SECTIO CAESAREA UNIT COST ANALYSIS BASED ON REAL COST METHODS AND INA-CBG TARIFF CALCULATIONS

Management, Economy, Healthcare

BPJS Health was established to provide affordable and equitable access to health services for Indonesian. By participating in BPJS, people gain protection against expensive health costs, because BPJS covers most of the costs of health services, including basic examinations, hospitalization, and complex medical procedures. The National Social Security System (SJSN) through BPJS Health implements non-discriminative payment rate mechanism. The payment rate is based on Indonesia Case Base Groups (INA-CBG); a health service payment system based on groups of similar diagnoses and treatment costs. However, hospital management policies are proven to be ineffective and inefficient. This research uses a quantitative descriptive method to compare unit costs between real cost calculation methods and INA-CBG rates in inpatient services for Sectio Caesarea cases in 2021 at Dr. Hj. Karmini EH Hospital in Tasikmalaya City West Java. This research aims to analyze the unit cost of the Sectio Caesarea action based on the real cost method calculation, analyze the INA-CBG package tariff for the Sectio Caesarea action, analyze the comparison of the unit cost of the Sectio Caesarea action based on the real cost method calculation with the INA-CBG package tariff, and analyze the unit cost comparison The Sectio Caesarea procedure is based on the real cost method calculation using hospital rates. The research results show that the real cost method calculation provides a more accurate picture of costs because it includes direct costs, direct overhead costs, and indirect overhead costs involved in Sectio Caesarea services. Although the INA-CBG rates provide cost certainty to patients, the results of the analysis show that these rates are insufficient to cover the real costs of patient care, especially in the case of Sectio Caesarea. There is a significant difference between the INA-CBG tariff and the real cost of treatment, with the INA-CBG tariff tending to be lower than the real cost required. This shows that determining rates must carefully take into account the need for treatment costs so as not to result in losses for the hospital.

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