Comparison of Real Cost Versus the Indonesian Case Base Groups (INZ-CBGs) Tariff Rates Among Patients of High- Incidence Cancers Under the National Health Insurance Scheme

Document Type: Research Articles

Authors

1 Faculty of Pharmacy, University Gadjah Mada, Indonesia.

2 Faculty of Pharmacy, Setyabudi University, Indonesia.

Abstract

Background: The national health insurance of Indonesia has implemented the Indonesian Case Base Groups
(INA-CBGs) tariff rates for healthcare payment. However, there is still problem of difference between the real cost of
healthcare and the INA-CBGs tariff rates. This study aimed to evaluate the real cost of healthcare in comparison with
the INA-CBG’s tariff rates and to analyze factors associating with the real cost. The study focus on healthcare cost of
non-chemotherapy expenditure among patients of high-incidence cancers having chemotherapy covered by the national
health insurance. Methods: The study was conducted from the perspective of healthcare provider. Costs data was
obtained from hospital billing of Sanglah hospital, a referral hospital in Bali Provincein the period of January – July
2014. The data involved 383, 161, and 152 of in-patient breast cancer cases, cervical cancer cases, and nasopharyngeal
cancer cases, respectively. Descriptive statistic was used to analyze patients characteristics, one sample t-test was used
to analyze the mean difference of healthcare cost based on real cost and INA-CBG’s tariff rates, and finally, bivariate
analysis was used to examine relationship between patients’ characteristics and the real cost. Results: The study shows
there were significant differences of non-chemotherapy expenditures based on the real cost and INA-CBG’s tariff rates,
in which the costs were lower for the real cost. Factors which significantly associated with the real cost were number of
procedure, type of hospitalized room, and length of stay. Conclusions: The study supports the necessary of evaluation
of the INA-CBG’s tariff rates to adjust to the real healthcare expenditure. On the other hand, the hospital needs to
evaluate the service quality of patient treatment by optimizing budget allocated by the health insurance.

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