Analisis Beban Biaya Sendiri Pasien Rawat Inap Peserta Askes di RSUD dr. Achmad Diponegoro, Putussibau, Kalimantan Barat

Johanes Eko Kristiyadi

Abstract


PT. Askes asuradur yang mengelola asuransi wajib pegawai negeri sipil yang dalam peraturannya membolehkan peserta membayar beban biaya sendiri (out of pocket) karena perbedaan antara tarif rumah sakit dengan tarif paket Askes. Penelitian ini bertujuan untuk mengetahui berbagai faktor yang berpengaruh dan model prediksi beban biaya sendiri pasien rawat inap peserta Askes di RSUD dr. Achmad Diponegoro-Putussibau, Kabupaten Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian yang digunakan adalah survei dengan sampel sebesar 257 pasien rawat inap tahun 2005. Dfitemukan Rata-rata beban biaya sendiri sebesar Rp. 215.472atau 20,84 % dari rata-rata biaya perawatan sesuai tariff RSUD. Beban minimum dan maksimum adalah Rp. 25.000,- dan Rp. 2.784.000,- dipengaruhi oleh faktor lama hari rawat, penyakit penyulit, obat-obatan, peserta, peserta3(isteri), golongan pegawai, interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan. Interaksi antara lama hari rawat dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai ? 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,313*lama hari rawat - 0,785*tidak ada penyakit penyulit + 0,819*obat-obatan (Non DPHO) + 67,397*peserta + 0,179*istri + 1,489*golongan + 0,260*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Interaksi lama hari rawat dengan penyakit penyulit.

Kata Kunci : Biaya sendiri, asuransi kesehatan

Abstract

PT Askes is the health insurance provider with mandatory membership for public officers in Indonesia. In reality, patient still have to cover some expenses from his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. The objective of this research is to find out the determinant factors and the prediction model of out of pocket expenses among hospitalized patients with Askes membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas Hulu District, West Kalimantan Province in 2005. This design used in this study is cross-sectional, using 257 samples of hospitalized patients in dr. Achmad Diponegoro Hospital in Putusibau, Kapuas Hulu District, West Kalimantan Province during the year of 2005. The average amount of out of pocket expenses of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare is Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospital, type of illness, medications, type of membership (member1=the person with the membership, member3=the spouse), level 1 employee, the interaction between length of stay with type of illness, and the interaction between complicated illness and drugs are the most influence factor ( the ? value are the highest, that is 0,624). The assumption and interaction test, resulted in the model: self expenses = 5,743 + 0,313*length of stay - 0,785*no complicated illness + 0,819*drugs (Non DPHO) + 67,397*member1 + 0,179*member3 + 1,489*employee1 + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between length of stay and complicated illness.

Key word : Out of pocket, health insurance


Full Text:

PDF


DOI: http://dx.doi.org/10.21109/kesmas.v2i4.260

Refbacks

  • There are currently no refbacks.