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Vol. 30. Núm. S6.
The 4th International Conference Hospital Administration (ICHA4)
Páginas 276-279 (Octubre 2020)
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Vol. 30. Núm. S6.
The 4th International Conference Hospital Administration (ICHA4)
Páginas 276-279 (Octubre 2020)
DOI: 10.1016/j.enfcli.2020.06.063
Revenue and financing of patients with national health insurance by the social security organizing agency to improve health services
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Syarifuddin Yusufa,
Autor para correspondencia
aryus_umpar@yahoo.com

Corresponding author.
, Nuzul Achmarb, Haniartia, Hasdianaa, Mahkrajani Madjida, Muhammad Aswadc, Tenri Esad
a Universitas Muhammadiyah Parepare, Indonesia
b Welfare Health Care Community, Indonesia
c Universitas Sulawesi Barat, Indonesia
d Universitas Hasanuddin, Indonesia
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Tablas (2)
Table 1. Comparison of BPJS and non BPJS claim revenue in Andi Makkasau Hospital period 2014–2018 (in millions of rupiah).
Table 2. Disease types, visits, and utilization of BPJS patient funds in Andi Makkasau Hospital (third quarter of 2019 period).
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Abstract
Objective

This study was aimed to analyze the comparison of income claims by social security organizing agency or Badan Penyelenggara Jaminan Sosial (BPJS) and non-BPJS and analyze the cost of health services.

Method

It was a descriptive analytic approach, this study analyzed the acceptance of BPJS and non-BPJS claim revenue with quantitative data, then the study analyzes the financing for BPJS patients in regional public hospital Andi Makkasau Parepare.

Result

BPJS claims revenue has increased very significantly, reached IDR 56.60 billion (86%), while for non-BPJS, it was IDR 7.98 billion (14%). BPJS patient visits hospital has reached 3793 people and absorbed around 1.8 billion funds per third quarter, and BPJS Health patient spending expenses are dominated by handling non-communicable diseases as high-cost diseases namely cataracts IDR 376 million (21.26%), cancer IDR 371 million (20.98%) and heart disease IDR 219 million (13.53%) are seen as a burden that dominates the absorption of national health insurance funds, but health services are already being felt by the community, and users are getting bigger as the participants increase BPJS.

Conclusion

BPJS claims revenue increased very significantly, reaching 86%, as BPJS patient visits at regional hospital Andi Makkasau Parepare continued to increase and absorb funds of around 7.5 billion per year along with patient financing dominated by handling non-communicable diseases (PTM).

Keywords:
Claim income
Types of illness
Patient financing
Health services

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