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印尼玛琅大学学术医院阴道分娩调查中INA-CBGs索赔与医院总费用对比

INA-CBGs claim versus total hospital cost: A vaginal delivery investigation at Airlangga University Academic Hospital, Indonesia.

作者信息

Wardhana Manggala Pasca, Gumilar Khanisyah Erza, Rahmadhany Prima, Rosita Dewi Erni, Laksana Muhammad Ardian Cahya

机构信息

Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Airlangga, Soetomo Teaching Hospital, Surabaya.

Department of Obstetrics and Gynaecology, Universitas Airlangga Academic Hospital, Surabaya.

出版信息

J Public Health Res. 2020 Dec 18;9(4):1999. doi: 10.4081/jphr.2020.1999. eCollection 2020 Oct 14.

Abstract

Inadequate funding for vaginal delivery can be one of the barriers to reducing the maternal mortality rate. It could be therefore critical to compare the vaginal delivery cost between total hospital cost and INA-CBGs cost in national health insurance. This was a retrospective cross-sectional study conducted from October to December 2019 in Universitas Airlangga Academic Hospital. It collected data on primary diagnosis, length of stay, total hospital cost, INA-CBGs cost, and counted disparity. The data analyzed statistically using -test independent sample (or Mann-Whitney test). A total of 149 vaginal delivery claims were found, with the majority having a level II severity (79.87%) and moderate preeclampsia as a primary diagnosis (20.1%). There was a significant disparity in higher total hospital costs compared with government INA-CBGs costs (Rp. 9,238,022.09±1,265,801.88 1,881,521.48±12,830.15; p<0.001). There was also an increase of LOS (p<0.001), total hospital cost (p<0.001), and cost disparity (p<0.01) in a higher severity level of vaginal delivery. Vaginal delivery costs in INA-CBGs scheme are underneath the actuarial value. There was also an increase in total hospital costs and a more significant disparity in the higher severity levels of vaginal delivery.

摘要

阴道分娩资金不足可能是降低孕产妇死亡率的障碍之一。因此,比较国家医疗保险中总住院费用和印尼国家健康保险基金(INA-CBGs)费用之间的阴道分娩成本可能至关重要。这是一项于2019年10月至12月在艾尔朗加大学学术医院进行的回顾性横断面研究。它收集了关于初步诊断、住院时间、总住院费用、INA-CBGs费用的数据,并计算了差异。使用独立样本t检验(或曼-惠特尼检验)对数据进行统计分析。共发现149例阴道分娩索赔,大多数为二级严重程度(79.87%),主要诊断为中度先兆子痫(20.1%)。与政府INA-CBGs费用相比,总住院费用存在显著差异(9,238,022.09印尼盾±1,265,801.88印尼盾 1,881,521.48印尼盾±12,830.15印尼盾;p<0.001)。在阴道分娩严重程度较高的情况下,住院时间(p<0.001)、总住院费用(p<0.001)和费用差异(p<0.01)也有所增加。INA-CBGs计划中的阴道分娩成本低于精算价值。在阴道分娩严重程度较高的情况下,总住院费用也有所增加,差异更为显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d1/7771029/f1339966c9b6/jphr-9-4-1999-g001.jpg

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