The Impact of Casemix Reimbursement on Hospital Revenue in Indonesia

Authors

  • Irwan Saputra University Kebangsaan Malaysia (UKM) United Nations Unoiversity - International Institute for Global Health ( UNU-IIGH)
  • Syed Mohamed Aljunid International Centre for Casemix and Clinical Coding UKM Department of Health Policy and Management, Faculty of Public Health Kuwait University
  • Amrizal Muhammad Nur International Centre for Casemix and Clinical Coding UKM

Keywords:

Hospital revenue, sosial health insurance, casemix system, fee for service

Abstract

The objective of this study is to examine the impact of the casemix reimbursement on the hospital revenue three selected hospitals (Type B, C and D) reimbursed using 602 INA-CBG groups from 17,547 cases. The results of the study showed that the hospitals received 32.4% higher income when reimbursed with INA-CBG as compared to fee-for-service. Type D hospitals is the biggest gainer with 81.0% increased in income followed by Type B hospital that obtained 34.7% higher revenue. In conclusion, the use of INA-CBG as a prospective payment method has benefitted the hospitals by the increase in the revenues. It is hope that additional resources gained in this programme will allow the hospitals to provide optimum care to the population. It is recommended that the JKA management will use the INA-CBG casemix data to monitor the performance of the hospitals to ensure that quality and efficiency of the services provided to the population is continuously maintained.DOI: https://doi.org/10.17576/jskm-2020-1802-01

Author Biographies

Irwan Saputra, University Kebangsaan Malaysia (UKM) United Nations Unoiversity - International Institute for Global Health ( UNU-IIGH)

I am a Ph.D Student focus on health economics under UKM Malaysia and UNU-IIGH. Currently I work for Health Academiy of Aceh Government as a lecturer for Health care delivery subject. In addition, I developed the isllamic health care services for public hospital services delivery in Aceh Province.

Syed Mohamed Aljunid, International Centre for Casemix and Clinical Coding UKM Department of Health Policy and Management, Faculty of Public Health Kuwait University

Dr Aljunid’s main interest is in the strengthening of national health care systems through research and development in health policy, health economics and financing. He was responsible for the development of Master of Public Health Programme, Master of Science in Public Health (Health Economics and Hospital Management), DrPH Programme and PhD programme in Public Health and Hospital Management in a number of countries in Asia and Middle East. He has supervised more than 50 PhD candidates in the areas of public health, health policy, health economics and hospital management. He has vast experience in health economic methodologies and techniques including Cost-Analysis, Cost Effectiveness and Cost Benefit Analysis. He has conducted more than 60 research projects, most which are to support decision making on new technologies in developing countries. He owned 6 copyrights and patents from his research output. He is currently involved in supporting a number of developing countries to develop and implement casemix systems for provider payment methods under Social Health Insurance programmes for universal health coverage. His work on casemix systems covers research and capacity building programmes in many countries around the world including Malaysia, Indonesia, Philippines, Mongolia, Vietnam, Bhutan, China, Saudi Arabia, United Arab Emirates, Sudan, Nepal, Uruguay, Iran, Chile, Kenya and Ghana. He has published more than 170 journal articles, book chapters and scientific reports. He has presented more than 250 papers in international conferences seminars and workshops. He has authored and co-authored 5 books. His recent book is Measuring Hospitals Efficiency: Theory and Practice.

Amrizal Muhammad Nur, International Centre for Casemix and Clinical Coding UKM

Dr. Amrizal’s main interest is to assist developing countries in casemix management implementation (especially in patient data analysis, costing data analysis) and cost analysis in Health Care System through research and development in health economics and financing. He is currently involves in supporting a number of developing countries to develop and implement casemix management, a health management and information tool to enhance quality and efficiency of healthcare services provided under Social Health Insurance programmes. He works together with Prof Syed Mohamed Aljunid on casemix system in UNU-IIGH covers research and capacity building programmes in Malaysia, Indonesia, Philippines, Uruguay, Yemen, Kenya, United Arab Emirates, Vietnam and Ghana. He is the one of the Co-Developer and owner of the patents for casemix groupers United Nation Case Based Groups (UNU-CBGs), Malaysian DRGs (MY-DRGs), and Clinical Costing Modelling Software (CCM) for patient level costing.

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Published

2020-06-30

Issue

Vol. 18 No. 2 (2020)

Section

Articles

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