Abstrak:

DBD merupakan penyakit menular, dapat menyerang semua orang, rnengakibatkan kematian, serta sering menimbulkan wabah. DBD menunjukkan beban ekonomi signifikan pada masyarakat yang terkena. Tujuan penelitian ini diperolehnya informasi tentang biaya per DRG's berdasarkan Clinical Pathway pada penderita DBD yang dirawat inap di RSU Dr. Soedarso Pontianak tahun 2005. Jenis penelitian kuantitatif dengan desain survei. Data dikumpulkan dari biaya-biaya yang dikeluarkan oleh penderita DBD yang di rawat inap di RSU Dokter Soedarso bulan Januari sampai Desember 2005. Penelitian dilaksanakan bulan Februari-Juni 2006, menggunakan data sekunder dan rekam medis pasien rawat inap DBD dan unit penunjang serta data primer dari wawancara dengan dokter, perawat, kepala ruangan dan kepala rekam medis tentang penatalaksanaan DBD. Unit cost dihitung berdasarkan direct cost dengan Activity Based Costing dan indirect cost dengan simple distribution. Variabel yang mempengaruhi penetapan DRG's DBD di RSU Dr. Soedarso Pontianak tahun 2005 antara lain: karakteristik pasien: jenis kelamin, diagnosa utama, penyakit penyerta dan penyulit, lama hari rawat dan pemanfaatan utilisasi. Clinical Pathway DBD yang di rawat inap di RSU Dr. Soedarso Pontianak tahun 2005 terdiri dari tahapan berikut : I. Pendaftaran, II. Penegakan Diagnosa: tindakan oleh perawat, dokter, pemeriksaan penunjang, penegakan diagnosa utama, terapi dokter, pendaftaran rawat inap, III. Terapi: visite dokter, pemeriksaan penunjang, penegakan DBD berdasarkan casemix, penentuan terapi (dokter), asuhan keperawatan, penggunaan alat kesehatan habis pakai, obat-obatan dan akomodasi serta IV. Pulang. Rata-rata lama hari inap dan biaya DBD berdasarkan DRG's (T63B) di RSU. Dr. Soedarso Pontianak Tahun 2005 adalah: DBD Murni 4,01 hari, biaya Rp.565.948,- - Rp.2.471.298,-. DBD dengan penyerta 4,46 hari, biaya Rp.572.692,- - Rp.2.740.687,- DBD dengan penyulit 4,82 hari, biaya Rp.652.352,- - Rp.3.256.826,-. DBD dengan penyakit penyerta dan penyulit 5 hari, biaya Rp.662.385,- - Rp.3.467.237,-. Sampel pada DBD dengan penyakit penyerta dan penyulit hanya 2 orang (1,65%) sehingga lama hari rawat inap dan biaya kurang bervariasi. Rumah sakit dapat melakukan penerapan DRG's secara bertahap. Perlu koordinasi lintas program antara Depkes RI, Ikatan Profesi, Asuransi, YLKI dan Rumah Sakit (Private dan Public) dalam penyusunan Clinical Pathway yang baku dan penetapan biaya berdasarkan DRG's serta akhimya tercipta Indonesian DRG's. Perlu dilakukan penelitian lebih lanjut dengan diagnosa penyakit lain dan di rumah sakit lain (private maupun public) agar perhitungan unit costIDRG's dapat digunakan sebagai alat untuk pembayaran sehingga adanya kepastian biaya yang diperlukan bagi RS, asuransi, konsumen dan pemerintah.

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DHF disease is contagious disease, could attack all people and cause death, and often cause epidemic. DHF show significant economical burden in infected society. This research aim is get the information about cost per DRG's based on Clinical Pathway of DHF patient that taken care at Dr. Soedarso General Hospital Pontianak in 2005. Research is quatitative with survey design. Data gathered from costs that spend by dengue haemorrhagic fever patient that taken care in Dr. Soedarso General Hospital from January to December 2005. Research done in February - June 2006, using secondary data from DHF inpatient medical record and supportive units and also primary data from interview with doctors, nurses, Hall Chief and Medical Record Chief toward dengue haemorrhagic fever menagery. Unit cost count based on direct cost by Activity Based Costing and indirect cost by simple distribution. Variables that affect DRG's DHF in Dr. Soedarso General Hospital Pontianak year 2005 such as: patient characteristics: sex, main diagnose, commorbidity and commortality disease (casemix), length of stay and utilization used. DHF's Clinical Pathway in Dr. Soedarso General Hospital Pontianak year 2005 consists of: I. Registration, IL Diagnose Straightening: action of nurse, doctor, supportive examiner, main diagnose straightening, doctor therapy, inpatient registration, III. Therapy: Visit Doctor, supportive examiner, DHF diagnose straightening with casemix, therapy determining (doctor), nursing education, after use health tools using, medication and accommodation and also 1V. Returning Home. Inpatient length of stay mean and DHF cost based DRG's (T63B) in Dr. Soedarso General Hospital Pontianak year 2005 are: Pure DHF is 4,01 days, with inpatient cost mean between Rp. 565.948,- to Rp. 2.471.298,-. DHF with commorbidity disease is 4,46 days. Inpatient cost mean between Rp. 572.692,- to Rp. 2.740.687,-. DHF with complicated disease is 4,82 days. Inpatient cost mean between Rp.652.352,- to Rp.3.256.826,-. DHF with casemix is 5 days. Inpatient cost between Rp.662.385,- to Rp.3.467.237,-. Sample on DHF with casemix only two people (1,65%) with the result that inpatient length of stay and cost less varying. Hospital can do DRG's implementation step by step especially in inpatient cases that often handled. Need cross program coordination between Depkes RI, Profession Band, Assurance, YLKI and Hospital (Private and Public) in arranging basic Clinical Pathway and cost determining based on condition in Indonesia and finally created Indonesian DRG's. Important to do the other research with other diagnostic and other hospitals (private and public) so unit costlDRG's can be used became tools to payment system So that cost certainty needed for hospitals, assurance, consumer and government created.

Abstrak: Reimbursement policy for DBD by Health Office Of DKI Jakarta Province, on be half Indonesian Government, on 17 State Hospitals has implication on delay of hospital cash inflow. At Pasar Rebo Hospital, from total amount of account receivable didn?t paid completely by Health Office Of DKI Jakarta Province. This payment lateness affect to hospital loss out, especially for financial capital which related with account receivables, in turn will be affect to cash inflow smoothness This research is quantitative and qualitative study, aimed to know number of account receivables distinction for DBD patient?s expenses and amount of opportunity cost from payment lateness of patient account receivable as effect from government reimbursement policy to Pasar Rebo Hospital and see how hospital manage this issue. The result of this research shows that policy from Health Office Of DKI Jakarta Province on manages the payment for DBD patient based-on decision of Governor DKI Jakarta no. 446/2005. Unfortunately, the policy did not followed by regulation to define time limit for reimbursement completion time of account receivables claim, so there is anticipation action if delay is happen. In other hand, at Pasar Rebo Hospital has no own policy on service regulation for DHF patients, just refer to regulation that released by Health Office Of DKI Jakarta Province. Longer time needed to complete account receivable claim payment affect to changes of value of money. The account receivables value changes observed through perspective of time value of money, where in this concept interest of bank?s loan is important factor. In this study, where number of interest which used for calculation is 14 % p.a, found that from total claim of DHF patient?s account receivable Rp. 389,547,330,- there is an opportunity cost Rp.31,409,925 or equal to 8.06 % From the study knew that due to the lateness of DHF patient?s account receivables reimbursement by Health Office Of DKI Jakarta Province to Pasar Rebo Hospital there is 84.51 % that still not paid from total claim, so for operational cost hospital must re-budgeting their spent for not disturb their cash flow and suggested to make a standard time requirement to complete claim payment since sent claim report until receive claim payment. The result of this study expected can be use for Pasar Rebo Hospital as an input for management, especially department that related to account receivable management.
References : 28 (1977 - 2005)

Abstrak: Diabetes Mellitus tipe 2 merupakan penyakit kronis yang dalam penatalaksanaan penyakit tersebut memerlukan biaya yang besar karena pengobatan dilakukan secara intensif dan berlangsung terus menerus seumur hidup. Penelitian ini bertujuan untuk menganalisis biaya per episode pengobatan rawat jalan penyakit DM tipe 2 dan faktor-faktor yang berhubungan dengan biaya tersebut berdasarkan perspektif RSUD Pasar Rebo pada tahun 2015. Penelitian ini merupakan penelitian analitik deskriptif degan rancangan penelitian cross sectional. Hasil penelitian menunjukkan total biaya pengobatan rawat jalan penyakit DM Tipe 2 selama setahun adalah sebesar Rp. 593.839.605, rata-rata biaya per episode pengobatan rawat jalan penyakit DM Tipe 2 di RSUD Pasar pada tahun 2015 adalah Rp 417.131 dan ada hubungan yang signifikan antara rata-rata biaya per episode pengobatan rawat jalan penyakit DM tipe 2 dengan umur, lama berobat dan jumlah komplikasi. Rata-rata pembayaran BPJS Kesehatan per episode pengobatan rawat jalan penyakit DM Tipe 2 di RSUD Pasar pada tahun 2015 adalah Rp 208.260. Dengan demikian, rata-rata pembayaran BPJS Kesehatan per episode pengobatan rawat jalan penyakit DM Tipe 2 lebih rendah dibandingkan biaya RSUD Pasar Rebo pada tahun 2015. Kata kunci : Biaya pengobatan rawat jalan penyakit DM tipe 2, COI DM tipe 2, penyakit kronis

Abstrak: POSTGRADUATE PROGRAM PUBLIC HEALTH SCIENCE STUDIES HEALTH ECONOMIC AND INSURANCE THESIS, August 2005 Roxanna Kuswandhani SELF-EXPENSE (OUT-OF-POCKET) VARIATION DETERMINANT OF IN-PATIENT SERVICES FOR COMPULSORY HEALTH INSURANCE MEMBERS IN CILEGON GENERAL HOSPITAL IN 2004 xv + 77 pages + 12 tables + 1 appendix ABSTRACT Based on the Government Regulation No. 69/91, PT (Persero) Askes is permitted to charge cost sharing to health insurance (Askes) members. The mistake in financing system implemented is that all premiums are carried on by the members. However, in practice, guarantees provided for the members are emphasized more on medical treatment and recovery by charging quite lots of cost sharing, though the services are delivered in Health Service Provider (PPK) net appointed. Consequently, civil servants still have to pay quite lots of self-expense (out-of-pocket). This causes chronic problem for social health insurance in Indonesia, which lead to complaints and blasphemies. Cilegon General Hospital implements health service tariff based on Cilegon Administrative Regulation. The tariff is higher than tariff packet released by PT (Persero) Askes based on a Joint Decree. To avoid more subsidies, compulsory health insurance members who utilize health services in the hospital have to pay by themselves (out-of-pocket) amounting the rest of health service tariff reduced by expense guaranteed by Askes plus Non-DPHO drug cost. This research was carried out in Cilegon General Hospital. The research object is Self-expense (Out-of-Pocket) Variation Determinants of In-Patient Services for Compulsory Health Insurance Members in Cilegon General Hospital in 2004. Data are from the 2004 in-patient register of compulsory health insurance members of Cilegon General Hospital, the 2004 compulsory health insurance member in-patient payment bill, at Cilegon General Hospital finance division, and the 2004 drug usage and prescription report of compulsory health insurance member in-patients of Cilegon General Hospital This research is an analytical survey using quantitative cross sectional approach. Dependent and independent variables are measured simultaneously. The result indicates that of 240 patient populations, self-expense (out-of-packet) variable has an average value of 671,719 rupiahs, with deviation standard 842,414 rupiahs and median 265,143 rupiahs. Meanwhile, the lowest self-expense (out-of-pocket) is 0 rupiahs and the highest is 5,683,925 rupiahs. Using bivariate analysis, variables related to self-expense (out-of-pocket) are age, officialdom level, education level, medical treatment pattern, medical care class choice, and length of care. The last modeling in multivariate analysis using double linear regression analysis yielded self-expense (out-of-pocket) =4.908+0.06*length of care + 0.156*local administration subsidies – 0.683*medical treatment pattern + 0.579*medical care class choice + 0.472*education 2(D3)-0.323 level (officialdom level II). It is recommended that PT Askes evaluate the determination of packet tariff and DHPO drugs periodically, disseminate medical treatment packets and medical care classes appropriate for their level/right and advocate PPK the proportional medical treatment days. It is also recommended for the next research to obtain more complete information on how much the expense for non-DHPO drugs is from respondents. It is hoped that Cilegon General Hospital provide qualified services in spite of different medical service class, upgrade their data so that they can help education, research and development of health. References: 42 (1985—2005)

Abstrak: Rumah sakit sebagai salah satu bentuk pelayanan kesehatan dituntut untuk memberikan pelayanan kesehatan dengan mum yang baik dan biaya yang dapat dijangkau oleh masyarakat. Untuk dapat memenuhi usaha di atas rumah sakit harus berkembang dan memenuhi kemajuan teknologi kedokteran yang ada.Mengingat bahwa bidang usaha perumahsakitan yang kompleks, dinamis, padat teknologi, padat modal dan padat karya, multidisiplin serta dipengaruhi oleh lingkungan yang selalu berubah, maka manajemennya juga sangat kompleks. Salah satu komponen manajemennya adalah manajemen keuangan rumah sakit, yang apabila dikelola dengan baik akan menunjang dalam pengembangan rumah sakit, dimana sasaran pokoknya adalah peningkatan pendapatan fungsional rumah sakit agar biaya operasional dan investasi dapat ditutupi (Cost recovery).Dalam manajemen keuangan rumah sakit yang perlu mendapat perhatian khusus adalah pengelolaan piutang pasien (Patient account receivable). Dengan pengelolaan piutang yang baik diharapkan terjadi pembayaran yang penuh terhadap semua pelayanan yang diberikan rumah sakit. Pos piutang dalam neraca biasanya merupakan bagian yang terpenting dari aktiva lancar dan oleh karenanya perlu mendapat perhatian yang cukup serius agar perkiraan piutang ini dapat dikelola dengan cara yang seefisien mungkin. Penelitian ini dilakukan di Rumah Sakit Pasar Rebo dari bulan Mei sampai dengan Juni 2002, bertujuan untuk mendapatkan upaya yang dapat dilakukan untuk meningkatkan efektifitas manajemen sistem piutang di RSUD Pasar Rebo. Rancangan penelitian yang digunakan adalah research operasional untuk menganalisis sitem penagihan piutang yang mempengaruhi keberhasilan penagihan piutang. Penelitian ini bersifat kualitatif dengan melakukan pengamatan langsung dan wawancara mendalam.Dari data keuangan RSUD Pasar Rebo didapat bahwa piutang pasien rawat inap terjadi setiap tahunnya sebesat 0,6 % dari total pendapatan. Piutang ini berasal dari pasien yang bayar sendiri. Pasien jaminan perusahaan dan ASKES tidak mempunyai piutang. Tetapi bila dibandingkan dengan pendapatan rawat inap piutang tersebut telah mencapai 2,5 % pada tahun 2001. Dari piutang ini yang dapat ditagih hanya sebesar 5-10 %, sisanya menjadi piutang yang tak tertagih yang secara terus menerus akan membebani keuangan rumah sakit. Dan juga mengingat perkembangan RSUD Pasar Rebo ke depan yang akan menjadi BUMD, maka perlu dilihat kembali bagaimana sistem manajemen piutang yang berlaku di rumah sakit Pasar Rebo.Dari hasil penelitian dapat disimpulkan bahwa:1.Piutang yang terjadi dibandingkan dengan biaya operasional rumah sakit sebesar 0,68 % pada tahun 2000 dan 0,64 % pada tahun 2001.2.Sistem deposit hanya untuk pasien jaminan perusahaan3.Sistem pemulangan pasien telah melewati prosedur medis dan administrasi4.Tidak tegasnya petugas dalam menarik uang muka perawatan.5.Tidak adanya bagian pra penerimaan dan penerimaan yang khusus menangani pasien rawat inap. Kegiatan ini dipegang oleh bagian informasi (front office).6.Tidak ditemukannya beberapa standard operating proceduer dari masing-masing tahapan piutang.7.Pemberitahuan jumlah tagihan pasien telah dilakukan secara periodik setiap 3 hari.8.Banyaknya tugas rangkap pada petugas yang bersifat pelayanan maupun penerimaan piutang.9.Kurangnya usaha rumah sakit untuk menagih piutang yang ada pada pasien.10.Penutupan piutang pasien berdasarkan peraturan Pemerintah Provinsi DKI.Saran yang diberikan adalah:1.Perlunya sosialisasi uang muka pada masyarakat2.Perlunya ketegasan petugas dalam menarik uang muka3.Melengkapi/membuat semua SOP pada setiap pelaksanaan tahapan piutang sebagai landasan petugas bekerja.4.Mengoptimalkan fungsi penerimaan pasien5.Pengadaan tim verifikator alamat.6.Memisahkan fungsi pelayanan dan penerimaan keuangan7.Perlunya mekanisme kontrol antara pemberi jasa dan penerima keuangan.8.Pengadaan kasir 24 jam9.Peningkatan keaktifan rumah sakit dalam menagih piutang.10.Membentuk tim khusus untuk menagih piutang dan pemberian reward pada petugas yang berhasil menagih piutang.

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Analysis of Accounts Payable Management System of Pasar Rebo District Hospital's In-Patient Department in the Year 2001Hospital is one of health services that are required to provide good quality of services within affordable price for the society. A hospital is an enterprise with characteristics of dynamic, technological based, large capital investment and requires a considerable amount of personnel, and multidiscipline. In addition, the enterprise is also highly interactive with its environment, which in result requires a highly complex management. Financial management is an essential component of hospital management and if it is properly managed will significantly contribute to the development of the hospital, with the specific focus on the effort to increase the functional income of the hospital. This increase will in turn recovers the operational and investment cost (cost recovery).In the hospital financial management, the attention should be given to patient account receivable with specific target to fulfill all charged cost of health care services received by the patient. Account receivable is the most important factor in the balance sheet; therefore it should be granted the most attention of all in terms of the efficiency of projected.This qualitative study used direct observation and in-depth interview on the success rate of the collection of account-receivable, in Pasar Reba Hospital during May - June 2002, with the design of the study is operational research in account collection's system analysis.From RSUD Pasar Rebo's financial data, it recorded that account receivable frin in-patient patients is 0.6 % from total income or if calculated from the total in-patient income is 2.5 % in the year 2001. This account receivable are source from out of pocket patient, and then is no problem from in patient from coorporate company and ASKES, because all of the service give by hospital will pay after that. From this percentage, the success ratio of collection is around 5-10%, and the rest would become un-collected account receivable. With the intention on becoming State Enterprise, these issues should get more attention.From the research's results:1. Account receivable is compare with operational budget is more than 0,68 % at 2000 and 0,64 % at 2001.2. Deposit system for corporate company patients3. Discharge system patients has done medical and administrative procedure4. Weak firmness of employee to receive down-payment for in-patient services5. There no standard operating procedure (SOP) in each steps of account collection and no pre admission and admission department6. Joint appointment in service area and financial area7. Regularly informs account receivable patient8. Little effort was conducted by the hospital to collect the account receivable.As suggestion are:1. There is a need to socialize down payment to all hospital customers and community.2. Develop necessary SOP at each step of collection.3. Optimalization admission department function.4. Separate service functions and payment receiving to simplify control.5. Develop a verificator patients address6. Establish 24 hours cashier7. Improve the hospital?s effort to collect account receivables.8. Make a special team for collect account receivable and give reward to the team by hospital if they successfully collate the account receivable.

Abstrak:

Sakit merupakan suatu kejadian yang tidal: dapat diduga kapan akan menimpa seseorang. Biaya yang harus dikeluarkan juga cukup bcsar khususnya untulc rawat inap. Untuk rnengurangi beban biaya yang dilimbulkannya, salah satu cara untuk mcntransfer resiko biaya dengan memiliki asuxansi kesehatan. PT. Askes merupakan salah satu asuradur yang wajib dimiliki oleh pcgawai negeri sipil tetapi dalam pelaksanaannya, peserta masih harus mengeluarkan beban biaya sencliri (our ofpocket) karena adanya perbcdaan antara biaya sesuai tarif rumah sakit dengan tarif paket Askes. Beberapa penelitian membuktikan kondisi tersebut, sepeni di RS PMI Bogor, RSUD Kota Cilegon dan RS Persahabatan Jakarta. Sedangkan di RSUD dr. Achmad Diponegoro - Putussibau, Kabupatcn Kapuas Hulu - Kalimantan Barat belum pernah diteliti. Studi ini dilakukan untuk mengetahui gambaran, faktor-faktor apa yang mempengaruhi dan faktor mana yang paling mempengaruhi serta model prcdiksi beban biaya sendiri (our of packcl) pasien rawat inap pegerla Askcs di RSUD dr. Achmad Diponegoro-Putussibau, Kabupatcn Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian ini cross sectional dengan sampel sebesar 257 pasien rawat inap di RSUD dr. Achmad Diponegoro - Putussibau, Kabupaten Kapuas I-lulu - Kalimantan Barat tahun 2005. Rata-rata beban biaya sendiri (out of pocket) pasien rawat inap pcserta Askes di RSUD dr. Achmad Diponegoro sebesar Rp. 2l5,472,76 atau 20,84 % dari rata-rata pengeluaran biaya perawatan sesuai tariff RSUD. Bcban minimum sebesar Rp. 25.000,- penyakit penyulit, obat-obatan, pesertal (peserta), peserta3(isteri), pegawail(golongan I), interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan dimana interaksi antara lama hari rawa dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai B yang tcrtinggi yakni sebesar 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,3l3*|ama hari rawat - 0,785*tidak ada penyakit penyulit + 0,8l9*obat~obatan (Non DPHO) + 67,39'7*peserta1 + 0,179*peserta3 + l,489*pegawail + 0,26O*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Imeraksi Iama hari mwat dengan Penyakit Penyulit. Diharapkan pihak manajemen RSUD dapat menghitung tarif RSUD sesuai kondisi riil sehingga dapat digunakan sebagai bahan masukkan ke Pemda Kabupaten Kapuas Hulu untuk menetapkan kebijakan tarif dan pcmberian subsidi ke RSUD khususnya untuk golongan 1, melakukan advokasi pada PT. Askes, menyarankan penggunaau obat-obatan DPI-10 dan diharapkan juga PT. Askes dapat mempenimbangkan untuk menyesuaikan pemberian manfaat kepada. pescrta khususnya untuk pcserta dengan status kepegawaian golongan 1 yaitu bcrupa penyesuaian tarif PT. Askes sesuai dengan situasi dan kondisi rumah sakit.

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No ones could predict when they would get sick. There will be some significant amount of expenses to be paid during the time of being hospitalized. In order to reduce the amount of expenses a patient should pay, to minimalize risk of cost by having health insurance is a way of working it out. PT Askes is one of the health insurance providers which its membership is a mandatory for every public service officers in Indonesia. Yet, in the reality, a patient still have to cover some oi' his or her expenses hom his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. Some researches bring forward eveidenoes regarding this issue, in example researched conducted in PMT hospital in Bogor, District Hospital of Cilcgon City, and Persahabatan hospital in Jakarta. While in Kapuas I-lulu District, dr. Achmad Diponegoro Hospital in Putussibau, West Kalimantan Province, such research has not been conducted yet. This researched is to find out the influence factors, the most influence factor, and the prediction model of out of pocket of hospitalized patient with Askcs membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas I-lulu District, West Kalimantan Province in 2005. This researched design is cross sectional, using 257 sample of hospitalized patients in dr. Achmad Diponcgoro Hospital in Putusibau, Kapuas Ilulu District, West Kalimantan Province during the year of 2005. The average amount of out of pocket self cost of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare id Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospitaL the kind of illness, medications, memberl (the person with the membership), mernber3 (the spouse), level 1 employee, thc interaction between long of stay with the type of illness, and the interaction between the complicated illness and the drugs are the most influence factor( the 6 value are the highest, which is 0,624). The assumption and interaction test, result the model of self expenses prediction model = 5,743 + 0,3 l3*long of stay - 0,785*no complicated illness + 0,8l9*drugs (Non DPHO) + 67,397*memberl + 0,179*member3 + l,489*employeel + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between long of stay and complicated illness. It is necessary for the District Hospital management to calculate the fare according to the real expenses as an advocacy for the Kapuas Hulu District government for the titre and subsidiary to District Hospital policies making especially for the base level oflicer, advocacy to the PT Askes, awareness to use DPHO drugs and it's necessary for PT Askes to consider adjustment in providing the benefits for its members especially for the base level oflicer to be more in line with the current situation of the hospital.

Abstrak:

ABSTRAK adalah salah satu upaya untuk mengendalikan biaya pelayanan kesehatan (cost containment) adalah dari bentuk fee for service ke bentuk Prospective Payment System (PPS). Prospective Payment System (PPS) adalah sistem pembayaran yang diberikan kepada pemberi pelayanan kesehatan yang besarnya ditetapkan sebelum suatu pelayanan dilaksanakan, tanpa memperhatikan tindakan medik atau lamanya perawatan di rumah sakit. Salah satu cara dalam sistem pembayaran ini adalah dengan "Diagnostic Related Group's (ORG's)" . Penelitian ini adalah penelitian desain survey tagihan pelayanan dimana hasil yang diharapkan adalah untuk mengetahui gambaran perbandingan tagihan rawat inap kelas III (Askeskin dan umum) tahun 2007 dengan tarif kelas Ill INA-DRG di 3 rumah sakit di Kota Bukittinggi, yaitu RSUD Dr. Achmad Machtar Bukittinggi, RS TNI AD Tk. IV Bukittinggi dan RS Ibnu Sina Bukittinggi. Dari hasil penelitian menunjukkan bahwa median hari rawat adalah 4 hari. Jika dibandingkan dengan INA·DRG, ternyata rata-rata hari rawat masing-masing rumah sakit lebih pendek. Untuk apendisitis tanpa komplikasi se!isih hari rawat adalah 1,1 hari, Median tagihan pasien apendisitis di RSUD Dr. Achmad Mochtar Bukitinggi adalah pada kisaran Rp.1.600.000,- - Rp. 1.799.999,-. Jlka dibandingkan dengan INA-DRG, temyata tagihan INA-DRG lebih besar. Sedangkan median tagihan ketiga rumah sakit adalah Rp. 1.800.000,- - 1.999.999,-. Jika dibandingkan dengan INA-DRG, tagihan rumah sakit lebih besar. Hal ini dipengaruhi tagihan dua rumah sakit lainnya yang cukup besar.