Kesehatan Nasional (JKN) in , to increase the healthy quality standard of .. STANDAR PELAYANAN MEDIS DAN FORMULARIUM JAMKESMAS PADA. Hendrartini, () EVALUASI IMPLEMENTASI INA-CBGs KASUS Compliance with Jamkesmas formularium was %. 8/24/ AM Curriculum vitae Nama: Prof. dr. Ketua, Komite Nasional (KOMNAS) Penyusun Formularium Jamkesmas, KemKes RI 7. Ketua Tim.

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Based on some of the issues that use for this systematic review, the aim of this article is to describe the implementation of the INA CBGs system and its effect on public hospitals’ financial performance.

formularium 2010

Searching process is done within time frame 1 s t January — 16 t h Novemberwith English and Indonesian language restriction. DRG classification system is grouped according to principal diagnosis, type of treatment, age, surgery, and discharge status [ 11 ].

In order to be able to give good quality services, hospitals need to be financially healthy. However, the fogmularium of the hospital should be able to address these challenges by jamksmas innovation using information system and technology, increasing hospital facilities to meet public demand, enhancing of hospital physical development, adding new types of services and confirming that the medical record is complete, timely and accurate.

Indonesia has reformed its national health insurance scheme. Hospital finance performance Hospital must provide good quality health care to make sure the goals of universal health coverage could be achieved efficiently and effectively. This new jajkesmas system can increase hospital efficiency so it formulsrium improve the financial performance as written in —Does prospective payment increase hospital in efficiency?

Because of diversity of comorbid types experienced by patients with diabetes mellitus, the cost of needed drugs tend to give greater impact on total costs of formularrium. A case study in Shanghai, China. This provides a basis for describing the types of patients or other health care provider treatments its case mix. Each public hospital management must have a strategy and innovation to improve the quality of service so they can compete with other hospitals and financial performance can be improved in universal health coverage era.


This system allows hospital managers to determine more accurately the type of resources to treat a particular group and to predict jamkesmax cost of the treatment.

formularium – [XLS Document]

In this system, there is only one insurer institution, BPJS Kesehatan, a social security agency established by the government to provide health insurance for Indonesian people. Jamkesmas is social aid to ensure health of poor community in Indonesia financed by the government. In this type of organization, public hospitals can be managed as a business organization with flexibility in financial management based on productivity and effectiveness [ 8 ].

Although DRG-based payment systems are now mainly understood as a reimbursement mechanism, the original purpose was to enable performance comparisons across hospitals [ 10 ]. Indonesia started the national health insurance system on 1 January Based on Undang – Undang No. Journal of Medical Systems, vol.

A Diagnosis-Related Group DRG is a statistical system of classifying any inpatient stay into groups for payment purpose. A case mix group CMG is used for inpatient classification system to group patients with similar characteristics together.

Hospital financial performance in the Indonesian national health insurance era.

In both outpatient cases and inpatient cases, the claims under the JKN are higher than under the hospitals’ rate. All people become participants so that they can be protected.

Evaluasi Ketersediaan Obat Terhadap Formularium

With all participants the obligation to pay contributions, there will be the principle of mutual cooperation where the healthy help the sick, the rich help the poor. More information and software credits.

Hospital payment systems based on diagnosis- related groups: The aim of this review is to describe the application of the INA-CBGs system and its effect on financial performance of the public hospital and helping them in identifying and anticipating problems in implementation of the INA-CBGs system. Starting with definition of the objectives of the DRG system, the most common diseases in each disease group should be first targeted so as to formulate pricing standards for each disease group and increase the feasibility of implementing DRGs.

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Other factors like supporting examination completeness of medical records can also affect the rate difference. Public hospital as one government agency should be able to provide accountable both financially and non-financially local government and the community as service users.


If those hand-searched articles were suitable, they were included for review. Universal Coverage is firmly based on the WHO constitution of declaring health as a fundamental human right. Causes of negative difference are mostly lack of understanding of doctors, jamoesmas medical records, and lack of effort to control quality and cost.

Evidence from the Swiss hospital sector journal. Diagnosis Related Groups DRGs are one of the most striking prospective payment systems around the world in recent years, since implementation of universal health coverage, jamkkesmas booming in the world, uses a system of claims based on DRG systems [ 11 ].

After that articles were screened by title and next 51 articles were screened by abstract. Exploring the transition to DRGs in developing countries: Public hospital is an institution under the supervision of local governments engaged in the public sector by giving health services.

The first restriction is filtered by year, period of —and by choosing academic journal articles, dissertation or thesis because most of Indonesian researchers are in the form of the latter. Hospitals will receive payments based on INA CBGs rate which jamkesmws the average amount spent by the group for a diagnosis. Fifteen 15 articles deemed relevant were then searched for full-text and assessed for its eligibility.

Next, the diagnosis codes are translated into the payment that must be compensated by insurers.

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