ANALISIS BIAYA PENGOBATAN KANKER SERVIKS SEBAGAI PERTIMBANGAN DALAM PENETAPAN PEMBIAYAAN KESEHATAN BERDASARKAN INA-DRGs DI RSUD Dr. MOEWARDI

The implementation of INA-DRGs system for the third-class patients of Jamkesmas (Public Health Insurance Program) in hospital is expectedly able to increase the access and the health service quality for the poor and underprivileged people in effectively and efficiently realizing the optimal health service. This research is purposively to obtain the average cost of medical treatment of cervical cancer and also learn the compatibility between cost of medical treatment of cervical cancer in RSUD Dr. Moewardi and the constancy of INA-DRGs based health financing. This is a descriptive research under the perspective of hospital in which its method in collecting data is retrospectively done by investigating the medical record document of patients with cervical cancer and the data of the medical treatment cost of patients. The research subject is cervical cancer case with the third-class patients of JAMKESMAS in RSUD Dr. Moewardi in the period of January-July 2010 that is in line with the inclusion criteria. Further, the data analysis is done by cross tab with Chi Square test and by comparing the average cost and ALOS (Average length of stay) through the constancy of INA-DRG. The test result of Chi Square shows a correlation between LOS, patient factor (the number of parities), disease factors (co-morbidity and severity level) with the health care cost for cervical cancer in RSUD. Dr. Moewardi. The health care average cost of cervical cancer based on the tariff of RSUD Dr. Moewardi for the severity level I include: IDR2.893.243 for surgery, IDR3.313.342 for chemotherapy, IDR3.988.027 for radiotherapy and IDR10.039.072 for radical hysterectomy. Meanwhile, in the severity level II, it includes IDR5.885.859 for surgery, IDR4.474.084 for chemotherapy. In the severity level III, it includes IDR13.347.209 for radical hysterectomy. The ALOS is longer compared to ALOS of INA-DRG except in the severity level III. This then gives an effect on the health care cost for cervical cancer that in general is higher than the tariff of INADRG. In conclusion, inefficient implementation of INA-DRG for the treatment of cervical cancer in patients of JAMKESMAS in RSUD Dr. Moewardi