tariff (b= -3.57; 95% CI= -4.34 to -2.80; p<0.001) and type of class treatment (b= 1508.70; 95% CI= 247.54 to 2769.87; p= 0.019) were directly influenced the difference of tariff. Length of stay (b= 122.18; 95% CI= 89.52 to 154.84; p<0.001), intensive care use (b= 1161.50; 95% CI= 844.01 to 1478.99; p<0.001), severity level (b= 375.58; 95% CI= 143.27 to 607.90; p= 0.002) positively influenced the difference of tariff through medicine tariff. Severity level also influenced medicine tariff (b=375.58), length of stay (b=1.55), and intensive care use (b=0.16).

Conclusion: The UNS Hospital cost for stroke patients exceeds the INA-CBGs tariff, which is influenced by medicine tariff and intensive care use.

Keywords: INA-CBG’s tariff, hospital tariff, stroke, UNS teaching hospital.

Correspondence: Dewi Wulandari. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: 085335705757.

Journal of Health Policy and Management (2019), 4(3): 176-181

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