Cost of Treatment Tonsilektomi di Instalasi Bedah Sentral RSUD Kajen Kabupaten Pekalongan Tahun 2015

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Administrasi Rumah Sakit 2016 ABSTRAK Imam Prasetyo Cost of Treatment Tonsilektomi di Instalasi Bedah Sentral RSUD Kajen Kabupaten Pekalongan Tahun 2015, xv + 111 halaman + 30 tabel + 3 gambar + 13 lampiran Tarif pelayanan RSUD Kajen yang dibebankan pada pasien umum saat ini dibuat berdasarkan perhitungan biaya operasional yang terjadi, seperti biaya jasa medis, bahan habis pakai, obat – obatan, kelas perawatan, dan sewa kamar operasi, tetapi belum menghitung seluruh komponen biaya yang terlibat untuk tindakan tonsilektomi. Pembuatan tarif belum memperhitungkan biaya – biaya yang tidak langsung. Perda Nomor 1 Tahun 2012, untuk tindakan tonsilektomi RSUD Kajen berdasarkan telusur di rawat inap biaya penanganan tonsilektomi adalah Rp 3.275.100,00 untuk kelas 3, sedangkan untuk klaim BPJS tindakan tonsilektomi kelas 3 di RS Regional 1 tipe C Rp 1.767.900,00; dalam hal ini masih ada selisih biaya antara besaran biaya yang seharusnya dikeluarkan untuk penanganan tonsilektomi dengan besarnya klaim dari BPJS. Seharusnya setiap pembiayaan perlu dihitung dengan baik sesuai dengan clinical pathway agar dapat ditetapkan unit costnya sehingga dapat menjadi efektif dan efisien agar tercipta pelayanan kesehatan yang bermutu. Tujuan penelitian ini adalah mengetahui besaran unit cost berbasis clinical pathway pada diagnosis tonsilektomi di RSUD Kajen. Jenis penelitian ini adalah penelitian observasional analitik dengan melakukan studi kasus di RSUD Kajen. Perumusan clinical pathway dilakukan melalui rapat tim penyusun. Perhitungan unit cost dilakukan dengan metode Activity Based Costing (ABC), penetapan biaya lebih. Hasil perumusan clinical pathway menunjukkan bahwa tahapan pathway diagnosis tonsilektomi adalah admision (pendaftaran), diagnostic (pemeriksaan), therapy (pengobatan) & follow up (tindak lanjut). Dari perhitungan dengan metode ABC diperoleh unit cost diagnosis tonsilektomi sebesar Rp. 2.717.662,00. Hasil perhitungan analisis pemulihan biaya (cost recovery rate) diketahui bahwa CRR pada pasien umum sebesar 121% sedangkan pasien BPJS sebesar 65% hal ini menunjukkan bahwa untuk setiap pasien umum RSUD Kajen mendapatkan surplus sebesar 21% sedangkan untuk pasien BPJS RSUD Kajen mendapatkan minus sebesar 35%. Rekomendasi manajerial yang dapat diberikan adalah: penyusunan clinical pathway kemudian implementasi konsep final clinical pathway tersebut sebagai quality control RUSD Kajen. Disarankan agar RSUD Kajen melakukan penelusuran biaya dan monitoring serta evaluasi kepatuhan clinical pathway. Kata kunci : unit Cost, Cost Of Treatment, Clinical Pathway, Tonsilektomi Kepustakaan : 45 (1993 – 2015) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Hospital Administration 2016 ABSTRACT Imam Prasetyo Cost of Tonsillectomy Treatment at Central Surgery Installation of Kajen Public Hospital in District of Pekalongan in 2015 xv + 111 pages + 30 tables + 3 figures + 13 appendices Tariff of services at Kajen Public Hospital charged on general patients was calculated based on operational costs like cost of medical services, consumables, medicines, treatment class, and rental cost of surgery room. Unfortunately, all components of costs for tonsillectomy treatment had not been included. Determination of the tariff had not calculated indirectly costs. Tariff of tonsillectomy treatment at the Kajen Public Hospital at inpatient room based on a local regulation Number 1 year 2012 was Rp 3,275,000 for class 3 whereas tariff for claim of BPJS at the same class at a regional hospital type C was Rp 1,767,900. In this case, there was any difference between costs that had to be spent for tonsillectomy treatment and claim from BPJS. Each cost must be calculated in accordance with clinical pathway to determine unit cost in order to provide high-quality of services. The aim of this study was to figure out amount of unit cost based on clinical pathway on tonsillectomy diagnosis at the Kajen Public Hospital. This was an observational analytic study by conducting a case study at the Kajen Public Hospital. Clinical pathway was arranged through meeting of a drafting team. A calculation of unit cost was performed using a method of Activity Based Costing (ABC), determination of exceeding cost. The results of clinical pathway arrangement showed that steps of tonsillectomy diagnosis pathway were as follows: admission, diagnostic, therapy, and follow up. Unit cost of tonsillectomy diagnosis based on the ABC calculation was Rp 2,717,662. The results of cost recovery rate calculation demonstrated that CRR among general patients was 121% whereas among BPJS patients was 65%. It means that each general patient of the Kajen Public Hospital obtained surplus as many as 21% otherwise each BPJS patient obtained minus as many as 35%. Arrangement of clinical pathway and implementation of final clinical pathway could be used as quality control of the Kajen Public Hospital. The hospital management needs to trace costs, to monitor, and to evaluate the obedience of clinical pathway. Keywords : Unit Cost; Cost of Treatment; Clinical Pathway; Tonsillectomy Bibliography: 45 (1993-2015