Analysis of Rate Differences between Hospital Real Costs and INACBG's Rates for Caesarean Section and Tonsillectom

Hospital tariff is the compensation received by the hospital for services from service and nonservice activities provided to service users. INA-CBG's tariff is the amount of claim payment by BPJS health to hospitals for service packages based on groupings of disease diagnoses and procedures. There is a difference in rates, where hospital rates are higher than INA-CBG's rates for caesarean and tonsillectomy procedures. The purpose of this study was to identify the tariff gap between INA-CBGs tariffs and hospital tariffs for caesarean section and Tonsillectomy procedures performed at Emanuel Hospital covered by BPJS in June 2023 - August 2023 and calculate the unit cost of the case. Descriptive research method by conducting document studies related to this research and make observations on the activities of Caesarean Section and Tonsillectomy procedures related to the costs arising from these activities. Identification of differences in INA-CBG's rates and hospital rates for the case groups studied, namely caesarean section of Rp. -179,981,100 and tonsil surgery Rp. -21,249,900. Calculation of unit cost of caesarean section for class I amounted to Rp. 8,179,260, Class II Rp. 7,939,260 and Class III Rp. 7,699,260. Tonsillectomy unit cost calculation for class I amounted to Rp. 5,666,590, Class II Rp. 5,506,590 and Class III Rp. 5,346,590. Class I, Class II and Class III INA-CBG's rates are lower than the unit cost of Caesarean Section and the unit cost of Tonsillectomy. Keywords: Real tariff, INA-CBG's Tariff, Caesarean Section, Tonsillectom