COST RECOVERY RATE OF HOSPITAL TARIFFS AND INA-CBGs REIMBURSEMENT FOR DENGUE HAEMORRHAGIC FEVER (DHF) AT TYPE C HOSPITAL IN INDONESIA
Keywords:
Cost Recovery Rate, Case-based payment system, INA-CBGs, Dengue Haemorrhagic Fever, Hospital resource
Abstract
The implementation of Indonesia's Case-Based Groups (INA-CBGs) payment system aims to improve efficiency in hospital financing. However, discrepancies between reimbursement and actual treatment costs remain a significant challenge for hospital financial sustainability. This study aimed to analyze the Cost Recovery Rate (CRR) by comparing hospital tariffs, INA-CBGs reimbursement, and the actual cost of treating Grade I Dengue Haemorrhagic Fever (DHF) patients while identifying factors contributing to cost discrepancies. A qualitative single embedded case study was conducted at a Type C private hospital in Palembang, Indonesia. Secondary financial and clinical data from 35 Class III inpatients with Grade I DHF were analyzed alongside semi-structured interviews with five key informants representing hospital management, clinical services, finance, and the casemix unit. Data were analyzed through document review, cost comparison, CRR calculation, and thematic analysis. The findings revealed differences between the hospital's internal tariff (Rp82,925,300), INA-CBGs reimbursement (Rp69,730,500), and the actual treatment cost (Rp72,479,198). The resulting Cost Recovery Rate (CRR) of 96.21% indicated that INA-CBGs reimbursement was insufficient to fully recover the actual cost of care. The financing gap was influenced by the interaction of several factors, including the package-based INA-CBGs payment mechanism, length of hospital stay, patients' clinical conditions, diagnosis and procedure coding accuracy, adherence to clinical pathways, laboratory and pharmaceutical utilization, and overall hospital resource efficiency. This study demonstrates that financial sustainability under the INA-CBGs system depends not only on reimbursement policies but also on integrated clinical and operational management. Strengthening clinical pathway adherence, documentation and coding accuracy, resource utilization, and cost monitoring may improve hospital financial performance while maintaining the quality and safety of patient care.
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2026-10-10
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Trilestari, A., Widyarini, M., & Grahadian, K. (2026). COST RECOVERY RATE OF HOSPITAL TARIFFS AND INA-CBGs REIMBURSEMENT FOR DENGUE HAEMORRHAGIC FEVER (DHF) AT TYPE C HOSPITAL IN INDONESIA. Jurnal Ilmiah Manajemen, Ekonomi, & Akuntansi (MEA), 10(3), 404-433. https://doi.org/10.31955/mea.v10i3.7845
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