Cost Analysis with Activity Based Costing Method on Coronary Heart Catheterization at Dr. Sardjito Hospital Yogyakarta (original) (raw)
Related papers
2018
The purpose of this study was to calculate unit cost coronary angiography with the ABC method and analyze the differences in the results of the calculation unit cost of the ABC method with the current rates at RSUP Dr. Sardjito Yogyakarta. The research method is qualitative with a descriptive design case study, this study uses primary data and secondary data. Primary data is in the form of interviews, while secondary data is obtained through financial data in 2016. Methods for analyzing costs using the method of Activity Based Costing (ABC). The study resulted that coronary angiography-guided by the SPO, the results of the calculation unit cost of the ABC method were Rp7.927.171,13 higher than the current fare. The unit cost of coronary angiography at RSUP Dr. Sardjito Yogyakarta by the ABC method is a unit cost for coronary angiography without difficulty which is calculated by charging all costs both direct costs and costs overhead. Hospital rates have not been recalculated since 2014, so it has not yet described the real conditions in 2016. In addition, personnel expenditure conditions that exceed the provisions of the proportion of a maximum of 44% as mandated in the Republic of Indonesia Minister of Health Regulation are the factors causing higher unit cost calculation ABC method rather than rates coronary-angiography hospital. Tujuan penelitian ini adalah menghitung unit cost coronaryangiography dengan metode ABC dan menganalisis perbedaan hasil perhitungan unit cost metode ABC dengan tarif saat ini di RSUP Dr. Sardjito Yogyakarta. Metode penelitian adalah kualitatif dengan rancangan deskriptif studi kasus, Penelitian ini menggunakan data primer dan data sekunder. Data primer berupa hasil wawancara, sedangkan data sekunder diperoleh melalui data keuangan tahun 2016. Metode untuk menganalisis biaya menggunakan metode Activity Based Costing (ABC). Penelitian menghasilkan bahwa tindakan coronaryangiography berpedoman pada SPO hasil perhitungan unit cost metode ABC sebesar Rp7.927.171,13 lebih tinggi dari tarif saat ini. Unit cost tindakan coronaryangiography di RSUP Dr. Sardjito Yogyakarta dengan metode ABC merupakan unit cost atas tindakan coronaryangiography tanpa penyulitan yang dihitung dengan membebankan seluruh biaya baik biaya langsung maupun biaya overhead. Tarif rumah sakit sejak ditetapkan pada tahun 2014 belum dilakukan perhitungan ulang, sehingga belum menggambarkan kondisi riil tahun 2016. Selain itu kondisi belanja pegawai yang melebihi ketentuan batas proporsi maksimal 44% sebagaimana diamanatkan dalam Peraturan Menteri Kesehatan RI menjadi faktor penyebab lebih tingginya hasil perhitungan unit cost metode ABC daripada tarif coronaryangiography rumah sakit.
Unit Cost Analysis of Sectio Caesarea with Activity-Based Costing in Yogyakarta City Hospital
Jurnal Medicoeticolegal dan Manajemen Rumah Sakit
The selection of unit cost calculation method in hospital services is a challenge for hospitals. Errors in the selection of the calculation method will make a big difference in the final results of the total costs required after the service. Yogyakarta City Hospital still uses traditional methods of determining service rates. Design of this study is a qualitative study with a case study approach to the unit costs required for uncomplicated section Caesarea which is calculated using the activity-based costing method compared to the unit cost of section Caesarea calculated using traditional methods. The purposes are to know the differences between the two methods. The results of this study indicate the unit cost of uncomplicated section Caesarea using the ABC method is IDR 2,703,919. the action rate by the hospital is IDR. 3,051,000, greater than the ABC method. The difference obtained is Rp 347,081. The Conclusions is a positive difference between the unit cost of the ABC method and the hospital rate so it is necessary to evaluate the service rates in Yogyakarta City Hospital. Pemilihan metode penghitungan unit cost pelayanan Rumah Sakit menjadi tantangan bagi Rumah Sakit, karena kesalahan dalam pemilihan metode penghitungan akan dapat memunculkan selisih yang besar dalam hasil akhir dari total biaya yang diperlukan setelah pelayanan. RSUD Kota Yogyakarta masih menggunakan metode tradisional dalam menentukan tariff pelayanan. Desain penelitian ini adalah penelitian kualitatif dengan pendekatan studi kasus terhadap biaya satuan / unit cost yang dibutuhkan untuk tindakan sectio caesarea tanpa penyulit yang dihitung menggunakan metode Activity-Based Costing dibandingkan unit cost tindakan sectio caesarea yang dihitung menggunakan metode tradisional. Tujuannya adalah mengetahui selisih diantara kedua metode tersebut. Hasil penelitian ini menunjukkan unit cost tindakan sectio caesarea tanpa penyulit menggunakan metode ABC sebesar Rp 2.703.919,00 Tarif tindakan yang ditetapkan rumah sakit sebesarRp 3.051.000,00 lebih besar dari pada metode ABC. Selisih yang didapatkan adalah sebesar Rp347.081,00. Terdapat selisih positif antara unit cost metode ABC dengan tariff Rumah Sakit sehingga perlu dilakukan evaluasi terhadap tarif pelayanan di RSUD Kota Yogyakarta
Journal of Social Research
Determination of health service tariffs also determines optimal health service outcomes. Determination of radiology examination rates at Naibonat Hospital until 2023 still refers to Regional Regulation No. 5 of 2012 concerning public service fees, where the determination of fees still uses the conventional calculation system, and there are changes in image processing modalities, tools, and materials used, this demands a rate adjustment. Calculation of rates using the Activity Based Costing (ABC) method, can be a solution to determine more accurate rates, supported by Pramawati's research (2021) which shows the results of determining rates are more accurate using the ABC method. The purpose of this study was to calculate the tariff pattern for radiological examinations at Naibonat Hospital using the ABC method and obtain an accurate tariff calculation model for radiological examinations. This research is a descriptive explorative study, with a quantitative approach using numerica...
Direct Medical Cost Inpatient ACS-STEMI at Sardjito Hospital 2017-2018
JPSCR: Journal of Pharmaceutical Science and Clinical Research, 2022
Cardiovascular disease is the main cause of human death worldwide. This disease is also a major burden in health financing, due to direct costs of treatment and hospitalization. One type of cardiovascular disease is Acute Coronary Syndrome (ACS). The incidence of ACS in Indonesia is still the highest with a prevalence rate of 7.2% and continues to increase every year. This study aimed to determine the average direct medical costs of new ACS-STEMI patients who are hospitalized at Dr. Sardjito Hospital Yogyakarta period 2017-2018 and the factors that influence the cost of the treatment statistically. This research was an observational study with a descriptive retrospective research design using data from medical records and the finance (accounting) department. The sampling technique used in this study was purposive sampling based on patients who met the inclusion criteria. A total of 495 patients matched the inclusion criteria and the average of the components of direct medical costs ...
The Pan African medical journal, 2012
Activity based costing (ABC) is an approach to get insight of true costs and to solve accounting problems. It provides more accurate information on product cost than conventional accounting system. The purpose of this study was to identify detailed resource consumption for chest x-ray procedure. Human resource cost was calculated by multiplying the mean time spent by employees doing specific activity to their per-minute salaries. The costs of consumables and clinical equipments were obtained from the procurement section of the Radiology Department. The cost of the building was calculated by multiplying the area of space used by the chest X-ray facility with the unit cost of public building department. Moreover, straight-line deprecation with a discount rate of 3% was assumed for calculation of equivalent annual costs for building and machines. Cost of electricity was calculated by multiplying number of kilo watts used by electrical appliance in the year 2010 with electricity tariff ...
Jurnal Kesehatan, 2017
Effectiveness of ABC Method in Planning Analysis of JKN Drugs in Dagangan Health Care Madiun City. Drug expenditure absorbs most of the health care budget. PHC was responsible for ensuring the used of available resources optimally aimed at achieving efficiency in cost control. Based on LPLPO at Dagangan health care 2015 showed an average supply of drugs JKN in primary health care Dagangan has excess stock that is as much as 93.18% (41) types of drugs than 100% (44) types of drugs. The purpose of this research was to determine the application of the ABC method in planning analysis of drugs in Dagangan health care Dagangan Madiun city. The design of this research was descriptive categorical, with a retrospective approach. Primary data obtained from an interview with Head of Health Centre and Head of Installation Pharmacy in Primary Health Care Dagangan while the secondary data obtained from LPLPO. The results showed that Dagangan health care use consumption method to planning the drug. By using the ABC analysis showed a group of JKN drugs that include group A as many as 8 types of drugs (18,2%). Group B as many as 30 types of drugs (68,2%). And group C as much as 6 types of drugs (13,6%). Based on these results, Dagangan health care needs to apply ABC analysis method to determine the priority drugs that need to be held, and there should be education and training for pharmacy personnel to increase knowledge about effective methods of drug design and efficient use of the budget.
Jurnal Sains Kesihatan Malaysia, 2018
Presently there is a gross lack of information on cost and cost weights in many developing countries that implement casemix system. Furthermore, studies that employed Activity Based Costing method (ABC) to estimate the costs of radiology procedures were rarely done in developing countries, including Malaysia. The main objective of this study is to determine the costs of radiology procedures for each group in casemix system, in order to develop cost weights to be used in the implementation of the casemix system. An economic evaluation study was conducted in all units in the Department of Radiology in the first teaching hospital using the casemix system in Malaysia. From the 25,754 cases, 16,173 (62.8%) of them were from medical discipline. Low One Third and High One Third (L3H3) method was employed to trim the outlier cases. Output from the trimming, 15,387 cases were included in the study. The results revealed that the total inpatients' charges of all the radiology procedures was RM1,820,533.00 while the cost imputed using ABC method was RM2,970,505.54. The biggest cost component were human resources in Radiology Unit (Mobile) (57.5%), consumables (78.5%) of Endovascular Interventional Radiology (EIR) Unit, equipment (81.4%) of Magnetic Resonance Imaging (MRI) Unit, reagents (68.1%) of Medical Nuclear Unit. The one highest radiology cost weight, was for Malaysia Diagnosis Related Group (MY-DRG ®) B-4-11-II (Hepatobiliary and Pancreas Neoplasms with severity level II, 2.8301). The method of calculation of the cost of procedures need to be revised by the hospital as findings from this study showed that the cost imposed to patient is lower than the actual cost.
There are various methods of costing approach. The two most important methods are bottom-up and top-down costing. Many countries which implement Case-Mix system use top-down costing approach. Universiti Kebangsaan Malaysia Hospital is the first hospital to implement case-mix system in Malaysia, with the objective to improve efficiency and quality of patient care. From July 2002 to June 2004, a total of 35,568 cases were grouped using 'International Refined Diagnosis Related Groups' (IR-DRG) version 1.1 case-mix grouper. Out of these, 3,622 cases or 10.2 % were cardiology cases in 'Major Diagnostic Category' (MDC) 05 (Diseases and Disorders of the Circulatory System) of which 86.5% were Medical Cardiology and the remaining 13.5% were Surgical Cardiology. Most of cardiology were in severity level one (43.4%), followed by severity level two (29.5%) and severity level three (27.1%). The mortality rates for severity level one, two and three were 1.0%, 2.6% and 11.5% respectively. Top three cardiology cases were Acute Myocardial Infarction Without Comorbidity and Complication (IRDRG 05331) (8.4%), Acute Myocardial Infarction With Major Comorbidity and Complication (IRDRG 05333) (7.6%) and Cardiac Catheterization for Ischeamic Heart Disease Without Comorbidity and Complication (IRDRG 05311) (7.4%). Top-down costing was carried out to obtain the cost for each DRG group. The mean cost per episode of care for Medical Cardiology cases was RM 4,277 (SD= RM 2,501) with average length of stay (LOS) of 6.3 days (SD= 3.7days). For the Surgical Cardiology cases, the mean cost per episode of care was RM 6,530 (SD= RM 4,588) and average LOS of 5.8 days (SD= 4.1 days). The three biggest components of cost for treatment of Medical Cardiology cases are ICU cost (38.0%), Pharmacy (14.2%) and Ward Services (12.7%). In Surgical Cardiology, the biggest component of cost was the Operation Theatre (27.9%), followed by Ward Services (25.4%) and Pharmacy (8.5%). Multivariate analysis using multiple linear regression showed that factors which significantly influence ( p<0.001) the treatment cost of cardiology cases were length of stay, followed by age of the patient, discharge outcome, case type ('surgical partition') and severity level. The HUKM experience have shown that the top-down costing approach is feasible to be implemented in a short period of time and produces quality result which can be used to improve the management of the hospital.
Cost variance of health services at PHC hospital, Surabaya, Indonesia: Operational audit
2020
espanolEl uso de auditorias operativas explica la diferencia en los costos incurridos al proporcionar servicios a los pacientes hospitalizados que usan BPJS. Este estudio tiene como objetivo identificar la diferencia de costo entre los costos reales y las tasas establecidas para la hospitalizacion de los tratamientos cardiaco isquemicos cronicos, infarto cerebral, enfermedad renal en etapa terminal y diabetes tipo 2. Se puede obtener la contencion de costos a traves del monitoreo y la administracion de costos. El costo de la variacion para manejar varias enfermedades no se puede evitar debido a las caracteristicas y al metodo de diferencia de costos. Se toman medidas para garantizar que las operaciones se lleven a cabo de manera efectiva y eficiente. EnglishThe operational audit uses to explain cost variances that occurred in the delivery of healthcare services to inpatients utilizing the BPJS. This study aimed to identify cost variance between actual cost and set tariff for inpatie...
Jurnal Manajemen Kesehatan Yayasan RS.Dr. Soetomo, 2017
Perkembangan organisasi rumah sakit menuntut diselenggarakannya manajemen keuangan yang efektif dan efisien termasuk dalam hal penetapan tarif. Penetapan tarif rumah sakit dapat mempengaruhi profitabilitas dan brand image rumah sakit. Rata-rata profit margin RS "x" Surabaya dari tahun 2013 sampai dengan tahun 2015 adalah (-4,02%). Penelitian ini dilakukan untuk menganalisis biaya satuan dalam evaluasi tarif pelayanan di RS "X" Surabaya. Penelitian ini dilaksanakan dengan studi cross sectional menggunakan pendekatan kuantitatif serta pengumpulan data melalui observasi dan wawancara mendalam. Kalkulasi biaya dilakukan melalui analisis biaya dengan metode Activity Based Costing (ABC) pada klinik spesialis bedah saraf di RS "X" Surabaya. Berdasarkan hasil penelitian didapatkan 9 produk pelayanan di klinik spesialis bedah saraf dan memiliki 2 tarif pelayanan yang rasional, 5 tarif rasional biaya langsung, dan 2 tarif lainnya adalah tarif tidak rasional. Kesimpulan yang dapat ditarik adalah tarif produk pelayanan klinik spesialis bedah saraf di RS "X" Surabaya cenderung pada tarif rasional dengan biaya langsung. Hal tersebut dapat disebabkan oleh output pelayanan kecil, waktu aktivitas besar, biaya tidak langsung besar, dan jumlah cost driver yang besar. RS "X" Surabaya dapat melakukan efisiensi biaya pada bagian administrasi dan manajemen serta bagian IPS. Hasil unit cost dapat dijadikan dasar dalam proses standarisasi pelayanan, evaluasi, dan penentuan tarif menggunakan strategi cost based pricing sebagai upaya penerapan activity based management di rumah sakit.