Penelitian ini mengkaji analisis capaian casemix dan casemix index rawat inap di Rumah Sakit Kelas B Grup Primaya Hospital. Data dikumpulkan dari lima rumah sakit (PH1-PH5) dalam kelompok Primaya Hospital. Penelitian mengevaluasi sumber daya manusia, anggaran, material, metode, dan proses terkait capaian casemix dan casemix index. Hasil penelitian menunjukkan bahwa implementasi clinical pathways (PPK-CP) di PH1, PH2, PH3, dan PH5 efektif dalam meningkatkan standar klinis dan efisiensi operasional. Kelengkapan rekam medis di PH1 tertinggi (93.3%) dibandingkan dengan PH lainnya. Meskipun demikian, tingkat klaim tertunda masih menjadi tantangan, terutama di PH4. Ketepatan koding di PH5 terbaik dengan hanya 14.6% data klaim yang tertunda. Verifikasi klaim di PH1 mencapai 98.2%, menunjukkan kualitas pengajuan klaim yang baik. Hasil penelitian ini memberikan wawasan tentang hubungan antara input, proses, dan output dalam manajemen capaian casemix dan casemix index di rumah sakit tersebut. Implikasi dari temuan ini berpotensi untuk merumuskan strategi korporasi yang efektif dalam meningkatkan kualitas layanan dan efisiensi operasional di rumah sakit kelompok Primaya Hospital.
This research examines the analysis of casemix achievement and casemix index inpatient care at Primaya Hospital Class B. Data were collected from five hospitals (PH1-PH5) within the Primaya Hospital group. The study evaluates human resources, budgets, materials, methods, and processes related to casemix achievement and casemix index. The results show that the implementation of clinical pathways (PPK-CP) in PH1, PH2, PH3, and PH5 is effective in improving clinical standards and operational efficiency. The completeness of medical records in PH1 is the highest (93.3%) compared to other hospitals. However, the level of delayed claims remains a challenge, especially in PH4. Coding accuracy in PH5 is the best with only 14.6% of delayed claim data. Claim verification in PH1 reaches 98.2%, indicating good quality of claim submission. The findings provide insights into the relationship between inputs, processes, and outputs in managing casemix achievement and casemix index at these hospitals. The implications of these findings have the potential to formulate effective corporate strategies to improve service quality and operational efficiency in Primaya Hospital group.
Yofen Dhamigus - Tesis-FKM-Full Text-2024.pdf ::