Abstract:

Abstract - Indonesian case-based groups (INA-CBG’S ) was a payment system of health care for cesarean section patients indicative of pregnancy and laboring complication or case mix complication based on disease group. The payment system was in a package of fee for service and prospective payment system in which government provides those in poverty with health assurance. The study aimed at finding out the patient action unit cost paid by government and the merit and the advantage and the implication of the policy of the implementation of Indonesian case-based groups (INA-CBG) in Indonesia. It used epidemiologic non-experimental design that examined the correlation of the risk factor and the effect of diseases in pregnancy with 62 respondents and its location was Undata Hospital of Central Sulawesi province. The results of the study showed that there were two indications of emergency type and effectiveness of cesarean section, viz.: 1) maternal indication and 2) infant indication. The biggest percentage of pregnant mother (66.7%) consisted of pre-eclampsia (43.5%) and placenta previa (26.7%) and the infant indication of transversal position (33.3%) and risky infant (66.7%). The ability of hospital to pay the cost for the patients because of the presence of the indication of emergency type and effective type at severe complication W/MCC affecting15 respondents with the action cost of $3285, and moderate complication W/CC affecting 20 respondents with the action cost of $3540, and light complication W/C affecting 24 respondents with the action cost of $3840. Thus, the total payment by the hospital for the 62 respondents of those in poverty was US$. The payment ability was classified into three disease groups, while the action cost was $11,145, and the mean action cost per patient was $180. The implementation of government policy of the implementation of INA-case-based groups in Indonesia would avoid over-utilization, unplanned and missed utilization so that the health cost for those in poverty would be more controlled and the quality of the health care for the health of mother and child would be higher in the future. Keywords - cesarean section, Indonesian case-based groups, people health payment assurance.

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