05Apr 2019

COMPARISON ANALYSIS OF HEMODIALYSIS UNIT PROFITABILITY BASED ON HOSPITAL RATES, UNIT COST AND INDONESIA CASE BASE GROUPS USING REALIST EVALUATION ANALYSIS AT SILOAM HOSPITALS BALIKPAPAN INDONESIA IN 2018.

  • Master of Hospital Administration Management, Hasanuddin University, Indonesia.
  • Public Health Faculty, Hasanuddin University, Indonesia.
  • Economics and Business Faculty, Hasanuddin University, Indonesia.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

This study aims to analyze the comparison of hemodialysis profitability based on hospital rates, unit costs, and Indonesia Case Base Groups (INA-CBGs) and evaluate the implementation of INA-CBGS tariff for hemodialysis. The object in this study was Hemodialysis Unit at Siloam Hospitals Balikpapan (SHBP). This type of research used the mix-methods method with a cross-sectional approach and case study. Primary data were obtained from in-depth interviews with structural and functional staff related to hemodialysis unit. Secondary data were obtained in the form of financial data for hemodialysis measures in 2018. Quantitative analysis was carried out to obtain unit cost values and comparison of the profitability of each tariff. Realist evaluation analysis was used to evaluate the implementation of INA-CBGs rates for hemodialysis. The results of the study showed that (1) the calculations of unit cost using Relative Value Units (RVU) method of both hemodialysis in SHBP was greater than the hospital unit cost; (2) The tariff calculation using RVU method with a margin of 20% was found that the hospital and INA-CBGs rates for both hemodialysis were smaller; (3) The calculation of both profitability hospital rates and INA-CBGs rates on the unit cost of the RVU method on both hemodialysis indicated that hospitals experienced losses from both hemodialysis; (4) Hemodialysis Standard Operating Procedure (SOP) and Clinical Pathway (CP) were already available and applied in hospitals. (5) Human resources and the amount of hemodialysis machines in the hemodialysis unit in SHBP were still lacking.


  1. Aditia, A., Alimin, M. and Sudirman, N. (2015) ?Perbandingan Tarif Berdasarkan Unit Cost Dengan Tarif Rumah Sakit Dan INA-CBGS?, JST Kesehatan, 5(2), pp. 111?118.
  2. Al-maidin, A. R. M., Noor, N. B. and Pasinringi, S. A. (2014) ?Perbandingan Tarif Tindakan Operasi Berdasarkan Relative Value Unit (RVU), Indonesia Case Based Groups (INA- CBG?s) dan Tarif Kolegium?, Al-Sihah: Public Health Science Journal, VI(2), pp. 397?409.
  3. Ashwini, N. S. and Gomes, L. A. (2012) ?Cost analysis of a dialysis unit at a tertiary care multi specialty teaching hospital?, Journal International Medical Sciences Academy, 25(3), pp. 177?178.
  4. Asih Eka Putri (2014) Paham BPJS. 2nd edn. Jakarta: Friedrich-Ebert-Stiftung.
  5. Azalea, M., Andayani, T. M. and Satibi (2016) ?Inap Dengan Hemodialisis Di Rumah Sakit Cost Analysis of Inpatient Hemodialysis in the Treatment of Chronic?, Jurnal Manajemen dan Pelayanan Farmasi, pp. 141?150.
  6. Badan Pusat Statistik (2018) ?Statistik Indonesia 2018?.
  7. Blocher Ed, Chen Kung, Cokins Gary, L. T. (2007) Manajemen Biaya: Penekanan Strategis. 3rd edn. Edited by Resthi Widyaningrum. Jakarta: Penerbit Salemba Empat.
  8. Bruen, L. R. (2016) ?We need to override the digital TCP microchip!?, pp. 144?158.
  9. Elgaard Jensen, C., S?rensen, P. and Dam Petersen, K. (2014) ?In Denmark kidney transplantation is more cost-effective than dialysis?, Danish Medical Journal, 61(3), pp. 1?5.
  10. Faeq Malallah Mahmood Albalaki, R. J. M. (2018) ?Customer Profitability Analysis, Cost System Purposes and Decision Making Process: A Research Framework?, Account and Financial Management Journal, 3(5), pp. 1547?1552.
  11. Fauziah, Djoko Wahyono, L. E. B. (2015) ?Cost of Illness Dari Chronic Kidney Disease Dengan Tindakan?, Jurnal Manajemen dan Pelayanan Farmasian Pelayanan Farmasi, 5(3), pp. 143?151.
  12. Fitri, E., Andayani, T. M. and Suparniati, E. (2015) ?Cost Analysis of Diabetes Melitus?, Journal of Management and Pharmacy Practice, 5(1), pp. 61?66.
  13. Gani, A. (1995) ?Teori Biaya?, in Buku Panduan Analisis Biaya dan Penyesuaian Tarif Pelayanan Kesehatan di Indonesia. Jakarta: FKM UI.
  14. Halle, M. P. et al. (2017) ?Cost of care for patients on maintenance haemodyalisis in public facilities in Cameroon?, African Journal of Nephrology, 20(1), pp. 230-237.
  15. Hansen, Don R., Mowen, M. M. (2009) Managerial Accounting. 8th edn. Jakarta: Penerbit Salemba Empat.
  16. Icks, A. et al. (2010) ?Costs of dialysis-a regional population-based analysis?, Nephrology Dialysis Transplantation, 25(5), pp. 1647?1652. doi: 10.1093/ndt/gfp672.
  17. Islam, Z. and Rusdi, N. K. (2014) ?Analisis Perbedaan Pengobatan Diabetes Melitus Tipe Ii Pada Pasien Bpjs Dan Pasien Umum the Analisys Different of Treatment Diabetes Melitus Type Ii on General Patients and National Health Insurrance Patients (BPJS)?, pp. 151?161.
  18. Kaur, G. et al. (2018) ?Cost of hemodialysis in a public sector tertiary hospital of India?, Clinical Kidney Journal, 11(5), pp. 726?733. doi: 10.1093/ckj/sfx152.
  19. Komenda, P. et al. (2010) ?The cost of starting and maintaining a large home hemodialysis program?, Kidney International. Elsevier Masson SAS, 77(11), pp. 1039?1045. doi: 10.1038/ki.2010.37.
  20. Laksono Trisnantoro (2006) Memahami Penggunaan Ilmu Ekonomi Dalam Manajemen Rumah Sakit. Yogyakarta: Gajah Mada University Press.
  21. Munawaroh, F. and Andayani, T. M. (2014) ?Pembiayaan Kesehatan Berdasar Ina-CBGs Cost Analysis of Bone Fracture Treatment in Determining Health Financing Based on Ina-Cbgs?, pp. 45?54.
  22. Mushi, L., Krohn, M. and Flessa, S. (2015) ?Cost of dialysis in Tanzania: evidence from the provider?s perspective?, Health Economics Review. Health Economics Review, 5(1). doi: 10.1186/s13561-015-0064-4.
  23. Mushi, L., Marschall, P. and Fle?a, S. (2015) ?The cost of dialysis in low and middle-income countries: A systematic review?, BMC Health Services Research. BMC Health Services Research, 15(1), pp. 1?10. doi: 10.1186/s12913-015-1166-8.
  24. Muslimah, Tri Murti Andayani, Rizaldy Pinzon, D. E. (2017) ?Perbandingan Biaya Riil Terhadap Tarif INA-CBGs Penyakit Stroke Iskemik di RS Bethesda Yogyakarta?, Jurnal Manajemen dan Pelayanan Farmasi, 7(2), pp. 105?114.
  25. National Institute of Diabetes and Digestive and Kidney Diseases, [NIDDK] (2009) ?Treatment Methods for Kidney Failure : Hemodialysis?, National Institutes of Health, pp. 1?11.
  26. Nugraheni, D. A. et al. (2016) ?Analisis Biaya Penyakit Ginjal Kronis Pada Pasien Jkn Rawat Inap Di Rumah Sakit Pku Muhammadiyah Yogyakarta?, (4), pp. 2541?474.
  27. Pawson R., T. N. (1997) Realistic Evaluation. 1st edn. SAGE Publications Ltd.
  28. Permenkes RI (2014) ?Peraturan Menteri Kesehatan Republik Indonesia Nomor 27 Tahun 2014 Tentang Petunjuk Teknis Sistem Indonesian Case Base Groups (INA-CBGs)?, in.
  29. Permenkes RI (2014) ?Peraturan Menteri Kesehatan Republik Indonesia Nomor 59 Tahun 2014 Tentang Standar Tarif Pelayanan Kesehatan Dalam Penyelenggaraan Program Jaminan Kesehatan?.
  30. PERNEFRI (2018) ?10 th Report Of Indonesian Renal Registry 2017 10 th Report Of Indonesian Renal Registry 2017?.
  31. Perpres RI (1992) ?Undang Undang No . 23 Tentang Kesehatan?, (23).
  32. Perpres RI (2009) ?Undang-Undang Nomor 40 Tentang Rumah Sakit?.
  33. Pudji R, Susalit E, S. (2009) ?Hemodialisis?, in Aru W. Sudoyo, Bambang Setiyohadi, Idrus Alwi, Marcellus Simadibrata K., S. S. (ed.) Buku Ajar Ilmu Penyakit Dalam. III. Jakarta: Interna Publishing.
  34. Rezapoor, A., Azar, F. E. F. and Safari, H. (2012) ?Cost Analysis of Services Delivered to Patients with End-Stage Renal Disease Referring to Bou-Ali-Sina Hospital Affiliated to Qazvin University of Medical Sciences?, World Applied Sciences Journal, 18(6), pp. 796?802. doi: 10.5829/idosi.wasj.2012.18.06.645.
  35. Ronald Hilton, Michael Maher, F. S. (2004) Cost Management Strategies for Business Decisions. 3rd edn. United States: McGraw-Hill Companies.
  36. Rusli, N. T. (2017) ?Analisis Biaya dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016?, Jurnal Administrasi Rumah Sakit, 3(3), pp. 158?168.
  37. Saran, K. and Sabry, A. (2012) ?The Cost of Hemodialysis in a Large Hemodialysis Center?, Saudi J Kidney Dis Transpl, 23(1), pp. 78?82. doi: 10.4103/1319-2442.91306.
  38. Sawada, T. and Kawahara, H. (2014) ?Cost of hemodialysis after coverage by national health insurance in Japan: a sharing experience with Indonesian health reform system?, Medical Journal of Indonesia, 23(2), p. 122. doi: 10.13181/mji.v23i2.652.
  39. Solikhah, P. T. M. (2011) ?Analisa Cost Sharing Perhitungan Tarif Hemodialisis (HD) Masyarakat Miskin di Rumah Sakit Umum PKU Muhammadiyah Unit I Yogyakarta?, Kes Mas, 5(3), pp. 162?232.
  40. Supriyono (1987) Akuntansi Biaya: Pengumpulan Biaya dan Penentuan Harga Pokok Produk. 2nd edn. Yogyakarta: BPFE Universitas Gajah Mada.
  41. Tatar, M., Ergin, G. and Ecder, T. (2013) ?Cost analysis of private hemodialysis centers in turkey?, Turkish Nephrology, Dialysis and Transplantation Journal, 22(3), pp. 270?282. doi: 10.5262/tndt.2013.1003.07.
  42. WHO (2017) Hospitals in Health Systems. Available at: https://www.who.int/hospitals/en/ (Accessed: 4 April 2019).
  43. Widiana, I. G. R. (2018) ?Dialysis treatment in Indonesia: Focus on Bali?, IOP Conference Series: Materials Science and Engineering, 434, p. 012334. doi: 10.1088/1757-899X/434/1/01233.

[Anneke Holly, Alimin Maidin and Syamsuddin. (2019); COMPARISON ANALYSIS OF HEMODIALYSIS UNIT PROFITABILITY BASED ON HOSPITAL RATES, UNIT COST AND INDONESIA CASE BASE GROUPS USING REALIST EVALUATION ANALYSIS AT SILOAM HOSPITALS BALIKPAPAN INDONESIA IN 2018. Int. J. of Adv. Res. 7 (Apr). 706-712] (ISSN 2320-5407). www.journalijar.com


Anneke Holly
Master of Hospital Administration Management, Hasanuddin University, Indonesia

DOI:


Article DOI: 10.21474/IJAR01/8875      
DOI URL: https://dx.doi.org/10.21474/IJAR01/8875