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Background The Government of Indonesia in reducing drug dependence has developed a rehabilitation program in an effort to reduce needs by reducing the population of drug users. The current policy program is very generic and has not paid attention to the needs of individual users. For this reason, research was conducted to assess the factors that influence the success of the rehabilitation program at the BNN Lido Rehabilitation Center.Method: This study used a survey cross sectional design in 90 study subjects who had a complete development record of 719 residents treated during 2018. What was assessed was behavioral changes assessed using the URICA questionnaire associated with variable subject characteristics, type of rehabilitation program, subject environment, and characteristics of human resources that provide services.Results: From the subjects studied 36% experienced an increase in the stages of behavior change. The group of variables that influenced it were marital status (OR = (2,767)), life support (OR = (0,257)), psychiatric status (OR = (5,477)), and duration of the program (OR = (0,484)). The 4-month program is considered more effective than 6 months because of the different complexity of the permasas drug use.Conclusion: The effectiveness of the community therapy rehabilitation program needs to be improved in developing individual programs by taking into account the complexity of the problems that are influenced by the background of prospective residents
Dari hasil penghitungan inimenunjukan pembiayaan terbesar adalah pada operasional yaitu sebesar 54% dari totalbiaya. Pengeluaran terbesar adalah belanja pegawai yaitu sebesar 26% dari total biaya,pemulihan biaya di NICU sebesar 85 % yang menggambarkan NICU mengalami defisit.Dalam mengatasi defisit tersebut manajemen RSUD dapat membuat kebijakan yangberkaitan dengan penetapan biaya satuan serta membuat langkah strategis antara lainmeningkatkan utilisasi, efisiensi, mengurangi lama hari rawat dan melibatkan perawatpelaksana. Rumah sakit dapat meningkatkan pemanfaatan NICU salah satunya denganmenjadi rujukan pelayanan NICU di DKI maupun rujukan nasional yang bekerjasamadengan asuransi swasta dan rumah sakit lainnya
Kata kunci:Biaya Pemulihan, Biaya Satuan, NICU RSUD Koja
This thesis discuss about the cost recovery rate analysis at NICU RSUD Koja in 2016.The existing problem is the amount of expense that should be borne by the hospital onNICU. This research is qualitative analysis by using quantitative data and interviews.the method use is step down and SWOT analysis.
From the results of this calculationshows that the largest financing is on the operational that is equal to 54% of the totalcost. The largest expense is employee expenditures that is equal to 26% of the total cost,cost recovery in the NICU described that the NICU is experiencing deficit. In addressingthe deficit management of RSUD can create a policy with regard to the costing unit aswell as making strategic steps such as improving utilization, efficiency, reducing lengthof stay and involving nurses. Hospitals can improve the utilization of NICU such asbecoming a referral NICU service in DKI as well as national reference that work togetherwith private insurance and other hospitals.
Key words:Cost Recovery Rate, Cost Unit, NICU RSUD Koja.
Since 2011, the government covered all treatment for thalassemia patients. BPJSprovide a supportive treatment including blood transfusion and chelating ironmedicine, but the hospital donot have accurate informationa on the real cost. Thisresearch done in Anna Medika Hospital was using Activity Based Costingapproach, activity on inpatient care of the patients was captured from sampled of20 adults and 20 children patients treated at the hospital. The study revealed thatunit cost per episode was Rp. 8.559.433 for adult thalassemia patient and Rp.6.411.485 for the thalassemia children patient with inpatient care. Cost driver wasoperational cost (60%). Cost recovery rate was 108%.Keywords: Cost, Cost Recovery Rate, Thalassemia, Activity Based Costing(ABC)
Tantangan yang dihadapi RSU GMC dalam mengelola biaya pelayanan kesehatan, khususnya pada tindakan operasi pterygium yang memiliki variasi rawat inap dan rawat jalan pada pelayanannya, di tengah sistem pembayaran berbasis INA-CBGs BPJS Kesehatan yang seringkali tidak mencerminkan biaya riil pelayanan. Penelitian ini bertujuan untuk menganalisis biaya satuan dan tingkat pemulihan biaya (Cost Recovery Rate/CRR) pada layanan operasi pterygium di RSU GMC, Pesawaran Lampung tahun 2024. Metode penelitian yang digunakan adalah studi kasus dengan pendekatan kuantitatif melalui analisis biaya menggunakan metode Double Distribution dan Relative Value Unit (RVU), serta pendekatan kualitatif melalui wawancara mendalam dengan informan kunci di rumah sakit. Data yang dikumpulkan meliputi biaya investasi, operasional, dan pemeliharaan untuk seluruh unit terkait selama tahun 2024, baik biaya langsung maupun tidak langsung. Hasil penelitian menunjukkan bahwa total biaya yang dikeluarkan RSU GMC untuk seluruh pelayanan rumah sakit pada tahun 2024 mencapai Rp18,4 miliar, dengan proporsi terbesar dialokasikan untuk biaya operasional (74%), diikuti investasi (25%) dan pemeliharaan (1%). Biaya satuan tindakan operasi pterygium rawat inap bervariasi menurut kelas, mulai dari Rp8.393.130 (VVIP) hingga Rp5.758.508 (kelas 3), sedangkan estimasi jika dilakukan rawat jalan sebesar Rp3.222.238 untuk metode konjungtival graft dan Rp2.680.442 untuk metode bare sclera. Terdapat selisih negatif yang signifikan antara unit cost aktual dan tarif INA CBGs, dengan tingkat pemulihan biaya (CRR) pada rawat inap hanya 80-87% dan rawat jalan 49-58%. Rekomendasi penelitian yaitu evaluasi ulang terhadap perjanjian KSO alat operasi, pengkajian ulang jasa medis, serta optimalisasi utilitas SDM dan ruang operasi. Kesimpulan dari penelitian ini adalah bahwa tarif INA CBGs belum mampu menutupi biaya riil pelayanan operasi pterygium di RSU GMC, baik pada layanan rawat inap maupun rawat jalan, sehingga diperlukan evaluasi biaya rumah sakit dan efisiensi internal agar keberlanjutan dan mutu pelayanan tetap terjaga.
The main challenge faced by RSU GMC in managing healthcare service costs is related to providing pterygium surgery, which includes both inpatient and outpatient care, within the limitations of the INA-CBGs payment system under BPJS Kesehatan that often does not reflect the actual service costs. This study aims to analyze the unit cost and cost recovery rate (CRR) of pterygium surgery services at RSU Gladish Medical Center (GMC) Pesawaran, Lampung, in 2024. The research applies a case study method with a quantitative approach using cost analysis based on the Double Distribution and Relative Value Unit (RVU) methods, supported by a qualitative approach through in-depth interviews with key hospital informants. The data collected include investment, operational, and maintenance costs for all related units in 2024, covering both direct and indirect costs. The results show that the total hospital expenditure in 2024 reached IDR 18.4 billion, with the majority allocated to operational costs (74%), followed by investment (25%) and maintenance (1%). The unit cost of inpatient pterygium surgery varied by class, from IDR 8,393,130 for VVIP to IDR 5,758,508 for Class 3. For outpatient procedures, the estimated cost was IDR 3,222,238 for the conjunctival graft method and IDR 2,680,442 for the bare sclera method. There is a significant negative gap between the actual unit cost and the INA-CBGs tariff. The CRR for inpatient care ranges from 80% to 87%, while for outpatient care it is lower, between 49% and 58%. Based on these findings, it is recommended that the hospital conduct a comprehensive review of the surgical equipment partnership agreement, reassess medical service fees, and optimize the use of human resources and operating room capacity. This study concludes that the INA-CBGs tariff does not sufficiently cover the actual costs of pterygium surgery at RSU GMC, for both inpatient and outpatient services. Therefore, regular cost evaluation and internal efficiency improvements are crucial to maintain the sustainability and quality of healthcare services.
