Analisis Perbedaan Tarif Klaim Indonesian Case Base Groups (INA-CBGs)Berdasarkan Kelengkapan diagnosis Dan Prosedur Medis Pasien rawat Bersama Trisemester I Di RSUD KOta Yogyakarta Tahun 2015

• Main Authors: NURHIDAYATI, RETNO (Author), , IBNU MARDIYOKO, SKM, MM (Author), , YULI KUSUMAWATI, SKM, M.Kes (Epid) (Author)
• Format: Book
• Published: 2016.
• Subjects: Thesis; NonPeerReviewed
• Online Access: Connect to this object online
• Notes: https://eprints.ums.ac.id/45593/49/NASKAH%20PUBLIKASI.pdf; https://eprints.ums.ac.id/45593/39/HALAMAN%20DEPAN.pdf; https://eprints.ums.ac.id/45593/40/BAB%20I.pdf; https://eprints.ums.ac.id/45593/42/BAB%20II.pdf; https://eprints.ums.ac.id/45593/44/BAB%20III.pdf; https://eprints.ums.ac.id/45593/45/BAB%20IV.pdf; https://eprints.ums.ac.id/45593/46/BAB%20V_.pdf; https://eprints.ums.ac.id/45593/47/BAB%20VI.pdf; https://eprints.ums.ac.id/45593/31/DAFTAR%20PUSTAKA.pdf; https://eprints.ums.ac.id/45593/48/LAMPIRAN.pdf; https://eprints.ums.ac.id/45593/35/SURAT%20PERNYATAAN%20PUBLIKASI%20FIX.pdf

The incompleteness medical record file can indirectly reduce the claim expenses based on software INA-CBGs. The purpose of this research is to know the INA-CBGs difference claim rates based on the diagnosis completeness and medical procedures of care together patients trimester I RSUD Kota Yogyakarta in 2015. The research method used is by observation and Pre-Experimental Design with one shot case study. The population of this research is all care together patients medical record file using INA-CBGs payment system trimester I RSUD Kota Yogyakarta in 2015, total of 255 medical record files. The technical completeness samples for diagnosis and medical procedures using Simple Random Sampling total of 155 medical record file. Whereas, the sample for the experiment is all care together patients who discovered 72 incompleteness files. The completeness figures obtained by observing the care together patients medical record file using INA-CBGs payment system and for INA-CBGs claims rate obtained from the care together patients reporting data rates by INA-CBGs payment system. Statistical test using Wicoxon Signed Ranks Test by SPSS 17. The results research to figure completeness of diagnosis and medical procedures in the form of medical resume is by 53,5%, whereas the figure of incompleteness is by 46, 5%. There is -27,5% rupiahs difference from the real data issued by the hospital compared with INA-CBGs tarrif claims. There is +19,4% difference, from the tarrif claims before completed compared with tarrif claims after completed. Total claims before most are equipped with Severity Level 2, which is 194.285.000 rupiah. While, the claims after most are equipped with Severity Level 3, which is 261.169.500,00 rupiahs. There is 35 or 48,6% positive (+) after completed than before compared, one claims file or 1,4% indicated negative (-). There is 36 files or 50% in the remain claims or not claimed. The statistical test results indicated that there is a real RS differences than INA-CBGs tarrif claims before completed in RSUD Kota Yogyakarta (p value = 0,002). There is no differences between the real RS tarrif and INA-CBGs tarrif after completed in RSUD Kota Yogyakarta (value = 0,409). There is a difference INA-CBGs tarrif claims before and after completed in RSUD Kota Yogyakarta (p value = 0,000).