A Comparative Unit Cost Analysis of Echocardiography Service between Activity-Based Costing, INA-CBGs, and Hospital Charge at Muhammadiyah Yogyakarta Hospital

Kusumawardhani Nindya, F. Pribadi
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Abstract

Background: All countries allocate a portion of resources to the health sector. Under the National Health Insurance (NHI, JKN), tariffs of hospital care service are pre-determined by the Indonesian Case Base Groups (INA-CBGs) payment scheme. Anecdotal evidence reported that there often occurred some discrepancy between hospital charge and INA-CBGs tariff for a specified hospital care service. This gap may cause either loss or excess profit to the hospital. This study aimed to estimate and compare the unit costs of providing echocardiography service using Activity Based Costing (ABC) method, hospital charge, and INA-CBGs tariff, respectively, at Muhammadiyah Yogyakarta Hospital. Subjects and Method: This was a cost analysis conducted at Muhammadiyah Yogyakarta Hospital, Yogyakarta. A sample of patients aged ≥45 years who used echocardiography was selected for this study. The dependent variable was unit cost of echocardiography. The independent variable was costing method (ABC, hospital charge, and INA-CBGs tariff). The data were obtained from the financial management of the hospital. Results: The estimated unit costs of echocardiography using ABC method, hospital charge, and INA-CBGs were Rp309.370, Rp343.000, Rp369.500, respecti-vely. The estimated unit cost using ABC method was Rp33.630 lower than hospital charge and Rp 60.130 lower than INA-CBGs tariff. Conclusion: The unit cost using ABC method was lower than hospital charge and INA-CBGs tariff. Corrective policy action should be made to fill this gap.
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日惹穆罕默迪亚医院超声心动图服务单位成本比较:作业成本法、INA-CBGs和医院收费
背景:所有国家都将一部分资源分配给卫生部门。根据国民健康保险(NHI, JKN),医院护理服务的收费是由印度尼西亚病例基础小组(INA-CBGs)支付计划预先确定的。坊间证据报告说,对于某一特定的医院护理服务,医院收费与国际卫生组织- cbgs收费之间经常存在一些差异。这种差距可能给医院带来损失,也可能带来超额利润。本研究旨在分别估算和比较穆罕默迪亚日惹医院使用作业成本法(ABC)提供超声心动图服务的单位成本、医院收费和INA-CBGs收费。对象和方法:这是在日惹穆罕默迪亚日惹医院进行的成本分析。本研究选择年龄≥45岁且使用超声心动图的患者为样本。因变量为超声心动图单位费用。自变量为成本核算法(ABC、医院收费和INA-CBGs关税)。数据来源于医院的财务管理。结果:ABC法超声心动图单位费用、住院费用、INA-CBGs分别为309.370、343.000、369.500。使用ABC法估算的单位成本比医院收费低33.630卢比,比INA-CBGs关税低60.130卢比。结论:采用ABC法单位成本低于医院收费和INA-CBGs收费标准。应该采取纠正政策行动来填补这一空白。
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