Fitriana Yuliastuti, Tri Murti Andayani, Dwi Endarti, Susi Ari Kristina
{"title":"乳腺癌、宫颈癌和肺癌癌症：国家医疗保险时代实际医疗费用和INA-CBG比率的比较。","authors":"Fitriana Yuliastuti, Tri Murti Andayani, Dwi Endarti, Susi Ari Kristina","doi":"10.18549/PharmPract.2023.1.2768","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In Indonesia, the cost of cancer treatment has been determined by the Indonesian Case Base Groups (INA-CBGs) based on a code called the INA-CBG's rates. However, a fair claim should be based on the severity of the disease and the class of treatment in the hospital, not on the rates of code. In fact, the real cost of therapy for cancer is influenced by several factors including stage, comorbidity, and severity (INA-CBGs coding, type of hospital, hospital class, treatment grade, side effects, and length of stay), so in many cases, there are reported differences between the real costs and the INA-CBGs rates charged to patients.</p><p><strong>Objective: </strong>This study aims to investigate the difference between real treatment costs and INA-CBG's rates for cases of lung cancer, cervical cancer, and breast cancer at a cancer center hospital in Indonesia.</p><p><strong>Methods: </strong>This work uses an observational study, and the data were taken retrospectively from hospital financial data and patient medical records. The data were then analyzed using a one-sample t-test to determine the difference between real costs and INA-CBGs costs.</p><p><strong>Results: </strong>The results showed that there was no significant difference between real costs and INA-CBG's cost on stage II lung cancer treatment in grade 2 with a sig. value of 0.683; code C-4-13-II in grade 3 with a sig. value of 0.151; and code C-4-13-III in grade 3 with a sig. value of 0.650; where the significance level (t alpha) is more than 0.05. Furthermore, the treatment costs for cervical cancer with codes C-4-13-I and C-4-13-II in grade 1 had sig. values of 0.155 and 0.720 respectively. Lastly, the treatment cost for breast cancer patients with codes C-4-12-II in grade 3 had a sig. value of 0.145 and code C-4-13-II in grade 3 showed a sig. value of 0.091.</p><p><strong>Conclusion: </strong>Although statistical evaluation showed a significant difference for some cases and not significant for other cases, in real conditions, there is a difference between the INA-CBGs and the real costs that must be evaluated by the government and stakeholders to provide justice for cancer patients.</p>","PeriodicalId":51762,"journal":{"name":"Pharmacy Practice-Granada","volume":"21 1","pages":"2768"},"PeriodicalIF":2.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/04/pharmpract-21-2768.PMC10117336.pdf","citationCount":"0","resultStr":"{\"title\":\"Breast, cervical, and lung cancer: A comparison of real healthcare costs and INA-CBGs rates in the era of national health insurance.\",\"authors\":\"Fitriana Yuliastuti, Tri Murti Andayani, Dwi Endarti, Susi Ari Kristina\",\"doi\":\"10.18549/PharmPract.2023.1.2768\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In Indonesia, the cost of cancer treatment has been determined by the Indonesian Case Base Groups (INA-CBGs) based on a code called the INA-CBG's rates. However, a fair claim should be based on the severity of the disease and the class of treatment in the hospital, not on the rates of code. In fact, the real cost of therapy for cancer is influenced by several factors including stage, comorbidity, and severity (INA-CBGs coding, type of hospital, hospital class, treatment grade, side effects, and length of stay), so in many cases, there are reported differences between the real costs and the INA-CBGs rates charged to patients.</p><p><strong>Objective: </strong>This study aims to investigate the difference between real treatment costs and INA-CBG's rates for cases of lung cancer, cervical cancer, and breast cancer at a cancer center hospital in Indonesia.</p><p><strong>Methods: </strong>This work uses an observational study, and the data were taken retrospectively from hospital financial data and patient medical records. The data were then analyzed using a one-sample t-test to determine the difference between real costs and INA-CBGs costs.</p><p><strong>Results: </strong>The results showed that there was no significant difference between real costs and INA-CBG's cost on stage II lung cancer treatment in grade 2 with a sig. value of 0.683; code C-4-13-II in grade 3 with a sig. value of 0.151; and code C-4-13-III in grade 3 with a sig. value of 0.650; where the significance level (t alpha) is more than 0.05. Furthermore, the treatment costs for cervical cancer with codes C-4-13-I and C-4-13-II in grade 1 had sig. values of 0.155 and 0.720 respectively. Lastly, the treatment cost for breast cancer patients with codes C-4-12-II in grade 3 had a sig. value of 0.145 and code C-4-13-II in grade 3 showed a sig. value of 0.091.</p><p><strong>Conclusion: </strong>Although statistical evaluation showed a significant difference for some cases and not significant for other cases, in real conditions, there is a difference between the INA-CBGs and the real costs that must be evaluated by the government and stakeholders to provide justice for cancer patients.</p>\",\"PeriodicalId\":51762,\"journal\":{\"name\":\"Pharmacy Practice-Granada\",\"volume\":\"21 1\",\"pages\":\"2768\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/04/pharmpract-21-2768.PMC10117336.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pharmacy Practice-Granada\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.18549/PharmPract.2023.1.2768\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/1/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pharmacy Practice-Granada","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18549/PharmPract.2023.1.2768","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/4 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Breast, cervical, and lung cancer: A comparison of real healthcare costs and INA-CBGs rates in the era of national health insurance.
Background: In Indonesia, the cost of cancer treatment has been determined by the Indonesian Case Base Groups (INA-CBGs) based on a code called the INA-CBG's rates. However, a fair claim should be based on the severity of the disease and the class of treatment in the hospital, not on the rates of code. In fact, the real cost of therapy for cancer is influenced by several factors including stage, comorbidity, and severity (INA-CBGs coding, type of hospital, hospital class, treatment grade, side effects, and length of stay), so in many cases, there are reported differences between the real costs and the INA-CBGs rates charged to patients.
Objective: This study aims to investigate the difference between real treatment costs and INA-CBG's rates for cases of lung cancer, cervical cancer, and breast cancer at a cancer center hospital in Indonesia.
Methods: This work uses an observational study, and the data were taken retrospectively from hospital financial data and patient medical records. The data were then analyzed using a one-sample t-test to determine the difference between real costs and INA-CBGs costs.
Results: The results showed that there was no significant difference between real costs and INA-CBG's cost on stage II lung cancer treatment in grade 2 with a sig. value of 0.683; code C-4-13-II in grade 3 with a sig. value of 0.151; and code C-4-13-III in grade 3 with a sig. value of 0.650; where the significance level (t alpha) is more than 0.05. Furthermore, the treatment costs for cervical cancer with codes C-4-13-I and C-4-13-II in grade 1 had sig. values of 0.155 and 0.720 respectively. Lastly, the treatment cost for breast cancer patients with codes C-4-12-II in grade 3 had a sig. value of 0.145 and code C-4-13-II in grade 3 showed a sig. value of 0.091.
Conclusion: Although statistical evaluation showed a significant difference for some cases and not significant for other cases, in real conditions, there is a difference between the INA-CBGs and the real costs that must be evaluated by the government and stakeholders to provide justice for cancer patients.
期刊介绍：
Pharmacy Practice is a free full-text peer-reviewed journal with a scope on pharmacy practice. Pharmacy Practice is published quarterly. Pharmacy Practice does not charge and will never charge any publication fee or article processing charge (APC) to the authors. The current and future absence of any article processing charges (APCs) is signed in the MoU with the Center for Pharmacy Practice Innovation (CPPI) at Virginia Commonwealth University (VCU) School of Pharmacy. Pharmacy Practice is the consequence of the efforts of a number of colleagues from different Universities who belief in collaborative publishing: no one pays, no one receives. Although focusing on the practice of pharmacy, Pharmacy Practice covers a wide range of pharmacy activities, among them and not being comprehensive, clinical pharmacy, pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology, etc.
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