Bhisma Jaya Prasaja, Yoga Utomo, Yura Witsqa Firmansyah

Factors Related to the Difference in Rates of Dengue Fever Cases

Introduction

Factors related to the difference in rates of dengue fever cases. Explore factors behind Dengue fever treatment cost differences & INA-CBGs tariffs at a Bandung hospital. Learn how length of stay, procedures & severity impact financial gaps.

Abstract

Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the Dengue virus and transmitted through the bite of the Aedes aegypti mosquito. The Bandung City Health Office said that this year as of April 26, 2024, the cumulative number of DHF cases in Bandung City exceeded 3,025 cases. This study aims to identify the factors associated between INA-CBGs tariffs and the actual treatment costs of Dengue Fever (DHF) patients at Hospital X Bandung. A correlation research method with a retrospective approach was used to analyze secondary data of JKN claims in 2023. The population in this study were patients who underwent inpatient treatment in 2023 at Hospital X Bandung with a diagnosis of Dengue Fever (DHF) with diagnosis code A91, totaling 906 medical record files. Samples were selected based on the criteria of medical record files with a primary diagnosis of Dengue Fever (DHF) and medical record files with JKN tariff setting. The results showed that length of stay (p < 0.001), medical procedures (p 0.018), and severity (p < 0.036) of illness significantly contributed to the tariff gap. This tariff gap has implications for the hospital's financial loss and potential reduction in service quality. Based on these findings, it is recommended to review the INA-CBGs tariff structure, develop clinical pathways, stricter management of treatment classes, and improve cooperation between hospitals and BPJS Kesehatan.

Review

This study tackles a critical issue concerning the financial sustainability of healthcare providers amidst a significant public health challenge, Dengue Hemorrhagic Fever (DHF), which has seen a substantial increase in cases in Bandung City. Specifically, it investigates factors contributing to the disparity, or "tariff gap," between INA-CBGs tariffs and the actual treatment costs for DHF patients at Hospital X in Bandung. Utilizing a retrospective correlational design, the researchers analyzed secondary data from 906 JKN claims for DHF inpatient treatments in 2023. This approach offers a data-driven examination of a pressing administrative and financial problem within the Indonesian healthcare system. The findings are highly significant and directly address the study's aim, identifying length of stay, medical procedures, and severity of illness as key determinants of the observed tariff gap. These results underscore a tangible financial burden on hospitals, indicating potential losses and a subsequent risk to the quality of patient care. By quantitatively demonstrating these associations with strong statistical significance, the study provides robust evidence for the practical challenges faced by healthcare facilities operating under the current INA-CBGs reimbursement system, particularly for high-prevalence infectious diseases like DHF. While the study offers valuable insights and timely recommendations for policy and operational improvements—such as reviewing tariff structures, developing clinical pathways, stricter management of treatment classes, and enhanced cooperation with BPJS Kesehatan—its generalizability might be strengthened by including data from multiple hospitals or different regions in future work. Exploring the specific clinical and administrative drivers behind variations in length of stay and procedure utilization could also provide deeper actionable insights. Overall, this paper makes a pertinent contribution to healthcare economics and policy, effectively highlighting crucial areas for reform to ensure both the financial viability of hospitals and the sustained quality of DHF patient care.

Full Text

Comments

You need to be logged in to post a comment.