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"Meningkatnya biaya kesehatan dapat mengakibatkan tidak teraksesnya pelayanan kesehatan oleh sebagian besar masyarakat Indonesia. Hal ini terjadi karena sebagian besar masyarakat Indonesia masih membayar biaya pelayanan kesehatan dengan cara pembayaran tunai (Out of pocket).Pembayaran secara out of pocket menyebabkan rumah sakit tidak kepastian tentang pendapatan dari pelayanan yang diberikan kepada pasien. Ketidakpastian tersebut disebabkan rumah sakit tidak bisa membuat proyeksi yang pasti tentang jumlah pasien yang akan dilayani.Prospective Payment System (PPS) atau Sistem pembiayaan praupaya merupakan sistem pembayaran pada pemberi pelayanan kesehatan baik rurnah sakit maupun dokter dalam jumlah yang ditetapkan sebelum suatu pelayanan medik dilaksanakan, tanpa memperhatikan tindakan medik atau lamanya perawatan di rumah sakit. Salah satu bentuk dari sistem pembiayaan praupaya adalah Diagnosis Related Groups (DRG's) yang mengelompokkan diagnosis terkait.Pengelompokkan penyakit berdasarkan DRG's yang menja.di objek penelitian ini adalah penyakit pneumonia yang berkontribusi cukup besar terhadap kematian anak dan balita dan ketertarikan untuk diteliti karena belum perah ada perhitungan unit cost biaya pengobatan penyakit pneumonia di RSUD. Kota Banjar berdasarkan DRG's.Tujuan penelitian ini adalah untuk mengetahui cost of treatment pneumonia berdasarkan Diagnosis Related Groups di RSUD.Kota Banjar tahun 2006. Metode penelian ini adalah penelitian deskriptif yang di1aksanakan pada bulan april sampai mei 2007 dengan menggunakan data sekunder dari rekam medik pasien rawat inap dengan diagnosa pneumonia tahun 2006 dan data primer dengan observasi serta wawancara dengan dokter spesialis, dokter umum, perawat, paramedik dan instalasi gizi serta bagian keuangan. Perhitungan unit cost dengan menggunakan Activity Based Costing.Pengelompokkan penyakit Pneumonia berdasarkan AR-DRGis di RSUD. Kota Banjar, yaitu : 1) Pneumonia dengan penyerta dan penyulit (E62A), 2) Pneumonia dengan penyerta atau penyulit (E62B) dan 3) Pneumonia murni (Eec). Untuk pneumonia yang meninggal tidak bisa diterapkan karena menurut AR-DRG's tidak ada pneumonia yang mengakibatkan meninggal, hal ini perlu dikembangkan sebagai model lisTA-DRG's.Clinical Pathway pnemonia di RSUD. Kota Banjar yang didapatkan terdiri atas 5 (lima) tahap, yaitu : pendaftaran, penegakan diagnosis, terapi, pulang dan rawat jalan. Diagnosis utama yang dipakai berdasarkan ICD-X merupakan hasil kesepakatan para dokter yaitu J18 terdiri atas J18.0 Bronchopneumonia dan J18.9 Pneumonia.Cost of treatment pneumonia path anak di RSUD. Kota Banjar tahun 2006 yaitu cost of treatment kelompok E62B di kelas III sampai kelas I dengan median hari rawat 4 hari biayanya antara Rp. 891971,- sampai dengan Rp. 944.429,- sedangkan cost of treatment kelompok E62C di kelas III sampai ke/as 1 dengan median hari rawat 3 hari biayanya antara Rp, 725,559,- sampai dengan Rp. 817.659,- Cost of treatment pneumonia path dewasa di RSUD. Kota Banjar tahun 2006 yaitu cost of treatment kelompok E62A di kelas III sampai kelas VIP dengan median hari rawat 8 hari biayanya antara Rp. 1.691.669,- sampai dengan Rp. 1,853.874,- cost of treatment pada kelompok E62B di kelas III sampai kelas VIP dengan median hari rawat 5 had biayanya antara 1.258.120,- sampai dengan Rp. 1.359.498,- sedangkan cost of treatment kelompok E62C di kelas III sampai kelas VIP dengan median hari rawat 5 hari biayanya antara Rp. 1120.411,- sampai dengan Rp. 1_221.789,-.Perlu ditetapkan cam perhitungan biaya perawatan pasien di rumah sakit secara nasional seperti perhitungan biaya berdasarkan Diagnosis Related Groups dan perlunya dilakukan penelitian lebih lanjut untuk penyakit lainnya dengan sampel dari berbagai rumah sakit sehingga diperoleh gambaran casemix setiap rumah sakit, yang diharapkan dapat memberikan kontribusi terhadap upaya pengembangan INA-DRG's

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Increasing of health cost is affecting health service become can not accessed by most of Indonesians. It happened because most of Indonesians still paying health service cost by cash (out of pocket).

Paying by out of pocket cause hospital does not have certainty toward income from given services to patients. It caused by inability of hospital making a certain projection toward total patients served.

Prospective Payment System (PPS) is payment system to health service giver whether hospital or doctor in decided amount before performed medical service, without concerning medical action or care length in hospital. One form of prospective payment system is Diagnosis Related Groups (DRG's) that group related diagnosis.

Disease grouping based on DRG's that become this research object is quite high contribution of pneumonia disease toward child death and toddlers and significance to research because no unit cost calculation of pneumonia disease medication at RSUD Banjar City based on DRWs.

This research purpose is to identify pneumonia cost of treatment based on Diagnosis Related Groups at RSUD Banjar City year 2006. This research method is descriptive research that performed in April to May 2007 by using secondary data from inpatient medical report with pneumonia diagnosis in 2006 and primary data with observation as well as interview with specialty doctor, public doctor, nurse, and paramedic and nutrition installation along with finance sector. Unit cost calculation is using Activity Based Costing.

Pneumonia disease grouping based on AR-DRG's at RSUD Banjar City, which are: 1). Pneumonia with accomplice and complication disease (E62A), 2). Pneumonia with accomplice or complication disease (E62B) and 3). Pure Pneumonia (E62C). For pneumonia, deaths not implemented because according to AR-DRG's there is no pneumonia caused death, it should improved as 11\IA-DRG's model.

Clinical Pathway of pneumonia disease at RSUD Bogor City obtained 5 steps, which are: registration, diagnosis maintenance, therapy, inpatient and outpatient. Used main diagnosis based on ICD-X is an agreed result of doctors that is J18 consist of J18.0 Bronchopneumonia and J18.9 Pneumonia.

Pneumonia cost of treatment in children at RSUD Banjar City year 2006 is E62B group cost of treatment in third class to first class with median of 4 days inpatient is Rp. 893,971 to Rp. 944.429 while E62C group cost of treatment in third class to first class with 4 days median is Rp. 725.559 to Rp. 817.659.

Pneumonia cost of treatment in adult at RSUD Banjar City year 2006 is E62A group cost of treatment in third class to VIP with median of 8 days inpatient is between Rp, 1.691.669 to Rp. 1.853.874, E62B group cost of treatment in third class to VIP with median of 5 days inpatient is Rp. 1.258.120 to RP. 1.359,498 while E62C group cost of treatment in third class to VIP with median of 5 days inpatient is Rp. 1.120.411 to Rp. 1.221.798.

Calculation of patient cost in hospital was need to be decided nationally as cost calculation based on Diagnosis Related Groups and require advanced research for other disease with samples from various hospital, so that obtained casernix description of every hospital, which expected to give contribution toward development effort of INA-DRG's. "

"[ABSTRAK Praktik residensi keperawatan medikal bedah peminatan sistem respirasi memiliki tujuan untuk menjalankan tiga peran ners spesialis. Peran sebagai manajer kasus, pemberi layanan dan inovator. Sebagai manajer kasus, residen mengelola kasus utama pasien tuberculosis dan diabetes mellitus, dan 30 kasus resume dengan menggunakan Teori Self-Care Orem. Masalah keperawatan utama yang paling sering muncul adalah ketidakefektifan bersihan jalan napas. Sebagai pemberi layanan, residen telah menerapkan intervensi keperawatan berdasarkan pembuktian yaitu oral hygiene dengan chlorhexidine 0,12% yang dapat mencegah terjadinya Ventilator Associated Pneumonia (VAP). Inovasi keperawatan yang dilakukan yaitu modifikasi Water Seal Drainage (WSD) 1 botol yang telah mendapatkan respon yang baik dari para ahli dibidangnya untuk meningkatkan keselamatan pasien dan keselamatan pekerja atau petugas kesehatan dalam proses asuhan keperawatan.ABSTRACT The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process.;The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process., The purpose of medical-surgical nurse resident in respiratory system clinical practice is to perform three roles of a nurse specialist as a case manager, healthcare provider and innovator. As a case manager, the resident managed a case of Tuberculosis and Diabetes Mellitus patient, and 30 resume cases with Orem Self-Care theory approach. The main nursing problem found during the clinical practice was ineffective airway clearance. As a healthcare provider, the resident had applied an evidence-based nursing intervention that has been using chlorhexidine 0,12% in oral hygiene procedure that can prevent Ventilator Associated Pneumonia (VAP). As an innovator, resident had made a modification of one bottle water-sealed drainage that has received good response from the experts to increase patients and employers or healthcare provider safety during the nursing care process.]"