ABSTRAKDalam rangka universal health coverage, Indonesia mempersiapkan pelaksanaan BPJS-SJSN
yang akan dimulai bulan Januari tahun 2014. Perbedaan tarif BPJS dan rumah sakit menjadi
masalah mendasar. RSIA swasta Hermina Bogor mempersiapkan diri mengantisipasi
pelaksanaan BPJS dengan tujuan agar tetap survive.
Melalui desain kuantitatif dilakukan analisis tagihan tindakan Sectio Caesaria (SC) pasien
kelas III, dengan komponen tagihan : jasa medis, penunjang medis, alat medis, kamar
perawatan, biaya lain - lain dan administrasi. Wawancara mendalam dilakukan kepada
manajemen rumah sakit.
Rata ? rata tagihan SC pasien kelas III = Rp.11,13 juta. Uji multivariat membuktikan bahwa
jenis tindakan paling mempengaruhi variasi tagihan. Rumah sakit diharapkan mampu
mengendalikan biaya penunjang medis, jasa medis dan anjuran pemeriksaan kehamilan
kepada pasien.
ABSTRACTIndonesia is on the move to prepare the implementation of Universal Health Coverage to be
conducted in 2014. The difference between BPJS tarieff and actual billing of hospitals
become a serious problem. Billing components comprised of doctor?s fee, medical support
(laboratorium, drugs, blood, Rontgent), room charges, medical equipments rent and
administrative cost. This quantitative and qualitative study of Sectio Caesaria patients, 3rd
class at Hermina MCH private hospital Bogor found that the average billing is Rp 11,1
million. Type of surgical action contributed most to the variation of billing.Recommendations
to the hospital are : to control usage of medical support, rental of medical equipments and to
encourage ANC to patients. Government to study further on tarieff variations of private
hospitals.
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