DR F

Analisa
Tarif INACBG dan

Biaya Operasional RS
Dr. dr. Fathema D. Rachmat, Sp. B, Sp. BTKV
Direktur Utama RS. Pelni
Disampaikan pada acara FGD implementasi tarif INACBG oleh DJSN, 18 September 2014
this is property of Pelni Hospital created
by Fathema D Rachmat and Astari
Mayang A, September 2014
Evaluasi Implementasi Tarif

INACBG di RS. Pelni


The Onion Concept of

Healthcare Delivery System

Konsep
Berwick
Trisnantoro, L. Kuliah Block II: Clinical Management System




RAWAT JALAN
Kunjungan Pasien Rawat Jalan Jan-Juli 2014

di RS. Pelni (total produksi = 131.760)
22,887
21,214
21411 21504
19,013 18,291
18522
RAJAL-JKN
RAJAL
4,533
2,595
JAN
5,522
6030
6617
7128
1,470
FEB
MAR
APR
MEI
JUN

JULI
N-3-15- Q-5-44- Q-5-42- H-3-12- Q-5-27- Q-5-43-M-3-16- Z-3-23- Q-5-31- Q-5-41- Q-5-120
0
0
0
0
0
0
0
0
0
0
Top 10 INACBG Kunjungan Rajal

Januari (N=2219)
GIGI
13
PENYAKIT AKUT BESAR LAIN-LAIN
16
FRAKTUR
16
PROSEDUR ULTRASOUND LAIN-LAIN
17
PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL

MUSKULOSKLETAL
18
PENYAKIT KRONIS BESAR LAIN-LAIN
22
SISTEM PERSARAFAN PUSAT AKUT
27
PROSEDUR LAIN-LAIN PADA MATA

PENYAKIT AKUT KECIL LAIN-LAIN
80
94
PENYAKIT KRONIS KECIL LAIN-LAIN

PROSEDUR DIALISIS

874
951
Top 3 INACBG + Rajal Januari
N-3-15-0
Q-5-29-0
G-3-13-0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
835,000
PROSEDUR ELEKROENSEFALOGRAFI (EEG)
925,456
2
425,393
GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG
LAIN-LAIN
648,022
2
891,676,091
PROSEDUR DIALISIS
934,499,199
951

Top 10 INACBG Rajal Januari

Q-5-44- H-2-36- Q-5-43- Q-5-42M-3-11- M-3-16- N-3-12- H-3-120
0
0
0
Z-3-23-0
0
0
0
0
Z-3-26-0
Tarif RS
Tarif BPJS
PROSEDUR BESAR RADIOGRAFI

PROSEDUR CYSTOSCOPI & PROSEDUR KECIL ENDOSKOPI
SALURAN KEMIH
Jumlah Kunjungan
3,616,660
993,145
5
80
15,742,466
13,108,720
2,975,000
299,221
1

MUSKULOSKLETAL
6,256,902
2,857,428
18
PROSEDUR DIAGNOSTIK DAN TERAPEUTIK MUSKULOSKELETAL
6,261,000
2,002,888
8
8,127,298
3,414,059
17
PROSEDUR OPERASI KATARAK
94
21,479,291
13,260,674
14,328,332
4,454,846
22
19,429,000
9,042,524
PENYAKITthis
KRONIS
KECIL LAIN-LAIN
is property
of Pelni Hospital
874
created
144,516,774
208,583,829
Q-5-44-0 N-3-15-0 M-3-16-0 H-3-12-0 Z-3-25-0 Z-3-12-0 Z-3-27-0 Z-3-23-0 Q-5-18-0 Q-5-41-0

Juli (N=5295)
48
KONSULTASI ATAU PEMERIKSAAN LAIN-LAIN
55
70
PERAWATAN LUKA
79
PROSEDUR REHABILITASI
81
PROSEDUR ULTRASOUND GINEKOLOGIK
84

MUSKULOSKLETAL
177
893
PROSEDUR DIALISIS

1224
2299
Top 10 INACBG + Rajal Juli

N-3-15- M-3-16- G-3-13- Q-5-27- N-3-10- N-3-11Q-5-16- U-3-13- O-7-100
0
0
0
0
0
I-3-13-0
0
0
0
Tarif RS
Tarif BPJS
PROSEDUR PERSALINAN DENGAN BEDAH CAESAR

PROSEDUR DIAGNOSTIK LAIN-LAIN PADA TELINGA, HIDUNG,
MULUT DAN TENGGOROKAN
Jumlah Kunjungan
935,000
982,649
1
1,099,306
1,148,000
2
VAKSINASI
100,000
158,746
1
PROSEDUR EKOKARDIOGRAFI
255,000
324,097
2
PROSEDUR DIAGNOSTIK LAIN PADA STUDI SALURAN KEMIH
1,400,000
1,478,702
4
PROSEDUR PADA GINJAL DAN URETER
50,000
158,746
1
SISTEM PERSARAFAN PUSAT AKUT
674,980
861,793
5
315,000
577,800
3

MUSKULOSKLETAL
PROSEDUR DIALISIS
893
205,080,667
208,400,534
1224
this is property of Pelni
Hospital created
894,946,555
904,421,505
Top 10 INACBG Rajal Juli

Q-5-44- H-2-36- H-3-12- Z-3-23- Q-5-18- K-3-15- Q-5-36- Q-5-41- Z-3-27- C-3-110
0
0
0
0
0
0
0
0
0
Tarif RS
Tarif BPJS
KEMOTERAPI PADA TUMOR PARU & KANDUNG KEMIH
Jumlah Kunjungan
9,450,054
4,680,008
2
PERAWATAN LUKA
23,068,080
18,226,291
79
27,965,703
22,439,783
48
KEKACAUAN METABOLIK AKUT
PROSEDUR ENDOSKOPI KECIL PADA GASTROINTESTINAL ATAS
8,714,827
2,724,307
4
10,770,070
4,521,262
1
25,673,864
19,148,595
55
27,955,493
20,534,965
70
177
50,441,270
42,473,232
29,008,750
17,528,957
17
2299
this is property of Pelni Hospital
created
735,037,774
595,724,181
Rawat

RAWAT INAP
Kunjungan Pasien Rawat Inap Jan-Juli 2014 di

RS. Pelni (total produksi = 7.506)
1132
1186
1196
1086
991
1019
896
RANAP
398
443
493
498
540
303
207
JAN
FEB
MAR
APR
MEI
JUN

JULI
RANAP-JKN
100
Higher Volume Lower Cost: BOR RS. Pelni
90
JAN
FEB
80
MARET
APR
70
MEI
JUN
JULI
60
AGUSTUS
50
40
30
20
10
Feb = 321 TT Mar = 327 TT Apr = 331 TT
Jan = 312 TT
0
1
10 11 12 13 this
14 15
16 17 18 of
19Pelni
20 21
22 23 24
25 26 27 28 29 30 31
is property
Hospital
created
property of Pelni Hospital, created

Fathema Djan
& Astari
Mayang
Anggarani, September 2014
bybyFathema
DRachmat
Rachmat
and
Astari
A-4-14-I J-1-20-III E-4-10-II I-4-12-III N-4-10-II H-1-30-I H-1-30-II A-4-14-III K-4-18-I K-4-17-I
Top 10 INACBG Episode Ranap Januari (N=225)

NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN (RINGAN)
DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN BERAT
PROSEDUR LENSA DAN INTRA OKULER SEDANG
PROSEDUR LENSA DAN INTRA OKULER RINGAN
TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL SEDANG
KEGAGALAN JANTUNG BERAT
PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK

SEDANG
PROSEDUR SISTEM PERNAFASAN NON KOMPLEKS BERAT
is property
of Pelni
PENYAKIT INFEKSI BAKTERI DAN PARASITthis
LAIN-LAIN
RINGAN
Hospital created
Top 10 INACBG + Ranap Januari (N=225)

J-1-20-III I-4-12-III J-1-30-II I-4-10-III K-1-11-III J-4-16-III I-1-17-I G-4-14-II K-4-10-II I-4-12-I
Tarif RS
Tarif BPJS
KEGAGALAN JANTUNG RINGAN
TUMOR PENCERNAAN SEDANG
KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK SEDANG
PROSEDUR LIGASI DAN STRIPPING PEMBULUH DARAH VENA

RINGAN
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
PROSEDUR ADHESIOLISIS PERITONEAL BERAT
INFARK MYOKARD AKUT BERAT
PROSEDUR SISTEM PERNAFASAN MODERAT KOMPLEKS SEDANG
Jumlah Kunjungan
9,177,926
19,809,964
5,976,237
17,461,050
10,636,754
22,656,168
16,412,603
30,504,225
10,909,933
28,450,656
1,934,269
20,272,943
1
3,602,230
25,060,946
5,319,271
27,805,274
37,756,934
61,599,594

created
8
115,615,179
228,436,387
Top 10 INACBG Ranap Januari (N=225)

H-1-30-I M-1-02-IIO-6-10-II H-1-30-II M-1-40-II V-1-14-II B-4-14-II J-1-01-III J-4-21-II I-4-15-III
Tarif RS
Tarif BPJS
GANGUAN PEMBULUH DARAH PERIFER LAIN-LAIN (BERAT)

GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN LAIN-LAIN
(SEDANG)
PROSEDUR VENTILASI MEKANIKAL LONG TERM DENGAN
TRAKEOSTOMI BERAT
GANGGUAN SALURAN EMPEDU LAIN-LAIN SEDANG
PROSEDUR PENGANGKATAN PROSTAT MELALUI URETRA SEDANG

PROSEDUR EKSISI LOKAL DAN PENGANGKATAN ALAT FIKSASI
INTERNAL SEDANG
PROSEDUR LENSA DAN INTRA OKULER SEDANG
PROSEDUR OPERASI PEMBEDAHAN CAESAR SEDANG
PROSEDUR AMPUTASI SEDANG
PROSEDUR LENSA DAN INTRA OKULER RINGAN
Jumlah Kunjungan
16,694,931
8,974,824
18,558,921
10,261,023
64,342,037
55,359,049
13,789,764
4,249,149
10,333,126
21,757,602
26,033,943
23,661,320
11,717,386
20,934,165
16,849,484

created
4
43,589,396
42,467,783
35,661,694
49,219,160
48,078,977
O-6-10-I
N-4-10- O-6-10- K-4-18- N-4-10- A-4-13- K-4-18K-4-17II

II
III
III
II
II
K-4-18-I U-4-14-I
III
Top 10 INACBG Episode Ranap Juli

(N=540)
NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN (BERAT)
16
PENYAKIT MULUT DAN GIGI RINGAN
16
17
DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
19
INFEKSI NON BAKTERI SEDANG
19
TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL BERAT
23
DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (BERAT)
25
25
PROSEDUR OPERASI PEMBEDAHAN CAESAR RINGAN

26
28
Top 10 INACBG + Ranap Juli

J-1-20- J-1-30- M-1-10- N-4-10- K-4-18- J-4-16- I-1-40- I-1-15- K-1-40- I-4-12III
III
III
III
III
III
III
III
III
III
Tarif RS
Tarif BPJS

PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (BERAT)
PROSEDUR KATETERISASI JANTUNG BERAT
PROSEDUR KARDIOVASKULAR PERKUTAN BERAT
DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (BERAT)
PROSEDUR KRANIAL DAN REKONSTRUKSI TULANG WAJAH
BERAT
PROSEDUR SISTEM PERNAFASAN MODERAT KOMPLEKS BERAT
Jumlah Kunjungan
142,879,332
182,987,026
15
7
82,586,767
123,947,851
99,503,825
141,324,444
255,427,383
307,489,871
6
10
47,034,208
103,133,628
103,913,515
160,903,370
25
138,050,100
195,337,091
23
64,111,776
1
133,071,075
82,879,500
4
11

172,950,756
224,906,819
330,503,710
Top 10 INACBG Ranap Juli

V-1-14- G-4-13- J-1-02- K-1-20- N-1-40- N-1-40S-4-16- A-4-15- A-4-15II
III
III
II
II
III K-1-13-I III
II
III
Tarif RS
Tarif BPJS
INFEKSI HIV BERAT
INFEKSI HIV SEDANG
LUKA BAKAR BERAT
PROSEDUR APPENDIK RINGAN
PROSEDUR PADA URETRA DAN TRANSURETRA BERAT
PROSEDUR PADA URETRA DAN TRANSURETRA SEDANG
PROSEDUR INTESTINAL KOMPLEKS (SEDANG)

PROSEDUR VENTILASI MEKANIKAL LONG TERM TANPA
TRAKEOSTOMI BERAT
PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK BERAT
Jumlah Kunjungan
115,944,081
93,004,092
10
101,416,520
77,570,864
14
37,271,089
13,228,453
39,031,718
14,170,064
42,683,966
17,018,973
53,147,949
27,214,098
148,863,307
120,832,068
190,245,488
148,176,654
26,391,415
5
created
83,946,434
61,998,755
129,900,098
Derajat Keparahan
Property of Pelni Hospital, created by

Fathema D. Rachmat & Astari Mayang
A, Agustus 2014
Rawat

ANALISA DATA-DATA KHUSUS

Analisa Data:
Top 10 Klaim Negatif peserta JKN April 2014
Kode
INACBGs
Deskripsi
GANGGUAN SEL DARAH MERAH SELAIN KRISIS

J-1-01-III ANEMIA SEL SICKLE BERAT
Negatif (Rp)
LOS
-100,920,137
52 Hari
-89,048,002
63 Hari
-45,109,457
22 Hari
-41,839,490
21 Hari
-38,286,051
10 Hari
-26,458,062
17 Hari
-24,570,406
12 Hari
K-4-18-III DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (BERAT) -23,900,071
19 Hari
INFEKSI NON BAKTERI SISTEM PERSARAFAN (TIDAK

G-4-19-III TERMASUK MENINGITIS
BERAT
this isVIRUS)
property of
Pelni Hospital created
-20,570,665
18 Hari
I-1-15-III
-17,851,625
17 Hari
GANGGUAN SEL DARAH MERAH SELAIN KRISIS

D-4-13-III ANEMIA SEL SICKLE BERAT
PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/
E-4-10-III METABOLIK BERAT
DIAGNOSIS SISTEM PEMBULUH DARAH LAIN-LAIN
I-4-24-III (BERAT)
N-1-20-II
PROSEDUR SALURAN URIN ATAS SEDANG

TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL
N-4-10-III BERAT
PROSEDUR OPERASI PENGANGKATAN RAHIM DAN
W-1-01-I VULVA RADIKAL & EVISCERASI RINGAN
PROSEDUR
Dr. dr. Fathema D. Rachmat, Sp. B, Sp.

BTKV.
RS. Pelni. BERAT
Juli 2014
KATETERISASI
JANTUNG
Mayang
A, September 2014
Analisa Data : LOS > 10 hari April 2014
LOS
(ALOS
target 5,8
hari)
1-6 hari
6-10 hari
11-20 hari
20-30 hari
>30 hari
TOTAL
Total
Jml
pasien
149
81
45
6
2
283
Negatif (Rp)
508,223,897
335,246,537
320,217,768
120,829,432
189,968,139
1,474,485,773
Jumlah Klaim
Negatif = 283
pasien (40,4%
Ranap JKN
April 2014)

BTKV. RS. Pelni. Juli 2014
Jum
lah
pasi
en
100
%
Analisa data: Proporsi Derajat Keparahan pada klaim negatif April 2014
$675,421,751
$476,811,358
$322,252,664
II
III

Kolaborasi: Prosedur Kardiovaskular Perkutan Ringan peserta

JKN di RS Pelni dengan RS Swasta Khusus Jantung Jan-Jun 2014
Bula
n
Mei
Mei
Juni
Juni
No. RM
390208
452246
454388
455645
4 Pasien
Kode
Tarif Dasar
INACBGs
I-1-40-I 21,837,685
I-1-40-I 21,837,685
I-1-40-I 21,837,685
I-1-40-I 21,837,685
Topup
15,598,347
15,598,347
15,598,347
15,598,347
Total Tariff
37,436,032
37,436,032
37,436,032
37,436,032
Tarif RS. Pelni

35,422,610
46,915,924
35,767,470
36,359,114
149,744,128 154,465,118
Rp. 4,7 juta

Kolaborasi: Prosedur Kardiovaskular Perkutan Sedang peserta

JKN di RS Pelni dengan RS Swasta Khusus Jantung Jan-Jun 2014
Bula
n
April
April
April
Mei
Juni
Juni
Juni
No. RM
452877
325481
452486
455359
454298
457612
456207
Kode
INACBGs
I-1-40-II
I-1-40-II
I-1-40-II
I-1-40-II
I-1-40-II
I-1-40-II
I-1-40-II
Tarif Dasar
22,244,316
31,142,042
31,142,042
31,142,042
26,693,179
31,142,042
31,142,042
Topup
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
7 pasien
Total Tariff
Tarif RS. Pelni
37,842,663
46,740,389
46,740,389
31,142,042
42,291,526
46,740,389
46,740,389
34,379,325
45,877,700
48,443,929
46,077,316
39,451,588
37,312,677
38,789,754
298,237,787
290,332,289
Rp. 7,9 Juta

Kolaborasi: Prosedur Kardiovaskular Perkutan Berat peserta JKN

di RS Pelni dengan RS Swasta Khusus Jantung Jan-Jun 2014
Bula
n
April
April
Mei
Mei
Mei
Mei
Juni
Juni
No. RM
452357
452246
453818
454388
453123
185075
120448
357776
8
pasien
Kode
INACBGs
I-1-40-III
I-1-40-III
I-1-40-III
I-1-40-III
I-1-40-III
I-1-40-III
I-1-40-III
I-1-40-III
Tarif Dasar
37,432,463
37,432,463
37,432,463
37,432,463
37,432,463
37,432,463
37,432,463
37,432,463
Topup
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
15,598,347
Total Tariff
53,030,810
53,030,810
53,030,810
53,030,810
53,030,810
53,030,810
53,030,810
53,030,810
Tarif RS. Pelni

45,826,222
54,793,975
35,343,616
46,683,573
47,671,453
45,454,543
45,563,124
95,676,741
424,246,480 417,013,247
Rp. 7,2 juta

DAMPAK UNTUK RS SECARA

UMUM
Impact tariff disparity
Moral Hazard (Class B, C and D hospital)
Fraudulent activities
Physicians opting Out the program
Driving the supplier to the edge of bankruptcy

Impact of 15 days Claim ability
Hospital Information System is essential (e-medical

record, billing, LIS, etc)
Install INACBG software
Casemix Center to Unit Casemix
Training and educate Coder
Educate physicians and nurses
Medical resume
Involvement of medical board for severity of illness III

Impact the JKN police
Knowledge about healthcare fraud
Medical statistician
Internal auditor/investigator
Anti fraud team
Culture transformation
Fraud
A knowing misrepresentation of
the truth or concealment of a
material fact to induce another to
act to his or her detriment- Blacks
Law Dictionary
CORPORATE
CLINICIAN
CODER

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
15 DIFFERENT TYPES OF FRAUDULENT BILLING PRACTICE

NHCAA, 2012

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
PEMBELAJARAN, KEBIJAKAN
& STRATEGI
Do More Charge Less
Devy Shetty
Economic Scale:
1. Tweaking process
2. Hard bargain
3. Creative partnership
deals
4. Replicating the model in
bigger scale
Affordable excellence
Bangalore:
500 beds Cardiac care + 500 multi specialistic
42 cardiac operation per day
24 open heart surgery per day
35 cardiac catheterisation per day
Price for cardiac surgery $600-800
2% mortality rate
2.8/1000 ICU days infection rate
!
!

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Controling the Length of Stay
Clinical Pathway: EBM based tools to

control LOS
property of Pelni Hospital, created by Fathema Djan Rachmat & Astari Mayang Anggarani, September 2014

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari


Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Waste Identification
Identifikasi Waste di Rumah Sakit
Defek: salah menyiapkan benang (atau

BMHP kamar bedah lainnya)
mengakibatkan tertundanya operasi
Over produksi: obat diresepkan dan

diantar ke rawat inap untuk 3 hari
Transportasi: mengantarkan obat pulang
ke rumah pasien
Waktu tunggu: pasien menunggu obat

pulang > 3 jam
Inventory: penumpukan obat di gudang

farmasi
Inefisiensi gerakan staf & pegawai: lay out
bagian farmasi tidak ergonomis, belum
implementasi 5R
Over proses: tidak memanfaatkan datadata produksi
Potensi sumber daya manusia: belum
mengoptimalkan kapasitas SIRS
7 ways to lean hospital:

1. Reduce never events 2. supply chain improvements
3. delay or cancel construction and expansion 4. redue overtime
5.reduce length of stay 6. reduce unnecessary testing and
diagnostic 7. reduce delays and errors in billing
Graban, Mark. Lean Hospital

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Lean Approach
Hospital and Supplier partnership
Long term relationship
Fact: we dont have power to influence the market
Adapt to the changing market
Good quality cost less (e.g: preventable medical errors

cost $2 billion per year)
Lean is a quality initiative NOT a cost cutting initiative

Graban, Mark. Lean Hospitalby Fathema D Rachmat and Astari

Strategies Reducing Waste
Patient Centered Strategic Planning
Culture Transformation
Redesigning business process :
1. Bed management, Discharge planning

2. One day dosage dispensing system
3. Case managers, Disposable medical supplies management in
Operating Theatre
4. Better supply chain logistics
Stop bleeding money:
1. Completing diagnostic tools: lab test, MS CT, MRI

2. Adding minimal invasive: ESWL
Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Hospital Policies
Shifting mind set, changing paradigm
Effective communication, cross functional daily

communication (morning briefing)
Physicians - Managements trust
Collaboration - Sister hospital
Financial engineering
Daily evaluation and monitoring
Data based decisions
Affordable excellence: adding competencies, adding skills,

adding capacity
Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
BEBAN, EFISIENSI &

PERTUMBUHAN
Prosentase capaian Beban Usaha & Overhead

2014 dibanding RKAP; Produksi Rajal
produksi rajal
Beban Usaha Pelayanan
Beban Usaha Penunjang Yan
BEBAN OVERHEAD
140%
120%
100%
80%
21214
21202
21411
21504
60%
40%
19013
18522
18291
20%
0%
Jan
Feb
Mar
Apri
Mei

Jun
Juli
Prosentase capaian Beban Usaha & Overhead

2014 dibanding RKAP; BOR
BEBAN OVERHEAD
140%
120%
100%
80%
60%
40%
48.79
59.9
65.13
72.35
73.93
Apri
Mei
72.79
BOR aktual
62.56
20%
0%
Jan
Feb
Mar

Jun
Juli
Prosentase Capaian Beban Usaha, Overhead &

Produksi Kamar bedah 2014 dibanding RKAP
BEBAN OVERHEAD
140%
produksi kamar bedah
120%
100%
80%
128%
60%
105%
104%
93%
91%
92%
77%
40%
20%
0%
Jan
Feb
Mar
Apri
Mei

Jun
Juli
Prosentase Capaian Beban Usaha, Overhead

& Produksi Hemodialisa 2014 dibanding RKAP
246%
produksi hemodialisa
231%
205%
169%
140%
BEBAN OVERHEAD
136%
120%
103%
100%
106%
80%
60%
40%
20%
0%
Jan
Feb
Mar
Apri
Mei

Jun
Juli
Prosentase capaian beban Usaha, Overhead &

Produksi Rehab Medik 2014 dibanding RKAP
produksi rehab medik
140%
BEBAN OVERHEAD
120%
100%
175%
80%
139%
60%
40%
110%
68%
82%
75%
75%
Mar
Apri
20%
0%
Jan
Feb
Mei

Jun
Juli

& Produksi Kamar bedah 2014 dibanding 2013
BEBAN OVERHEAD
140%
produksi kamar bedah
120%
100%
80%
128%
60%
105%
104%
93%
91%
92%
77%
40%
20%
0%
Jan
Feb
Mar
Apri
Mei

Jun
Juli
Prosentase capaian beban Usaha, Overhead &

Produksi Hemodialisa 2014 dibanding 2013
246%
produksi hemodialisa
231%
205%
169%
BEBAN OVERHEAD
136%
140%
120%
103%
106%
100%
80%
60%
40%
20%
0%
Jan
Feb
Mar
Apri
Mei

Jun
Juli
Prosentase Capaian beban Usaha, Overhead

& Produksi Rehab Medik 2014 dibanding 2013
produksi rehab medik

BEBAN OVERHEAD
140%
120%
100%
175%
80%
139%
60%
40%
110%
68%
82%
75%
75%
Mar
Apri
20%
0%
Jan
Feb
Mei

Jun
Juli
Capaian Produksi & Biaya Farmasi 2014

dibanding RKAP; Jumlah Pasien Rajal
19,013
produksi farmasi
biaya farmasi
RAJAL-JKN
RAJAL
22,887
21,214
21411
21504
18522
18,291
145%141%
85% 91%
2,595
Jan
78%
86%
4,533
83%
93%
5,522
95% 98%
6030
98% 99%
6617
111%108%
7128
1,470
Feb
Mar
Apr
Mei

Jun
Juli
Capaian Produksi & Biaya Farmasi 2014

dibanding RKAP; Jumlah Pasien Ranap
penghasilan
produksi
farmasi
bebanfarmasi
biaya
RANAP
1186
1132
896
Jan
1196
1086
991
1019
145%141%
85% 91%
207
RANAP-JKN
78%
303
Feb
86%
398
Mar
83%
93%
443
Apr
95% 98%
493
Mei

98% 99%
498
Jun
111%108%
540
Juli
Capaian Produksi & Biaya Laboratorium

2014 dibanding RKAP; Jumlah Pasien Rajal
produksi lab
RAJAL-JKN
19,013
85%
78%
2,595
Jan
21,214
biaya lab
RAJAL
22,887
21411
21504
18522
18,291
86%91%
76%81%
4,533
84%
76%
5,522
99%
90%
6030
111%
109%
6617
117%
106%
7128
1,470
Feb
Mar
Apr
Mei

Jun
Juli
Capaian Produksi & Biaya Laboratorium 2014

dibanding RKAP; Jumlah Pasien Ranap
produksi lab
RANAP
RANAP-JKN
1196
1186
1132
1086
991
896
Feb
Mar
Apr
Mei

1019
540
498
493
443
398
303
207
Jan
biaya lab
Jun
Juli









Hospital Growth
February:
312 beds > 321 beds
Benchmarking
March:
321 beds > 327 beds
ESWL
April:
327 beds > 331 beds
USG, Ventilator
Executive clinic & MCU
May:
MS CT, MRI
June:
Benchmarking
Adding 73 Hemodalisys
Next:
Add more beds
Extend ER, ICU, OR

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Human Resource Growth

Recruitment January-August 2014
Physician, specialists
3
Physician, GPs
11
Nurse & midwives
25
Pharmacists
7
Radiologists
2
Medical record staff
1
Non medical staff
2
TOTAL
51
Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
IT Modules Growth
Bed Management (Feb-14)
BOR harian online (Mar-14)
Resep Online (Mei-14)
Resume Medis Online (Mei-14)

Daftar Kontrol Rajal (Apr-14)
One Day Dose Dispensing (Mei-14)
Anjungan Mandiri Daftar Rawat Jalan
(Juli-14)
SEP online (Juni-14)

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Physicians Take Home Pay January-June 2013 Vs 2014

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Internists
General Surgeons
Obgyns
Medical Rehabs

Fathema Djan
& Astari
Mayang
bybyFathema
DRachmat
Rachmat
and
Astari
Contoh Jasmed dokter neurologi

semester I 2013 vs 2014 & BOR
73.92
73.27
60.68
62.79
60.88
65.13
61.26
59.16
72.74
56.05
51.16
49.72
2013
47,328,748
37,525,360
33,271,040
35,509,472
2014
32,137,069 32,798,500
29,613,600
33,110,006
29,998,750
24,192,160
2013
26,303,750
24,118,500
2014
122%
100%
99%
99%
Januari
Februari
Maret
April
94%
Mei
79%
Juni
Survei Kepuasan Pasien Peserta JKN

Rawat Jalan
15
12
12 12
7
8
5
01
0
Sangat
Tidak
Puas
Tidak
Puas
Cukup
Puas
Puas
Rawat Inap
Sangat
Puas
20
Alur
Pendaftaran
Pelayanan
Rawat Inap
15
Pelayanan
Farmasi
Pelayanan
Administrasi
Sangat Tidak Puas
Tidak Puas

18
17
Cukup
Puas
Puas
Sangat
Puas
Kesimpulan
Perubahan mind set : JKN = Kesempatan

Manfaatkan data internal RS
Kendalikan LOS dengan Clinical Pathway
Long term partnership
Lean Management
RS menjalani learning curve kesatu,
kedua, ketiga dst
Saran
Revisi (sebagian) tarif INACBG; disparitas
antar kelas RS; top up implant
E catalog dengan E purchasing untuk RS
Swasta
Coordination fo Benefit
Pedoman Nasional Pelayanan Kedokteran
Lebih aktif libatkan profesi
TERIMA KASIH
fathemadr@gmail.com ; @bpjspulse

Q-5-44-0 N-3-15-0 M-3-16-0 H-3-12-0 Z-3-27-0 Z-3-23-0 Q-5-42-0 Z-3-12-0 Q-5-41-0 Z-3-25-0

Februari (N= 2621)
15
18
26
30
36
PERAWATAN LUKA
37

MUSKULOSKLETAL
120
212
PROSEDUR DIALISIS

this is property
of Pelni Hospital created

912
1057
Top 10 INACBG + Rajal Februari

N-3-15- M-3-16- Z-3-12- D-3-10- Q-5-30- Q-5-29- N-3-11- M-2-52- Q-5-23- Q-5-250
0
0
0
0
0
0
0
0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
GASTROINTESTINAL AKUT
155,000
140,060
1
PEMERIKSAAN ANTEPARTUM
265,436
262,806
2
PROSEDUR KECIL PADA JARINGAN LUNAK
180,000
194,107
1
1,100,000
1,256,648
4
GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAIN-LAIN
1,740,569
1,944,066
6
INFARK MIOKARD AKUT DAN ARITMIA
PROSEDUR TRANSFUSI & TERAPI SUMSUM TULANG
MUSKULOSKLETAL
PROSEDUR DIALISIS
155,000
375,615
1
9,260,044
11,752,020
7
2,880,000
6,424,548
26
21,815,000
33,654,152
212
912 created
865,278,888
896,175,888
Top 10 INACBG Rajal Februari

Q-5-44M-3-11Q-5-36Q-5-420
H-2-36-0Z-3-23-0H-3-12-0N-3-10-0
0
Z-3-27-0
0
Z-3-26-0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
6,058,805
4,232,130
30
3,130,737
1,191,774
6
2,623,220
609,372
2
PERAWATAN LUKA
PROSEDUR PADA GINJAL DAN URETER
9,362,996
7,016,569
37
5,148,807
2,753,971
11
9,825,126
3,268,176
12
120
27,105,733
19,663,080
22,173,834
7,229,772
36
74,420,835
40,691,358
this is property of Pelni1057

Hospital created
174,776,007
254,269,199
Q-5-44- N-3-15- M-3-16- H-3-12- Z-3-25- Z-3-27- Q-5-18- Z-3-23- Z-3-12- Q-5-410
0
0
0
0
0
0
0
0
0

Maret (N=3302)
40
41
44
48
PERAWATAN LUKA
54
55

MUSKULOSKLETAL
126
258
PROSEDUR DIALISIS

1021
1379
Top 10 INACBG + Rajal Maret

M-3-16 N-3-15- Z-3-12- D-3-10- Q-5-29 N-3-11- Q-5-34 Q-5-30 Q-5-32 U-3-14-0
0
0
0
-0
0
-0
-0
-0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
PROSEDUR TES FUNGSI PADA TELINGA, HIDUNG, MULUT DAN

TENGGOROKAN
155,000
179,239
1
SALURAN KEMIH AKUT
275,301
308,836
2
294,934
375,615
1
INFEKSI VIRUS HIV
562,600
694,578
3
1,434,913
1,570,810
5
GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAINLAIN
1,560,775
2,268,077
7
1,250,826
3,357,720
2
PROSEDUR DIALISIS
MUSKULOSKLETAL
4,485,000
10,131,018
41
1021
24,195,286
40,956,468
258

990,858,430
1,003,284,629
Top 10 INACBG Rajal Maret

Q-5-44- H-2-36- Z-3-23- M-3-11- H-3-12- J-3-13- Z-3-27- Q-5-18- Z-3-25- Z-3-260
0
0
0
0
0
0
0
0
0
Tarif RS
PERAWATAN LUKA
PROSEDUR TERAPI SALURAN PERNAFASAN

PROSEDUR DIAGNOSTIK DAN TERAPEUTIK
MUSKULOSKELETAL
Tarif BPJS
Jumlah Kunjungan
6,531,929
2,184,919
11
55
14,199,279
9,666,085
11,877,520
6,523,200
48
54
15,608,682
10,240,398
9,767,544
3,824,400
15
126
28,855,460
20,646,234
19,985,279
7,010,108
28
27,814,361
8,836,388
44
16
123,013,581
72,340,192
1379

228,019,029
333,710,460
Q-5-44-0 N-3-15-0M-3-16-0H-3-12-0 Z-3-25-0 Q-5-42-0 Z-3-23-0 Z-3-27-0 Q-5-41-0Q-5-43-0

April (N=3588)
42
42
PERAWATAN LUKA
46
56
62
74

MUSKULOSKLETAL
164
319
PROSEDUR DIALISIS

1050
1506
Top 10 INACBG + Rajal April

N-3-15- M-3-16- Z-3-12- Q-5-29Q-5-30- G-3-13- B-2-13- Q-5-34- Q-5-190
0
0
0
J-3-13-0
0
0
0
0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
KONTAK PELAYANAN KESEHATAN LAIN-LAIN
100,000
152,449
1
INFEKSI VIRUS HIV
158,775
231,526
1
PROSEDUR LAIN-LAIN PADA HEPATOBILIARI & PANKREAS
1,488,576
1,619,253
1
680,000
925,456
2
402,043
751,230
2
2,371,710
3,059,520
12
GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAIN-LAIN
1,541,019
2,268,077
7
2,515,000
5,683,254
23

MUSKULOSKLETAL
PROSEDUR DIALISIS
29,018,671
50,639,974
319
1050

999,429,606
1,031,781,450
Top 10 INACBG Rajal April

Q-5-44- H-2-36H-3-12- M-3-11Q-5-42- Q-5-180
0
Z-3-23-0
0
0
Z-3-25-0Z-3-26-0Z-3-27-0
0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
7,819,457
4,892,400
36
12,345,425
8,746,402
62
PERAWATAN LUKA
13,124,980
8,723,302
46
9,551,335
2,780,806
14
74
21,545,542
13,005,278
14,292,320
4,756,859
19
164
56
40,627,668
26,872,876
27,265,480
11,246,312
14
1506
109,748,109
63,297,668

249,018,606
357,350,132
Q-5-44- N-3-15- M-3-16- H-3-12- Z-3-23- Q-5-42- Z-3-25- Q-5-41- Q-5-43- Z-3-120
0
0
0
0
0
0
0
0
0

Mei (N= 3918)
35
35
40
63
64
69

MUSKULOSKLETAL
185
343
PROSEDUR DIALISIS

1094
1750
Top INACBG + Rajal Mei

N-3-15- M-3-16- Z-3-12- C-3-13- K-3-10- D-3-10- Q-5-26- J-3-13- Q-5-36- Q-5-300
0
0
0
0
0
0
0
0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
257,297
375,615
1
768,656
914,058
3
1,112,132
1,274,800
5
BRONKIAL AKUT
3,989,702
4,166,694
21
1,491,784
1,678,860
1
PROSEDUR KECIL LAIN-LAIN PADA GASTROINTESTINAL
134,791
369,112
1
KEMOTERAPI PADA TUMOR PAYUDARA ATAU OVARIUM
1,327,000
2,652,762
1
3,840,000
8,648,430
35

MUSKULOSKLETAL
PROSEDUR DIALISIS
33,452,035
54,449,878
343
1094

1,044,499,397
1,075,018,006
Top INACBG Rajal Mei

Q-5-44- H-2-36- Z-3-23- H-3-12- M-3-11- Z-3-26- H-2-22- Z-3-25- Q-5-42- U-3-150
0
0
0
0
0
0
0
0
0
Tarif RS
Tarif BPJS
PROSEDUR LAIN-LAIN PADA TELINGA, HIDUNG, MULUT DAN

TENGGOROKAN
Jumlah Kunjungan
5,495,216
2,493,216
16
12,364,758
9,028,544
64
16,014,408
11,072,061
63
PROSEDUR SEDANG PADA MATA
7,068,897
386,533
1
10,561,884
3,178,064
16

MUSKULOSKELETAL
13,204,458
5,257,581
21
185
69
42,686,402
30,313,915
36,135,167
13,857,063
13
1750
109,583,282
58,776,406

400,256,782
289,364,250
Q-5-44-0N-3-15-0
M-3-160
H-3-12-0 Z-3-23-0 Z-3-25-0 Z-3-12-0 Z-3-27-0 Q-5-43-0Q-5-18-0

Juni (N= 5078)
54
55
PERAWATAN LUKA
58
61
80
99

MUSKULOSKLETAL
203
693
PROSEDUR DIALISIS

1,059
2,368
Top 10 INACBG + Rajal Juni

M-3-16- N-3-15- Z-3-12- Q-5-29- Q-5-30- D-3-10- M-2-63- Q-5-26C-3-130
0
0
0
0
0
0
0
I-2-22-0
0
Tarif RS
Tarif BPJS
Jumlah Kunjungan
KEMOTERAPI PADA TUMOR PAYUDARA ATAU OVARIUM
2,357,801
2,652,762
1
PROSEDUR SEDANG PADA PEMBULUH DARAH
935,000
1,324,036
1
BRONKIAL AKUT
2,695,322
3,174,624
16
PROSEDUR INSISI, BIOPSI DAN GRAFT PADA TULANG
911,623
1,555,504
2
919,642
1,678,860
1
1,732,644
3,004,920
8
GAGAL JANTUNG KONGESTIF DAN KONDISI JANTUNG LAINLAIN
1,821,560
3,240,110
10
PROSEDUR DIALISIS
MUSKULOSKLETAL
6,640,000
15,072,978
61
1,059
693
70,842,189
110,010,978

1,010,545,924
1,040,625,291
Top 10 INACBG Rajal Juni

Q-5-44- H-2-36- Z-3-23- H-3-12- M-3-11- Z-3-26- Z-3-25- U-3-16- Q-5-41- Z-3-270
0
0
0
0
0
0
0
0
0
Tarif RS
Tarif BPJS
PERAWATAN LUKA
14,199,490
10,998,946
58
12,040,482
8,806,917
49
PROSEDUR PADA GIGI

MUSKULOSKELETAL
Jumlah Kunjungan
8,368,965
3,505,500
20
21,771,503
14,059,760
80
10,806,194
2,979,435
15
15,788,283
7,761,191
31
203
99
17
47,812,731
33,263,377
44,893,739
19,881,873
149,194,803
74,600,823
2,368 of Pelni Hospital created

this is property
391,551,168
550,447,800
N-4-10-II
G-4-14- N-4-10III
III
K-4-18-II A-4-14-II K-4-18-I I-4-12-III A-4-13-I A-4-14-I J-4-16-III
Top 10 INACBG Episode Ranap Februari

(N=420)
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN RINGAN
INFEKSI NON BAKTERI RINGAN
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN SEDANG
10
11
12
12
KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK

BERAT
12

16
Top 10 INACBG + Ranap Februari (N=420)

J-1-30- J-1-20K-4-10- K-4-18- J-4-16- M-1-50- J-1-30- I-4-10- G-4-14III
III I-1-20-II
II
II
III
III
II
III
II
Tarif RS
Tarif BPJS

SEDANG
INFARK MYOKARD AKUT BERAT
PROSEDUR SISTEM PERNAFASAN MODERAT KOMPLEKS SEDANG
PROSEDUR JARINGAN LUNAK BERAT
TUMOR PENCERNAAN SEDANG
PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN SEDANG
Jumlah Kunjungan
38,377,730
53,308,630
6
3
3
2
23,533,701
38,730,552
25,968,738
41,707,911
22,944,073
39,523,756
64,055,309
81,795,636
47,265,731
65,124,679
12
2
13,068,485
34,922,100
47,990,178
77,375,120
99,986,962
5
12,705,306

created
3
150,670,809
103,770,453
Top 10 INACBG Ranap Februari (N=420)

G-1-10J-1-02A-4-11O-6-10II
I-1-20-I O-6-10-IV-1-14-II III
K-1-11-I
III I-4-12-III
II
K-1-20-I
Tarif RS
Tarif BPJS
Jumlah Kunjungan
PROSEDUR INTESTINAL KOMPLEKS (RINGAN)
INFEKSI SESUDAH OPERASI & TRAUMA BERAT
PROSEDUR ADHESIOLISIS PERITONEAL RINGAN

TRAKEOSTOMI BERAT
PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN RINGAN
PROSEDUR KRANIOTOMI SEDANG
30,976,025
14,006,183
31,921,816
14,646,732
113,775,457
96,022,896
33,686,397
13,825,590
8,518,479
29,857,487
120,518,638
98,784,436
36,598,979
14,466,376
20,351,995
50,826,399
53,088,139
2
12,058,811

created
1
84,099,699
66,909,851
A-4-14-I A-4-13-IIG-4-14-IIN-4-10-IIN-1-12-II K-4-18-II
A-4-14- E-4-10- K-4-17III

III
III
J-4-16-I
Top 10 INACBG Episode Ranap Maret

(N=606)
SIMPLE PNEUMONIA & WHOOPING COUGH RINGAN
10
10

BERAT
11
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN BERAT
11
11
PROSEDUR MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT

DIALISIS SEDANG

14
15
18
20
29
Top 10 INACBG + Ranap Maret (N=606)

J-1-20K-1-20G-4-14J-1-01III
I-1-20-I I-1-20-II
III
I-4-12-III
II
J-1-20-II I-1-17-II
III
I-1-17-III
Tarif RS
Tarif BPJS

BERAT
TRAKEOSTOMI BERAT
SEDANG
PROSEDUR SISTEM PERNAFASAN NON KOMPLEKS SEDANG
SEDANG
PROSEDUR INTESTINAL KOMPLEKS (BERAT)
Jumlah Kunjungan
29,483,685
55,119,849
38,868,040
64,585,558
11,211,258
44,559,843
69,604,488
103,869,433
108,801,645
143,933,302
18
40,540,934
77,905,369
77,749,061
119,847,442
81,944,504
132,643,062
this is property of Pelni10Hospital created

145,575,567
199,080,523
119,592,905
306,201,967
Top 10 INACBG Ranap Maret (N=606)

K-4-11- O-6-10G-4-13M-1-04- J-1-30- N-4-10- J-1-02III
II
O-6-10-I V-1-14-I
III
V-1-14-II
II
III
II
III
Tarif RS
Tarif BPJS

TRAKEOSTOMI BERAT

PROSEDUR PADA SENDI TUNGKAI/ANGGOTA TUBUH BAGIAN
BAWAH MAYOR (SEDANG)
PROSEDUR PENGANGKATAN PROSTAT MELALUI URETRA
SEDANG
PERDARAHAN INTRA KRANIAL BUKAN TRAUMATIK BERAT
PROSEDUR PENGANGKATAN PROSTAT MELALUI URETRA RINGAN
GASTRITIS & ULKUS PEPTIKUM BERAT
Jumlah Kunjungan
20,580,091
45,279,892
70,389,207
15
72,798,449
10,719,743
14,955,135
62,412,197
51,042,649
91,077,506
18,568,575
7
created
99,958,005
42,081,540
28,932,752
97,201,910
45,128,337
49,798,891
44,013,214
122,294,353
128,525,848
123,411,594
A-4-13-II
N-4-10- N-4-10E-4-10A-4-13N-1-12II
III
K-4-18-II
III
A-4-14-II
III
A-4-14-I
II
O-6-10-I
Top 10 INACBG Episode Ranap April

(N=697)
11
PROSEDUR MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN

ALAT DIALISIS SEDANG
12
12
INFEKSI NON BAKTERI BERAT
12
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN SEDANG
13

BERAT
13

15
17
24
36
Top INACBG + Ranap April (N=697)

J-1-20G-4-14- A-4-15- B-1-10J-4-15- K-4-17III
N-1-12-II I-1-20-II I-4-12-III
II
III
III
J-4-15-II
III
III
Tarif RS
Tarif BPJS
Jumlah Kunjungan
PERADANGAN DAN INFEKSI PERNAFASAN BERAT
PERADANGAN DAN INFEKSI PERNAFASAN SEDANG
PROSEDUR HATI DAN PANKREAS BERAT
INFEKSI HIV BERAT

PROSEDUR MEMBUAT BARU, MEREVISI DAN MEMINDAHKAN ALAT
DIALISIS SEDANG
29,256,965
46,892,303
40,448,295
61,180,123
44,836,138
65,773,346
10
16,340,547
38,095,862
27,131,955
49,502,178
51,408,037
74,632,083
46,246,329
72,470,111
32,303,698
60,794,736
139,618,193
180,855,444
12
4
created
42,971,488
116,648,368
Top INACBG Ranap April (N=697)

J-1-01- D-4-13O-6-10N-4-10- B-4-13K-4-12- W-1-01III
III O-6-10-I
II
K-1-14-I
II
II
L-1-50-I
II
I
Tarif RS
Tarif BPJS
PROSEDUR OPERASI PENGANGKATAN RAHIM DAN VULVA

RADIKAL & EVISCERASI RINGAN
GANGGUAN ESOFAGUS SEDANG
PROSEDUR PADA PAYUDARA RINGAN

GANGGUAN HATI SELAIN TUMOR, SIROSIS ATAU HEPATITIS
ALKOHOLIK SEDANG
PROSEDUR HERNIA INGUINAL DAN FEMORAL RINGAN

GANGGUAN SEL DARAH MERAH SELAIN KRISIS ANEMIA SEL
SICKLE BERAT
TRAKEOSTOMI BERAT
Jumlah Kunjungan
38,429,596
13,859,190
45,918,945
20,418,729
66,849,883
39,844,176
54,607,610
26,528,653
145,732,460
116,506,272
24
71,947,647
39,997,474
72,927,164
32,222,812
11
57,516,507
5,680,459

139,166,939
94,728,461
101,491,590
202,693,162
K-4-18-II N-4-10-II
N-4-10E-4-10G-4-14III
A-4-13-II A-4-14-I
III
A-4-15-II
III
O-6-10-IIG-4-14-II
Top 10 INACBG Episode Ranap Mei

(N=830)
SEDANG
BERAT
INFEKSI HIV SEDANG
BERAT
14
15
16
17
18
20
22
23
23

26
Top 10 INACBG + Ranap Mei (N=830)

J-1-20- J-1-30I-1-15- K-1-20- J-4-16- I-1-40- N-4-10- G-4-14- M-1-70III
III I-1-20-II III
II
III
III
III
III
I
Tarif RS
Tarif BPJS
PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN KAKI (RINGAN)

KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK BERAT
Jumlah Kunjungan
38,919,018
61,497,918
135,863,663
163,314,310
16
170,558,547
198,168,063
23
175,153,185
212,123,240
4
8
3
48,125,365
85,351,968
24,529,277
62,048,899
112,858,217
173,937,776
8
34,890,762
3
99,482,296
173,453,151
11
created
155,271,526
318,229,390
320,783,012
Top 10 INACBG Ranap Mei (N=830)

J-1-02B-4-13- D-4-13- M-1-80O-6-10A-4-13III V-1-14-II V-1-14-I
II
III
II
K-1-11-II III
K-1-14-I
III
Tarif RS
Tarif BPJS
Jumlah Kunjungan
INFEKSI NON BAKTERI BERAT
PROSEDUR OPERASI PEMBEDAHAN CAESAR BERAT
PROSEDUR ADHESIOLISIS PERITONEAL SEDANG
PROSEDUR ANGGOTA TUBUH ATAS SEDANG

GANGGUAN SEL DARAH MERAH SELAIN KRISIS ANEMIA SEL
SICKLE BERAT
GANGGUAN HATI SELAIN TUMOR, SIROSIS ATAU HEPATITIS
ALKOHOLIK SEDANG
PROSEDUR PENGANGKATAN PROSTAT MELALUI URETRA RINGAN

TRAKEOSTOMI BERAT
46,142,457
24,980,670
51,825,810
29,266,445
44,119,577
19,458,741
80,671,667
51,125,646
64,603,253
32,088,916
41,720,477
5,680,459
12
92,820,275
56,480,358
60,527,716
21,663,338
74,701,930
35,132,628

152,292,672
292,977,181
A-4-13-II N-4-10-II U-4-14-I A-4-14-I O-6-10-I K-4-18-I J-4-15-II J-4-16-III O-6-10-II K-4-18-II
Top 10 INACBG Episode Ranap Juni

(N=874)
15
16
17
PERADANGAN DAN INFEKSI PERNAFASAN SEDANG
18
18
20
22
PENYAKIT MULUT DAN GIGI RINGAN
22

25
26
Top 10 INACBG + Ranap Juni (N=874)

J-1-20J-1-30- J-4-16- N-1-20G-4-14III
I-1-20-II
III
III
II
I-1-20-I I-1-15-IIII-1-20-III
II
I-1-17-II
Tarif RS
Tarif BPJS

SEDANG
SEDANG
PROSEDUR SISTIM PEREDARAN DARAH LAIN BERAT
PROSEDUR SALURAN URIN ATAS SEDANG
Jumlah Kunjungan
12
20,560,112
44,559,843
75,622,165
101,286,398
29,976,506
58,098,168
53,119,510
86,968,888
133,221,890
194,656,510
149,475,767
14
94,829,095
17
97,803,173
5
242,696,491
190,263,762
200,622,876
185,238,274
11
13
created
143,357,165
353,714,829
379,107,196
Top 10 INACBG Ranap Juni (N=874)

M-1-04- V-1-14- D-1-20- D-4-11- K-1-40- I-1-40- I-4-15- N-1-30- K-1-20III
II
III
III
III
III
III
III
II
K-1-14-I
Tarif RS
Tarif BPJS

PROSEDUR KANDUNG KEMIH DAN SALURAN URIN BAWAH
BERAT
GANGUAN PEMBULUH DARAH PERIFER LAIN-LAIN (BERAT)
PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (BERAT)
GANGGUAN PEMBEKUAN DARAH BERAT
PROSEDUR PADA DARAH DAN ORGAN PEMBENTUK DARAH
LAIN-LAIN (BERAT)
PROSEDUR PENGANGKATAN PROSTAT MELALUI URETRA
SEDANG
PROSEDUR PADA SENDI TUNGKAI/ANGGOTA TUBUH BAGIAN
BAWAH MAYOR (BERAT)
Jumlah Kunjungan
72,771,079
40,973,023
202,556,251
169,818,042
8
3
7
73,548,262
39,444,356
88,562,345
53,848,945
141,239,865
106,061,620
154,260,315
112,679,864
7
2
2
4
1
28,441,047
73,695,557
47,741,727
43,399,129
19,392,280

97,582,960
96,731,646
76,299,456
Prosentase Capaian Beban Usaha & Overhead

2014 dibanding 2013; Capaian Produksi Rajal
130%
produksi dibanding RKAP
BEBAN OVERHEAD
produksi dibanding tahun lalu
120%
112%
110%
100%
106%
90%
104%
80%
70%
101%
97%
97%
95%
50%
104%
103%
100%
60%
106%
95%
101%
96%
40%
30%
20%
10%
0%
Jan
Feb
Mar
Apr
Mei

Jun
Juli

2014 dibanding 2013, capaian BOR
140%
BOR dibanding RKAP
BEBAN OVERHEAD
BOR dibanding tahun lalu
120%
100%
80%
143%
60%
87%
40%
95%
79%
101% 104%
109%
117%
110%
118%
125%
109%
112%
87%
20%
0%
Jan
Feb
Mar
Apr
Mei

Jun
Juli

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this is property of Pelni Hospital created

this is property of Pelni Hospital created

The Onion Concept of

this is property of Pelni Hospital created

Trisnantoro, L. Kuliah Block II: Clinical Management System

this is property of Pelni Hospital created

this is property of Pelni Hospital created

this is property of Pelni Hospital created

this is property of Pelni Hospital created

Kunjungan Pasien Rawat Jalan Jan-Juli 2014

this is property of Pelni Hospital created

Top 10 INACBG Kunjungan Rajal

PENYAKIT AKUT BESAR LAIN-LAIN

PROSEDUR ULTRASOUND LAIN-LAIN

PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL

PENYAKIT KRONIS BESAR LAIN-LAIN

SISTEM PERSARAFAN PUSAT AKUT

PROSEDUR LAIN-LAIN PADA MATA

PENYAKIT KRONIS KECIL LAIN-LAIN

this is property of Pelni Hospital created

Top 3 INACBG + Rajal Januari

this is property of Pelni Hospital created

Top 10 INACBG Rajal Januari

PROSEDUR BESAR RADIOGRAFI

PROSEDUR LAIN-LAIN PADA MATA

PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL

PROSEDUR DIAGNOSTIK DAN TERAPEUTIK MUSKULOSKELETAL

PROSEDUR ULTRASOUND LAIN-LAIN

PENYAKIT AKUT KECIL LAIN-LAIN

PENYAKIT KRONIS BESAR LAIN-LAIN

PROSEDUR OPERASI KATARAK

Top 10 INACBG Kunjungan Rajal

KONSULTASI ATAU PEMERIKSAAN LAIN-LAIN

PROSEDUR ULTRASOUND LAIN-LAIN

PROSEDUR ULTRASOUND GINEKOLOGIK

PROSEDUR LAIN-LAIN PADA MATA

PENYAKIT KRONIS KECIL LAIN-LAIN

this is property of Pelni Hospital created

Top 10 INACBG + Rajal Juli

PROSEDUR PERSALINAN DENGAN BEDAH CAESAR

PROSEDUR DIAGNOSTIK LAIN PADA STUDI SALURAN KEMIH

PROSEDUR PADA GINJAL DAN URETER

SISTEM PERSARAFAN PUSAT AKUT

PROSEDUR ELEKROENSEFALOGRAFI (EEG)

PROSEDUR THERAPI FISIK DAN PROSEDUR KECIL

Top 10 INACBG Rajal Juli

KEMOTERAPI PADA TUMOR PARU & KANDUNG KEMIH

PENYAKIT AKUT BESAR LAIN-LAIN

KEKACAUAN METABOLIK AKUT

PROSEDUR ENDOSKOPI KECIL PADA GASTROINTESTINAL ATAS

KONSULTASI ATAU PEMERIKSAAN LAIN-LAIN

PROSEDUR ULTRASOUND LAIN-LAIN

PROSEDUR LAIN-LAIN PADA MATA

PROSEDUR OPERASI KATARAK

PENYAKIT KRONIS KECIL LAIN-LAIN

this is property of Pelni Hospital created

Kunjungan Pasien Rawat Inap Jan-Juli 2014 di

this is property of Pelni Hospital created

Higher Volume Lower Cost: BOR RS. Pelni

Feb = 321 TT Mar = 327 TT Apr = 331 TT