Determinants of Cost Recovery Rate of Inpatient Cases: Evidence from Indonesian Public Hospitals
DOI:
https://doi.org/10.23887/jia.v8i1.59019Keywords:
cost recovery rate, inpatient cost, cost management, DRG, public hospitalAbstract
This study aims examine the influence of patient profile, severity, length of stay, and bed class for cost recovery rate (CRR) of inpatient cases in three Indonesian public hospitals located in Aceh Province, Indonesia. Data were collected from hospital insurance claim from 2018 to 2020. The number of patient dataset collected in this study is 23,125 cases from top ten most frequent cases. Using Multiple Linear Regression, this study found that patient gender, age, length of stay, severity and bed class have a positive significant effect on CRR the inpatient cases. In addition, this study also used questionnaires to elaborate the perspective of managers and doctors in the public hospitals on cost management system and procedures in their hospitals. The results suggested that improved cost management system and procedures are required to improve CRR of the patient treatments.References
Aljunid, S. M., & Jadoo, S. A. A. (2018). Factors influencing the total inpatient pharmacy cost at a tertiary hospital in Malaysia: A retrospective study. Inquiry (United States), 55, 0–7. https://doi.org/10.1177/0046958018755483
Angstman, K.B., Doganer, Y.C., Dejesus, R.S. & Rohrer, J.E. (2016), Increased medical cost metrics for patients 50 years of age and older in the collaborate care model of treatment for depression, Psychogeriatrics, 16(2), 102-106.
Annisa, R., Winda, S., Dwisaputro, E., & Isnaini, K. N. (2020). Mengatasi Defisit Dana Jaminan Sosial Kesehatan Melalui Perbaikan Tata Kelola. INTEGRITAS: Jurnal Antikorups, 6(2), 209–224. https://doi.org/10.32697/integritas.v6i2.664
Ariwardani, B.N., Tamtomo, D.G. and Murti, B. (2019), Factors affecting the cost gap between INA CBGs tariff and hospital tariff for patients with dengue hemorrhagic fever in Ngawi regional public hospital, East Java, Journal of Health Policy and Management, 4 (3), 204-213
Arfiani, M., Fahlevi, H., Akuntansi, P. S., & Aceh, P. (2020). Cost Recovery Rate dan Pengendalian Biaya di Rumah Sakit: Studi kasus pada Rumah Sakit Pemerintah. Jurnal ASET (Akuntansi Riset), 12(2), 372–383. https://doi.org/10.17509/jaset.v12i2.26317
Aulia, S., Supriadi, S., Sari, D. K., & Mutiha, A. (2016). Cost Recovery Rate Program Jaminan Kesehatan Nasional Bpjs Kesehatan. Akuntabilitas, 8(2), 111–120. https://doi.org/10.15408/akt.v8i2.2767
Aurelia, A., & Pujiyanti, E. (2017). Biaya Satuan dan Pemulihan Biaya (Cost Recovery Rate) Layanan Pasien Acute Coronary Syndrome dengan Rawat Inap di Rumah Sakit X Tahun 2015. Jurnal Ekonomi Kesehatan Indonesia, 1(3), 132–137. https://doi.org/10.7454/eki.v1i3.1778
Camilleri, C., Jofre-Bonet, M., & Serra-Sastre, V. (2018). The suitability of a DRG casemix system in the Maltese hospital setting. Health Policy, 122(11), 1183–1189. https://doi.org/10.1016/j.healthpol.2018.08.002
Chaikledkaew, U., Pongchareonsuk, P., Chaiyakunapruk, N. & Ongphiphadhanakul, B. (2008), Factors affecting health-care costs and hospitalizations among diabetic patients in Thai public hospitals”, Value in Health, 11, 69-74.
Cook, A., & Averett, S. (2020). Do hospitals respond to changing incentive structures? Evidence from Medicare’s 2007 DRG restructuring. Journal of Health Economics, 73, 102319. https://doi.org/10.1016/j.jhealeco.2020.102319
di Giacomo, M., Piacenza, M., Siciliani, L., & Turati, G. (2017). Do public hospitals respond to changes in DRG price regulation? The case of birth deliveries in the Italian NHS. Health Economics (United Kingdom), 26(May), 23–37. https://doi.org/10.1002/hec.3541
Dumaris, H. (2015). Analisis Perbedaan Tarif Rumah Sakit dan Tarif INA-CBG ’ s Pelayanan Rawat Jalan di RSUD Budhi Asih Jakarta Tahun 2015 Analysis on Tariff Differences Between Hospital’ s Tariff and INA - CBG ’ s Tariff for Outpatient In Budi Asih Hospital Jakarta on 2015. Jurnal ARSI, 3, 20–28.
Eldenburg, L. G., Krishnan, H. A., & Krishnan, R. (2017). Management Accounting and Control in the Hospital Industry: A Review. Journal of Government & Nonprofit Accounting, 6(1), 52–91. https://doi.org/10.2308/ogna-51922
Fahlevi, H. (2016). Understanding why the role of accounting is unchanged in Indonesian public hospitals. Journal of Accounting and Organizational Change, 12(2). https://doi.org/10.1108/JAOC-03-2014-0020
Fahlevi, H., Irsyadillah, I., Indriani, M., & Oktari, R. S. (2022). DRG-based payment system and management accounting changes in an Indonesian public hospital: exploring potential roles of big data analytics. Journal of Accounting and Organizational Change, 18(2), 325–345. https://doi.org/10.1108/JAOC-10-2020-0179
Fahlevi, H., Mustika, V. M., Mulyany, R., Rahavu, M., Yasir, M., & Dawood, R. (2021). Predicting Cost Recovery Rate of Inpatient Cases: The Application of Machine Learning Approaches. 2021 International Conference on Decision Aid Sciences and Application, DASA 2021, 1002–1006. https://doi.org/10.1109/DASA53625.2021.9682351
Fahlevi, H., Putra, T. R. I., & Oktari, R. S. (2020). Predicting Cost Recovery Rate of Ischemic Stroke Patients: A Potential Application of Big Data Analysis in Hospital. Journal of Physics: Conference Series, 1500(1). https://doi.org/10.1088/1742-6596/1500/1/012106
Gümüş, A., Çilli, A., Çakın, Ö., Karakurt, Z., Ergan, B., Aksoy, E., & Cengiz, M. (2019). Factors affecting cost of patients with severe community-acquired pneumonia in intensive care unit. Turkish Thoracic Journal, 20(4), 216–223. https://doi.org/10.5152/TurkThoracJ.2018.18084
Handayani, L., Suharmiati, S., & Pratiwi, N. L. (2019). Unit Cost Rumah Sakit Dan Tarif Ina-Cbgs: Buletin Penelitian Sistem Kesehatan, 21(4), 219–227. https://doi.org/10.22435/hsr.v21i4.45
Jacobs, K., Marcon, G., & Witt, D. (2004). Cost and performance information for doctors: An international comparison. Management Accounting Research, 15(3), 337–354. https://doi.org/10.1016/j.mar.2004.03.005
Jovanović, T., Dražić-Lutilsky, I., & Vašiček, D. (2019). Implementation of cost accounting as the economic pillar of management accounting systems in public hospitals–the case of Slovenia and Croatia. Economic Research-Ekonomska Istrazivanja , 32(1), 3754–3772. https://doi.org/10.1080/1331677X.2019.1675079
Kulkarni, S., Ambekar, S.S. and Hudnurkar, M. (2021), Predicting the inpatient hospital cost using a machine learning approach", International Journal of Innovation Science, 13 (1), 87-104. https://doi.org/10.1108/IJIS-09-2020-0175
Kuo, C. Y., Yu, L. C., Chen, H. C., & Chan, C. L. (2018). Comparison of models for the prediction of medical costs of spinal fusion in Taiwan diagnosis-related groups by machine learning algorithms. Healthcare Informatics Research, 24(1), 29–37. https://doi.org/10.4258/hir.2018.24.1.29
Lehtonen, T. (2007). DRG-based prospective pricing and case-mix accounting — Exploring the mechanisms of successful implementation. Management Accounting Research, 18, 367–395. https://doi.org/10.1016/j.mar.2006.12.002
Leotta, A., & Ruggeri, D. (2012). Changes in performance measurement and evaluation systems as institutional processes: The case of an italian teaching hospital. Studies in Managerial and Financial Accounting, 25, 427–463. https://doi.org/10.1108/S1479-3512(2012)0000025019
Liputan 6. Bertahun-tahun Defisit, Keuangan BPJS Kesehatan Akhirnya Surplus Rp 38,7 Triliun. https://www.liputan6.com/bisnis/read/5005877/bertahun-tahun-defisit-keuangan-bpjs-kesehatan-akhirnya-surplus-rp-387-triliun.
Maghfira, K., Fahlevi, H., & Basri, H. (2018). The Role of Doctor in Accounting and Cost Containment Strategy in Public and Private Hospitals in Banda Aceh. Account and Financial Management Journal, 3(03), 1437–1442. https://doi.org/10.18535/afmj/v3i3.11
Mardiah. (2016). Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RSUP Dr. Mohammad Hoesin Palembang Tahun 2015. Jurnal Administrasi Rumah Sakit Indonesia, 2(3), 245–259.
Mardiah, M., & Rivany, R. (2017). Cost Recovery Rate Tarif Rumah Sakit dan Tarif INA-CBG’s Berdasarkan Clinical Pathway pada Penyakit Arteri Koroner di RS Pemerintah A di Palembang Tahun 2015. Jurnal Ekonomi Kesehatan Indonesia, 1(4), 175–184. https://doi.org/10.7454/eki.v1i4.1794
Perelman, J., & Closon, M. C. (2007). Hospital response to prospective financing of in-patient days: The Belgian case. Health Policy, 84(2–3), 200–209. https://doi.org/10.1016/j.healthpol.2007.05.010
Pettersen, I., & Solstad, E. (2014). Managerialism and profession-based logic: The use of accounting information in changing hospitals. Financial Accountability & Management, 30(4), 363–382.
Rahayuningrum, I. O., Tamtomo, D., & suryono, A. (2016). Comparison Between Hospital Inpatient Cost and INA-CBGs Tariff of Inpatient Care in the National Health Insurance Scheme in Solo, Boyolali and Karanganyar Districts, Central Java. Journal of Health Policy and Management, 01(02), 102–112. https://doi.org/10.26911/thejhpm.2016.01.02.05
Rawung, L. C., & Sholihin, M. (2017). Does Extended Autonomy of Public Service Agency Lead to A Better Performance? A Case of Indonesian Community Health Centers. Jurnal Dinamika Akuntansi Dan Bisnis, 4(2), 231–248. https://doi.org/10.24815/jdab.v4i2.8082
Rauliajtys-Grzybek, M., Baran, W., & Macuda, M. (2017). Cost accounting in public hospitals in Poland: Usefulness for internal and external purposes. Journal of Health Management, 19(2), 275–291. https://doi.org/10.1177/0972063417699690
Sari, R. P. (2014). Perbandingan Biaya Riil Dengan Tarif Paket INA CBGs. Journal Spread, 4(April), 61–70.
Suhartoyo, S. (2018). Klaim Rumah Sakit Kepada BPJS Kesehatan Berkaitan Dengan Rawat Inap Dengan Sistem INA– CBGs. Administrative Law and Governance Journal, 1(2), 182–195. https://doi.org/10.14710/alj.v1i2.182-195
Sushmita, S., Newman, S., Marquardt, J., Ram, P., Prasad, V., De Cock, M., & Teredesai, A. (2015). Population cost prediction on public healthcare datasets. ACM International Conference Proceeding Series, 2015-May, 87–94. https://doi.org/10.1145/2750511.2750521
Sutoto. (2014). Perubahan Tarif INA-CBGs. Info BPJS Kesehatan, 8, 1–12.
Wang, C., Pan, X., Zhuang, W., & Ma, F. (2018). Forecast of hospitalization costs of child patients based on machine learning methods and multiple classification. Journal of Advances in Information Technology, 9(4). https://doi.org/10.12720/jait.9.4.89-96
Wu, A., Dong, H., Wu, Q., & Ling, L. (2011). A survey of application-level protocol identification based on machine learning. Proceedings - 2011 4th International Conference on Information Management, Innovation Management and Industrial Engineering, ICIII 2011, 3, 201–204. https://doi.org/10.1109/ICIII.2011.331
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