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Dengan masuknya globalisasi ke Indonesia informasi dapat mudah diperoleh. Perusahaan asuransi mempromosikan produknya secara cepat, membuat masyarakat mengetahui pentingnya pelayanan kesehatan. Karyawan mengharapkan perusahaannya memberikan ketenangan dan kemudahan dalam mendapatkan pelayanan kesehatan. Untuk itu RSPAD Gatot Soebroto bekerja sama dengan pihak ke tiga memberikan pelayanan kesehatan. Dengan adanya kerjasama ini rumah sakit mempunyai piutang yang harus dikelola secara baik. Piutang pasien rawat inap dengan jaminan pihak ke tiga di Pavilyun Kartika RSPAD Gatot Soebroto per 30 Juni 2002 mencapai Rp.3.648.374.261,-(tiga milyar enam ratus empat puluh delapan juta tiga ratus tujuh puluh empat ribu dua ratus enam puluh satu rupiah). Dari penelitian yang dilakukan dengan_kerangka konsep input, proses dan output berdasarkan data primer dan data sekunder diperoleh data bahwa banyak piutang pasien yang sudah dibayar namun belum dibukukan, sehingga rekening piutang pasien belum ditutup. Berdasarkan uraian kondisi tersebut diatas dapat disimpulkan bahwa sesungguhnya piutang pasien rawat inap dengan jaminan pihak ke tiga di Pavilyun Kartika RSPAD Gatot Soebroto per 30 Juni 2002 tidak mencapai Rp.3.648.374.261,-. Hal ini disebabkan oleh lemahnya fungsi monitoring adrninistrasi keuangan khususnya pencatatan piutang. Selanjutnya disarankan agar fungsi monitoring terhadap sistem pencatatan piutang dapat lebih ditingkatkan. Daftar Pustaka : 21 (1979 - 2001)
Management Analysis for Account Receivables of day in patient under third parties guarantee in "Paviliun Kartika RSPAD Gatot Soebroto" for the period of 30"' June 2001 until 30"` June 2002 The globalization era is coming to Indonesia, information are coming faster, Insurance companies promote their products rapidly, educate the people how important is medical care. People are more conscious about medical service and now can afford health insurance. Employees demand their companies to facilitate them a better medical assistance. Therefore, in order to accommodate all the above trends, Pavilyun Kartika RSPAD Gatot Soebroto try to give a better service, by working together with insurance companies and institutions. By working together with them Pavilyun Kartika RSPAD Gatot Soebroto give a more convenience way for their patients to receive medical assistance. As the result, the hospital has account receivable that has to be taken care accurately. The account receivables under third parties guaranteed until 30th June 2002 amounted to Rp3, 648,374,261. (Three billion six hundred and forty eight million three hundreds seventy-four thousands two hundred and sixty one rupias). Based on our analysis using input skeleton concept, process and output based on prime data and secondary data, concluded that there were a lot of patient accounts that were not yet booked even though that the account has been paid, resulting on an unclosed accounts which gave a high account receivables. In conclusion, actually the account receivable in Pavilyun Kartika RSPAD Gatot Soebroto per 30th June 2002 was not as high as Rp 3,648,374,261.00. This was the result from lack of financial administration control on account receivables. Finally, we advice that the hospital have to have had a better system on monitoring and controlling the account receivables.
Rumah Sakit Haji Jakarta, is a type ?C? Plus hospital with service performance of medical service production has been increasing from year to year, has proven with ISO 9001-2000 certificate. However, hospitalization unit experienced decrease since 2003. It needs to concern by observing the influencing factors to ?demand? and hospitalization ?use?. Objective of this research is to know general description on the hospitalization unit use especially class I, II and III, and to know characteristic description of the patient and the amount of tariff type related to the patient?s perception to the hospitalization service tariff. This research is descriptive research with survey method and the primary data were derived from interview referring to the questioner by taking purposive sample and held on June 2005. The result of Research shows from the 85 respondents with comparison at 60% from health care class II, while class I and III are respectively amounting to 20% Education of the respondent is sufficiently high more than 85% graduated from Senior High School (SLTA) and university. And type of occupation is mostly entrepreneur and private employee, The low income (however the income is less than one million is about 30%, and one million until up to three million about 50% and only 20% more than three million).is one of the factors influencing patient?s perception to the tariff, and influencing the most capability to pay. In addition, the difference of tariff for class II is nearly three times of tariff class III. While concerning the expensive medical service tariff, medicine, medical support, health equipment, medical treatment and administration are influenced by the level of disease size, and the period of hospitalization other than the technology equipment and imported medicines. This research is hoped in order the management is able to concern on the difference of room tariff and the proportion change of health care class, medicine prescription such as generic, the use of medical technology is only for the required one. It is recommended to conduct further research to know the market segment in order to defend the existing market.
Kata kunci: kepuasan pasien, kualitas layananan rumah sakit
Service Quality is very important in creating patient satisfaction. This study aims to determine the criteria of patients on hall of residence services, the relationship of dimensions of service quality with patient satisfaction and to determine which dimensions have the most influence on patient satisfaction. This study carried out univariate, bivariate and multivariate analyzes. With a total sample of 150 respondents. It was found that the characteristics of patients for the age with the highest category were in the range of 30-49 years, namely 54%, the sex of the most respondents was 78%, the history of the highest education was SMA 53.3%, the work of the most respondents was IRT, the highest frequency of income was income per month Rp.3,000,000 to Rp. 4,000,000. For bivariate analysis it was found that from the five dimensions of four-dimensional service quality had a significant effect on patient satisfaction: reliability (p value 0.001), responsiveness (p value <0.0001), emphaty (p value <0.0001) and tangible (p value <0.0001). And the multivariate analysis found that the dimensions of reliability and empathic affect patient satisfaction.
Keywords: patient satisfaction, hospital service quality
This thesis aims to test the validity and reliability of the NAURAH instrument for measuring patient satisfaction and analyzing patient satisfaction with the quality of inpatient health services at Mitra Medika Bondowoso Hospital using the servqual and importance performance analysis (IPA) methods. This research is quantitative and descriptive-analytic. This research was attended by 100 respondents who filled out a satisfaction questionnaire based on Servqual theory and the NAURAH instrument. The research results showed the reliability and validity of the NAURAH instrument and that patients at Mitra Medika Bondowoso Hospital were satisfied with the services at the hospital. Based on the IPA analysis, there is an empathy aspect of servqual that must be considered, and an understanding and respect aspect of the NAURAH instrument that needs to be developed. Then Mitra Medika Bondowoso Hospital has practiced Total Quality Management. To develop empathy, the PDCA matrix is used which includes TQM aspects.
ABSTRAK
Nama
: Muhamad Rezaldi
Program Studi : Kajian Administrasi Rumah Sakit
Judul
: Analisis Faktor Penentu Keterlambatan Klaim INA CBG’s Pasien
Rawat Inap di RSIA Murni Asih Kabupaten Tangerang pada Januari
2018
Pembimbing : DR. dr. Sandi Iljanto, MPH.
Latar Belakang: Jaminan Kesehatan Nasional (JKN) melalui Badan Penyelenggara
Jaminan Sosial (BPJS) Kesehatan sebagai pemberi perlindungan sosial menuntut rumah
sakit untuk memberikan pelayanan bermutu dan berkualitas kepada peserta BPJS
Kesehatan. Dalam menjalankan fungsi rumah sakit untuk memberikan pelayanan kepada
peserta BPJS Kesehatan, maka rumah sakit perlu melakukan klaim dana kepada pihak
BJPS Kesehatan sesuai diagnosa yang sudah ditetapkan Indonesian Case-Based Groups
(INA CBG’s). Klaim biaya tersebut digunakan sebagai pengganti dari biaya yang sudah
dikeluarkan rumah sakit dalam menjalankan pelayanan kesehatannya kepada peserta
BPJS Kesehatan. Namun pada kenyataannya masih banyak berkas-berkas yang ditunda
ataupun ditolak BPJS sehingga rumah sakit tidak mendapatkan klaim tersebut. Penundaan
dan atau penolakan klaim disebabkan karenan tidak lolosnya berkas-berkas melalui
verifikator BPJS Kesehatan. Dengan diberlalukannya system Vedika (Verifikasi di
Kantor) ada beberapa perubahan kebijakan pada proses klaim berkas INA CBG’s yang
membuat rumah sakit dituntu untuk bisa beradaptasi.
Tujuan: Mengetahui faktor-faktor penentu keterlambatan klaim INA CBG’s BPJS
Kesehatan berdasarkan beberapa variabel yang sudah ditentukan sebelumnya dan
dimodifikasi oleh peneliti.
Metode: Penelitian ini bersifat deskriptif analitik dengan pendekatan kuantitatif.
Pengumpulan data dilakukan kepada berkas-berkas klaim INA CBG’s yang akan
diajukan ke BPJS Kesehatan dari pasien rawat inap. Data yang dikumpulkan dimasukkan
ke dalam checklist kuesioner yang kemudian akan diolah hasilnya.
Hasil: Dari 8 variabel independent yang diuji, variabel Ketepatan Pengisian Resume
Medis Koding Diagnosa Sekunder memiliki peran paling penting menyebabkan berkas
klaim tertunda. Koding Diagnosa Sekunder juga berhubungan dengan Variabel
Independent Severity Level atau tingkat keparahan penyakit yang bisa mempengaruhi
kelayakan berkas klaim.
Kesimpulan: Saat ini, aspek dan kaidah koding berperan penting dalam kelayakan berkas
klaim INA CBG’s, sehingga rumah sakit harus terus belajar dan mencari tahu apa saja
yang baik untuk diinputasi dalam nenentukan koding yang tepat, sehingga berkas klaim
dapat terbayarkan tepat waktu tanpa ditunda.
(kata kunci: INA CBG’s, klaim BPJS, verifikator BPJS, Vedika)
ABSTRACT Name : Muhamad Rezaldi Study Program : Kajian Administrasi Rumah Sakit Title : Analisis Faktor Penentu Keterlambatan Klaim INA CBG’s Pasien Rawat Inap di RSIA Murni Asih Kabupaten Tangerang pada Januari 2018 Counsellor : DR. dr. Sandi Iljanto, MPH. Background: National Health Insurance (JKN) through the provider of Social Security Administering Agency (BPJS) Health as a social protection provider requires the hospital to provide quality and quality services to BPJS Kesehatan participants. In performing the function of the hospital to provide services to participants BPJS, eating hospital needs to make claims of funds to the BJPS Kesehatan according to the diagnosis set by Indonesian Case-Based Groups (INA CBG’s). Claim fees are used in lieu of the costs already incurred hospital in running health services to participants BPJS Kesehatan. But infact there are still many files that are postponed or rejected by BPJS Kesehatan so that the hospital does not get the claim. Delays and or rejection of claims are caused due to not passing the files through BPJS Kesehatan verifier. With the implementation of The Vedika (Verification in the Office) there were several policy changes to the claim process of INA CBG's file which made the hospital to be able to adapt. Purpose: Find out the determinants of the delay in INA CBG's BPJS Kesehatan claims based on some predefined variables which has been predetermined and modified by the researcher. Method: This research is analytical descriptive with quantitative approach. The data collection is done to the claims file of INA CBG’s that will be submitted to BPJS Kesehatan of inpatients. The data collected is included in the checklist of questionnaires which will then be processed. Result: Of the 8 independent variables tested, the Adjustment Resume Filling variable Medical Coding Secondary Diagnosis has an important role causing the tertunda claim. Secondary Diagnostic coding is also associated with the Severity Level variable that may affect the eligibility of the claim. Conclusion: Currently, coding aspects and rules play an important role in the feasibility of INA CBG's claim, so hospitals must continue to learn and find out what is good to input in determining proper coding so that claims files can be paid on time without delay. (key words: INA CBG’s, Claim BPJS, Verifikator BPJS, Vedika).
