ABSTRAK

Latar belakang dilakukannya penelitian ini adalah karena meningkatnya persalinan sejak dilaksanakannya Program Jaminan Persalinan (JAMPERSAL) di Rumah Sakit Umum Pusat (RSUP) Fatmawati tahun 2011.

Metode penelitian deskriptif analitik melalui pendekatan kuantitatif dengan jumlah sampel 297 responden, diambil sebelum dan setelah dilaksanakan Program JAMPERSAL. Studi kualitatif dilakukan melalui wawancara dengan peserta JAMPERSAL dan karyawan RSUP Fatmawati serta audit klinik pada peserta dengan selisih biaya tertinggi setiap tahun.

Ketidaktepatan rujukan ditunjukkan dengan rujukan yang dominan dari Puskesmas DKI Jakarta serta dari RSUD Depok, tingginya persalinan spontan (25,25%- 35,4%) dan ketidaksesuaian diagnosis antara perujuk dan Dokter Spesialis Kebidanan dan Kandungan (14,8%- 22,9%). Didapatkan rerata selisih biaya persalinan spontan sebesar Rp 1,286,079.82 - Rp 4,306,453.02 dan sectio caesarea Rp 4,076,727.07 - Rp 6,280,824.40. Diperlukan penyempurnaan pelaksanaan Program JAMPERSAL didukung kebijakan lain secara terintegrasi.

ABSTRACT

This sudy is conducted due to uprising number of labor in Fatmawati General Hospital (RSUP Fatmawati) as a referral hospital in Jakarta ever since the Labor Insurance Programme (JAMPERSAL) initiated in the year 2011.

Descriptive analytic method was used with quantitative and qualitative approach. The total sample of 297 correspondents was taken from the labeor bofore and after the JAMPERSAL is launched. The qualitative study is achieved by interviewing the JAMPERSAL participant, the staff of RSUP Fatmawati, and also by conducting the clinical audit on patient with the highest cost difference annually.

Imprecision of the referral system is shown accordingly to the dominant referral from Puskesmas DKI Jakarta (21%-49,4%), RSUD Depokoverload quota as a reason (before JAMPERSAL 78,6% - after JAMPERSAL 90,5%), high number of spontaneous delivery (25,25%- 35,4%) and the dissimilarity between the diagnosis of the refers and the Obstetric Gynecologist (14,8%- 22,9%). It is drawn that the mean of cost difference in spontaneous delivery is 1,286,079.82 - 4,306,453.02 IDR while in caesarean section 4,076,727.07- 6,280,824.40 IDR. Improvement of the JAMPERSAL guidance is needed, supporting by other integrated policy.

ABSTRAK Tesis ini menganalisis selisih biaya rawat inap operasi reseksi prostat trans uretra pasien Jamkesmas berdasarkan tarif Peraturan Walikota, tarif INA-CBG’s dan biaya berdasarkan clinical pathway di RSUD Kota Bekasi tahun 2012,mengetahui penyebab terjadinya selisih dan mencari upaya-upaya untuk memperkecil selisih biaya tersebut. Penelitian ini adala hpenelitian kualitatif observasional. Hasil penelitian menunjukkan terdapat selisih biaya cukup besar antara biaya berdasarkan tarif Perwal dan clinical pathway dengan tarif INA-CBG’s, penyebab utamanya adalah karena perbedaan dalam cara penghitungan dan penetapan tarif.Penelitian ini menyarankan agar rumah sakit dan Kemenkes menggunakan unit biaya (unit cost) dan clinical pathway sebagai instrumen dalam penghitungan biaya, kendali biaya dengan tetap menjaga mutu pelayanan.

ABSTRACT The study analyzed the cost discrepancy of transurethral resection of prostate on jamkesmas patient based on Perwal Tariff, INA-CBG’s Tariff and the cost based on clinical pathway in RSUD Kota Bekasi in 2012 to find the cause and the solution to minimalize it. It was an observational qualitative study. The result show that there were a quit big discrepancy between the cost based on Perwal tariff and the clinical pathway with the cost based on INA-CBG’s , with the main Analisis selisih..., Bagus Taufiqur Rachman, FKM UI, 2013 cause are the different method in calculating the cost and tariff determination. The study recommend that hospitals and The Ministry of Health use unit cost and clinical pathway as the instrument in calculating and controlling the cost while maintaining quality’