Selain tingkat morbiditas dan mortalitas yang tinggi, pembiayaan penyakit katastropik (gagal ginjal, kardiovaskular, kanker, thalassemia dan hemophilia) yang menyerap biaya sangat tinggi harus menjadi perhatian serius. Penelitian bertujuan untuk menganalisis biaya penyakit katastropik berdasarkan karakteristik peserta. Jenis penelitian kuantitatif analitik menggunakan data klaim di BPJS Kesehatan berupa data peserta dan biaya tahun 2014 berjumlah 309.301 klaim. Hasil analisis menunjukkan ada perbedaan bermakna rata-rata biaya penyakit katastropik menurut length of stay, kelas perawatan dan kelas rumah sakit. Upaya promotif, preventif serta manajemen penyakit penderita perlu ditingkatkan untuk mencapai efektivitas dan efisiensi biaya pelayanan kesehatan dalam menjamin keberlangsungan program jaminan kesehatan nasional.

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In addition to morbidity and mortality are high, financing catastrophic diseases (kidney failure, cardiovascular disease, cancer, thalassemia and hemophilia) that absorb very high cost should be a serious concern. The study aims to analyze the cost of catastrophic diseases based on the characteristics of participants. Quantitative research analytical uses claims data in the form of data BPJS participants and costs in 2014 amounted to 309 301 claims.

The analysis showed significant difference in the average cost of catastrophic illness according to length of stay, classes and class hospital care. Promotive, preventive and disease management of patients need to be improved to achieve cost effectiveness and efficiency of health care in ensuring the sustainability of national health insurance program.