ABSTRAK
Kesehatan adalah hak fundamental setiap warga sehingga negara bertanggung jawabuntuk mengaturnya. Pemerintah dengan program Jamkesmas menjamin pembiayaanmasyarakat miskin dengan perhitungan biaya berdasar sistem pembiayaan INA-CBG.Kraniotomi termasuk 3 terbanyak tindakan medik operatif pasien Jamkesmas tahun2011 di RSUP dr. Kariadi. Terdapat perbedaan pengelompokan dan perbedaan biayakraniotomi berdasar INA – CBG dan RSUP Dr. Kariadi Semarang. Clinical pathwaykraniotomi belum ada di RSUP Dr. Kariadi Semarang.Tujuan penelitian ini adalah menyusun clinical pathway dan menganalisa biayakraniotomi berdasar tarif paket INA CBG di RSUP Dr. Kariadi Semarang tahun 2012.Data primer yang didapatkan meliputi : jumlah dan identitas pasien Jamkesmas yangmenjalani tindakan kraniotomi pada tahun 2012, hasil wawancara dan wawancaramendalam, hasil wawancara dalam fokus grup diskusi, hasil pengamatan langsung padasaat kraniotomi dilakukan. Data sekunder didapatkan dari dokumen rekam medis pasienJamkesmas yang menjalani tindakan kraniotom pada tahun 2012. Instrumen yangdigunakan pada penelitian ini yaitu formulir penelitian, pedoman wawancara, databiling tagihan keuangan pasien Jamkesmas yang menjalani kraniotomi , dan pedomandiskusi grup.Berdasar diagnosis utama, diagnosis penyerta dan penyulit , tingkat kesadaran , lokasidan besar neplasma / perdarahan , tersusun 6 clinical pathway kraniotomi yaitu :kranitomi ringan trauma , kraniotomi ringan non trauma , kraniotomi sedang trauma ,kraniotomi sedang non trauma , kraniotomi berat trauma , dan kraniotomi berat nontrauma.Cost of treatment tindakan kraniotomi di RSUP Dr. Kariadi untuk kelompokkraniotomi ringan Rp. 22.627.449,00 , kraniotomi sedang Rp. 27.589.090,00 , dankraniotomi berat Rp. 46.372.634,00. Terdapat selisih antara cost of treatment tindakankraniotomi berdasar tarip INA CBG dan RSUP DR. Kariadi Semarang. Selisih biayauntuk kraniotomi ringan Rp. 18.715.922,80 , kraniotomi sedang Rp. 22.066.987,50 , danuntuk kraniotomi berat Rp. 39.827.762,99.

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ABSTRACT
Right to health is a one of basic human rights, and it’s an obligation for the governmentthat every citizens have it equally.The Indonesian government with its social programguarantee the cost of health expenditure for the poor named INA CBG payment scheme.One of the top 3 most performed medical surgery with the Jamkesmas social insurancepayment at Kariadi hospital in 2011 was craniotomi. There’s differences in groupingand cost in craniotomi procedure if we compare between INA CBG medical expenditureplan with Kariadi hospital. Kariadi hospital don’t have clinical pathway on craniotomi.The goal of this research is to make a clinical pathway on craniotomi and to analyze thecraniotomi expenditure plan based on INA CBG for Kariadi hospital in 2012.The primary data will be patients with Jamkesmas social insurance that had craniiotomiprocdure in 2012, deep and structured interviewed on focus group discussion, directobservation when craniotomi’s were performed. Secondary data was medical records onpatients with jamkesmas social insurance that had craniotomi in 2012. The researchinstruments are research form, deep and structured interview guidance and discussiongroup protocol.Based on primary diagnosis, complimentary diagnosis, the difficulty level, the degreeof conciuosness, location and the degree of bleeding/ the size of the neoplasma, wemanaged to make 6 clinical pathway on craniotomi procedures which are mild traumacraniotomi, mild non trauma craniotomi, intermediate trauma craniotomi, intermediatenon trauma craniotomi, severe trauma craniotomy, and severe non trauma craniotomy.The cost of treatment of mild craniotomi in Kariadi hospital was Rp. 22.627.449,00 ,intermediate craniotomi was Rp. 27.589.090,00 , while severe craniotomy was Rp.46.372.634,00. There were differences cost of treatments on craniotomy procedurebetween INA CBG and Kariadi hospital which were : for mild craniotomy Rp.18.715.922,80 , intermediate craniotomy Rp. 22.066.987,50 , and severe craniotomiRp. 39.827.762,99.