Analysis of Ideal Cost Service Claims for Hospitalized Covid-19 Patient

DOI

10.2991/978-94-6463-204-0_13How to use a DOI?

Keywords

claim rates; actual rates; COVID-19

Abstract

This study analyzes the ideal cost service claims for reimbursement of hospitalized COVID-19. The variable used in this study is the dependent variable which is divided into claim rates consisting of cost-per-day rates and INA-CBG’s rates. The independent variables were divided into accurate rates and length of stay. The sample was selected by non-probability sampling with purposive sampling method by limiting the inclusion criteria: COVID-19 patients who received treatment from January 28, 2020, to July 31, 2022, with complete medical record data at Muhammadiyah Selogiri Hospital. The data was obtained from 90 medical record files and patient financial administration, which were used as research samples. The collected data was carried out by inferential statistical analysis to identify the difference between accurate rates and claims based on MoH regulations which were divided into three groups and supported by a qualitative study using the in-depth interview method. The results showed a significant difference (p = 0.00 < 0.05) between the real and claims rate for reimbursement of costs for services for COVID-19 patients in all groups. Interviews conducted by researchers with representatives of doctors in charge of services and hospital management gave the opinion that group 2 regulations are ideal for handling COVID-19 patient care. It is hoped that the government will comply with group 2 rules with the proposed tariffs ranging from Rp. 18,174,633 to Rp. 38,335,538 per patient; hence the treatment of COVID-19 patients can be carried out optimally. The applicable regulation is the group 3 rule with an average tariff of IDR 18,174,633 per patient, which could be better. Hospitals must be able to arrange appropriate strategies through periodic monitoring and evaluation of compliance with the implementation of clinical pathways, consequently improving the quality and quality of services and hospital operations effectively and efficiently.

Copyright

© 2024 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Sri Umaryani
AU  - E. M. Sutrisna
AU  - Imronuddin Imronuddin
AU  - Edy Purwo Saputro
PY  - 2023
DA  - 2023/10/04
TI  - Analysis of Ideal Cost Service Claims for Hospitalized Covid-19 Patient
BT  - Proceedings of the International Conference on Economics and Business Studies (ICOEBS-22-2)
PB  - Atlantis Press
SP  - 149
EP  - 159
SN  - 2352-5428
UR  - https://doi.org/10.2991/978-94-6463-204-0_13
DO  - 10.2991/978-94-6463-204-0_13
ID  - Umaryani2023
ER  -