A comparative study of real hospital costs and INA-CBG rates for stroke in Indonesia

IF 0.5 Q4 EDUCATION, SCIENTIFIC DISCIPLINES

Pharmacy Education Pub Date : 2024-05-01 DOI:10.46542/pe.2024.243.166172

Gusti Agung, Putu Deddy Mahardika, Y. Nita, Y. Priyandani

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引用次数: 0

Abstract

Background: The claim payment method in JKN program uses the prospective Indonesian Case Base Groups (INA-CBG) method, in which the rate has been determined before health services are provided based on the diagnosis code group. This potentially causes a discrepancy in the costs incurred by health facilities. Objective: This systematic review aimed to provide an overview of the comparison of actual hospital costs with the INA-CBG rates of the JKN program for inpatient stroke. Method: The collection method used a PRISMA flowchart on several databases. This systematic review is a comparative study comparing the significance of the average actual direct medical costs with the INA-CBG rates. Result: Cost differences on intracerebral haemorrhage (I619) and unspecified stroke diagnosis (I64) consistently give a negative difference around IDR 110,659 – IDR 8,184,007/patient/episode. Medicine and medical equipment are the most significant components of stroke treatments. Factors that significantly influence direct medical costs are the length of stay (LOS), class of JKN, and age. Conclusion: Cost differences can be influenced by several factors that can affect the direct medical costs of hospitals. The factor that has the most influence on the amount of direct medical cost is LOS.

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印度尼西亚中风实际住院费用与 INA-CBG 比率的比较研究

背景：JKN 计划的报销付款方法采用预期印尼病例基础组（INA-CBG）方法，即在提供医疗服务之前根据诊断代码组确定费率。这可能会导致医疗机构产生的费用出现差异：本系统性综述旨在概述中风住院患者实际住院费用与 JKN 项目 INA-CBG 费率的比较情况：方法：采用 PRISMA 流程图对多个数据库进行收集。本系统综述是一项比较性研究，比较了平均实际直接医疗费用与 INA-CBG 比率的重要性：结果：脑出血（I619）和不明原因中风诊断（I64）的成本差异始终为负差，约为 110,659 印尼盾 - 8,184,007 印尼盾/患者/病程。药物和医疗设备是中风治疗中最重要的组成部分。对直接医疗成本有重大影响的因素包括住院时间（LOS）、JKN等级和年龄：成本差异可能受多种因素影响，这些因素会影响医院的直接医疗成本。对直接医疗成本影响最大的因素是住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacy Education EDUCATION, SCIENTIFIC DISCIPLINES-

CiteScore

0.80

自引率

20.00%

发文量

174

期刊介绍： Pharmacy Education journal provides a research, development and evaluation forum for communication between academic teachers, researchers and practitioners in professional and pharmacy education, with an emphasis on new and established teaching and learning methods, new curriculum and syllabus directions, educational outcomes, guidance on structuring courses and assessing achievement, and workforce development. It is a peer-reviewed online open access platform for the dissemination of new ideas in professional pharmacy education and workforce development. Pharmacy Education supports Open Access (OA): free, unrestricted online access to research outputs. Readers are able to access the Journal and individual published articles for free - there are no subscription fees or ''pay per view'' charges. Authors wishing to publish their work in Pharmacy Education do so without incurring any financial costs.