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"Casemix, casemix index dan hospital baserate merupakan indikator penting untuk melihat kinerja rumah sakit dengan pembayaran DRG. Indikator tersebut merupakan penyusun besaran tarif INA-CBGs, instrumen penilaian kinerja rumah sakit mitra BPJS Kesehatan dan instrumen penyusun pembayaran klaim mixed method INA-CBGs dan global budget yang mulai diujicobakan. Cakupan pelayanan rawat inap dan rawat jalan rumah sakit Muhammadiyah Jawa Timur didominasi pasien JKN, rumah sakit harus mempunyai keunggulan kompetitif dan dapat berkembang di era JKN. Penelitian bertujuan menganalisis capaian casemix, casemix index dan hospital baserate Rumah Sakit Muhammadiyah Jawa Timur tahun 2017-2020. Studi observasional dengan pengamatan selama empat tahun dilakukan pada 27 rumah sakit. Penelitian menggunakan data sekunder yang didapatkan dari elektronik klaim (E-klaim) Kementerian Kesehatan. Hasil penelitian menunjukkan klasifikasi rumah sakit, jenis rumah sakit, kelas perawatan, dan lama hari rawat inap mempengaruhi capaian casemix, casemix index dan hospital baserate. Casemix, casemix index dan hospital baserate rumah sakit kelas B lebih besar dibandingkan rumah sakit kelas C dan kelas D, capaian indikator rumah sakit umum kelas C lebih besar dibandingkan rumah sakit khusus kelas C. Capaian indikator antar rumah sakit pada kelas yang sama dapat berbeda signifikan tergantung variasi dan derajat keparahan kasus. Rumah sakit yang menangani kasus derajat berat mempunyai nilai casemix, casemix index dan hospital baserate lebih besar. Hasil uji statistik menunjukkan lama rawat inap berpengaruh signifikan terhadap kenaikan hospital baserate rawat inap, semakin lama hari perawatan maka peluang peningkatan hospital baserate semakin besar (p<0,05). Rumah sakit yang menangani kasus hemodialisis dan operasi katarak mempunyai casemix, casemix index dan hospital baserate rawat jalan lebih besar. Pandemi COVID-19 pada tahun 2020 berdampak pada capaian casemix, casemix index dan hospital baserate rumah sakit. Sebanyak 19 rumah sakit (70,4%) mengalami penurunan capaian casemix rawat inap dan 20 rumah sakit (74,1%) mengalami penurunan casemix rawat jalan. Sebanyak 21 rumah sakit (77,4%) mengalami peningkatan hospital baserate rawat inap dan 23 rumah sakit (85,2%) mengalami peningkatan hospital baserate rawat jalan pada tahun 2020. Kesimpulan: capaian indikator casemix, casemix index dan hospital baserate dipengaruhi oleh klasifikasi, jenis rumah sakit, jumlah kasus, variasi dan derajat keparahan kasus serta lama rawat inap. Pandemi COVID-19 berdampak pada penurunan nilai casemix dan peningkatan hospital baserate rawat inap dan rawat jalan. Rumah sakit harus meningkatkan cakupan pelayanan, mengendalikan biaya pelayanan dan menjamin kualitas pengkodean diagnosis dan prosedur secara optimal. Rumah sakit harus memonitor capaian casemix, casemix index dan hospital baserate rawat inap dan rawat jalan secara berkala dan membandingkan dengan rumah sakit lain yang mempunyai kelas dan kapasitas yang sama.......Casemix, casemix index and hospital baserate are important indicators to see the hospital performance with DRG payments. These indicators are the compilers of the INA-CBGs tariff rate, the performance assessment instrument for Healthcare and Social Security Agency partner hospitals and the instrument for compiling claims for the mixed method INA-CBGs and global budget which are being piloted. The coverage of inpatient and outpatient services at Muhammadiyah Hospitals in East Java is dominated by the National Health Insurance patients, therefore the hospitals must have a competitive advantages and be able to develop well in the JKN era. This study aims to analyze the achievement of casemix, casemix index and hospital baserate at Muhammadiyah Hospitals in East Java in year 2017-2020. An observational study within four years of observation was conducted in 27 hospitals. The study used secondary data obtained from the Ministry of Health's electronic claims (E-claims). The results showed that hospital classification, type of hospital, treatment class, and length of stay affected the achievement of casemix, casemix index and hospital base-rate. The casemix, casemix index and hospital base-rate of class B hospitals are higher than those of class C and class D hospitals, the indicator achievement of class C general hospitals is greater than those of special class C hospitals. The achievement of indicators between similar class hospitals can differ significantly. depending on the variety and severity level. Hospitals that handle severe cases have higher casemix, casemix index and hospital baserate values. The results of statistical tests showed that the length of stay had a significant effect on the increase of inpatient hospital baserate, the longer the days of stay, the greater the chance of increasing the hospital baserate (p <0.05). Hospitals that handle cases of hemodialysis and cataract surgery have a higher casemix, casemix index and outpatient hospital base-rate. The COVID-19 pandemic in 2020 had an impact on the achievement of casemix, casemix index and hospital base-rates. A total of 19 hospitals (70.4%) experienced a decrease in inpatient casemix achievement and 20 hospitals (74.1%) experienced a decrease in outpatient casemix. A total of 21 hospitals (77.4%) experienced an increase in inpatient hospital baserate and 23 hospitals (85.2%) experienced an outpatient hospital baserate increase in 2020. Conclusion: the achievement of the casemix, casemix index and hospital baserate indicators are influenced by classification, type of hospital, number of cases, variation and severity level and length of stay. The COVID-19 pandemic has resulted a decrease in casemix values and an increase in inpatient and outpatient hospital baserates. Hospitals must increase healthcare coverage, control costs and ensure optimal quality of diagnostic coding and procedures. Hospitals must monitor the achievement of casemix, casemix index and hospital baserates of inpatient and outpatient regularly and compare to other hospitals of the same class and capacity."

"Casemix, casemix index dan hospital baserate merupakan indikator penting untuk melihat kinerja rumah sakit di bawah sistem pembayaran INA-CBGs. Indikator tersebut merupakan penyusun besaran tarif INA-CBGs, instrumen penilaian kinerja rumah sakit mitra BPJS Kesehatan dan instrumen penyusun pembayaran klaim mixed method INACBGs dan global budget yang mulai diujicobakan. Penelitian ini bertujuan untuk menganalisis capaian indikator casemix, casemix index dan hospital baserate RSPON Mahar Mardjono tahun 2018 - 2022. Penelitian dilakukan di RSPON Mahar Mardjono selama bulan Maret - Juni 2024, menggunakan data sekunder yang didapatkan dari rekapitulasi elektronik klaim (e-klaim) Kemenkes dan laporan rumah sakit.Penelitian ini menggunakan studi cross sectional menggunakan pendekatan analitik untuk menghitung capaian indikator Casemix, CMI dan HBR rawat inap dan rawat jalan. Analisis multivariat dengan regresi linier digunakan untuk melihat variabel independen yang berkaitan dengan variabel dependen indikator casemix dan CMI. Hasil penelitian menunjukkan bahwa jumlah kasus, jumlah kasus dengan prosedur canggih, dan proporsi produktif berpengaruh signifikan terhadap casemix rawat jalan. Jumlah Kasus, Jumlah Kasus dengan Prosedur Canggih, dan Proporsi SL3 berpengaruh signifikan terhadap Casemix Rawat Inap. Jumlah Kasus, Jumlah Kasus dengan Prosedur Canggih, dan Proporsi Produktif berpengaruh signifikan terhadap CMI Rawat Jalan. Jumlah Kasus, Jumlah Kasus dengan Prosedur Canggih, Proporsi SL2, Proporsi SL3, dan Proporsi Meninggal berpengaruh signifikan terhadap CMI Rawat Inap.Casemix rawat jalan tertinggi pada bulan November 2022 yakni 7956, sedangkan casemix terendah terjadi pada bulan Mei 2020 sebesar 1929. Capaian rata-rata casemix rawat jalan tertinggi pada tahun 2022 yaitu 6.738,01. Casemix rawat inap tertinggi pada bulan Desember 2022 sebesar 2392 dan terendah pada Mei 2020 sebesar 1006. Capaian rata-rata casemix rawat inap tertinggi pada tahun 2022 yaitu 1980,98CMI rawat jalan tertinggi pada bulan Maret 2021 sebesar 1,0821 dan terendah pada April 2018 sebesar 0,9461. Capaian rata-rata CMI rawat jalan tertinggi pada tahun 2021 yaitu 1,044. CMI rawat inap tertinggi terdapat pada bulan Februari 2018 sebesar 3,65 dan terendah pada Desember 2020 sebesar 2,18. Capaian rata-rata CMI rawat inap tertinggi pada tahun 2018 yaitu 3,009.HBR Rawat Jalan tertinggi pada tahun 2020 sebesar Rp413.578, dan terendah dicapai pada tahun 2018 sebesar Rp356.297. HBR Rawat Inap tertinggi pada tahun 2022 sebesar Rp10.528.093, dan terendah dicapai pada tahun 2019 sebesar Rp9.309.404. HBR Rawat Jalan RSPON tahun 2018-2022 lebih rendah dari HBR Nasional Kelas A Regional I yang berarti RSPON mengalami profit dengan tarif INA-CBGs rawat jalan, sedangkan HBR rawat inap, dan rawat inap per kelas perawatan RSPON tahun 2018-2022 lebih tinggi dari HBR Nasional Kelas A Regional I yang berarti RSPON mengalami defisit dengan tarif INA-CBGs rawat inap.......Casemix, casemix index and hospital baserate are important indicators for assessing hospital performance under the INA-CBGs payment system. These indicators determine the INA-CBGs tariff rates, serve as performance assessment tools for hospitals partnered with BPJS Kesehatan, and contribute to the payment claim structure of the mixed-method INACBGs and global budget being piloted. This research aims to analyze the achievements of casemix, casemix index, and hospital baserate indicators at RSPON Mahar Mardjono from 2018 to 2022. The research was conducted from March to June 2024 by researchers at RSPON Mahar Mardjono.Analysis of the achievement of casemix, casemix index and hospital baserate using secondary data obtained from data recapitulation on electronic claims (e-claims) of the Ministry of Health and hospital reports. This cross-sectional study employed an analytical approach to calculate the achievement of casemix, casemix index, and hospital baserate for both inpatient and outpatient care. Multivariate analysis with linear regression was used to examine independent variables associated with the dependent variables of casemix and casemix index. The results indicate that variables such as number of cases, number of cases with advanced procedures, and productive proportion significantly influence outpatient casemix. Similarly, the number of cases, cases with advanced procedures, and SL3 proportion significantly affect inpatient casemix. For outpatient casemix index, the variables influencing significantly are number of cases, cases with advanced procedures, and productive proportion. For inpatient casemix index, significant variables include number of cases, cases with advanced procedures, SL2 proportion, SL3 proportion, and mortality proportion.The highest outpatient casemix was in November 2022, at 7956, while the lowest occurred in May 2020 at 1929. The highest average outpatient casemix achievement in 2022 was 6,738.01. The highest inpatient casemix was in December 2022, at 2392, and the lowest was in May 2020 at 1006. The highest average inpatient casemix achievement in 2022 was 1980.98.The highest outpatient casemix index was in March 2021 at 1.0821, and the lowest was in April 2018 at 0.9461. The highest average outpatient casemix index achievement in 2021 was 1.044. The highest inpatient casemix index was in February 2018 at 3.65, and the lowest was in December 2020 at 2.18. The highest average inpatient casemix index achievement in 2018 was 3.009.The highest Hospital Baserate for outpatient care was IDR548.434 in 2020, and the lowest was IDR481.862 in 2018. The highest Hospital Baserate for inpatient care was IDR12.852.109 in 2018, and the lowest Rp11.031.593 in 2021. The Hospital Baserate for outpatient care at RSPON from 2018 to 2022 was lower than the National HBR Class A Regional I, indicating that RSPON made a profit with INA CBG's outpatient tariffs. Conversely, the Hospital Baserate for inpatient care at RSPON from 2018 to 2021 was higher than the National HBR Class A Regional I, indicating that RSPON incurred a deficit with INA CBG's inpatient tariffs."