Analysis of Single-Use Hemodialysis Tariff Determination Based on INA-CBG: A Case Study at Siaga Medika Banyumas General Hospital

Nur Fitri Margaretna; Arlette Suzy Puspa Pertiwi; Oke Andikarya

doi:10.55606/ijhs.v5i2.5664

Authors

Nur Fitri Margaretna Adhirajasa Reswara Sanjaya University
Arlette Suzy Puspa Pertiwi Adhirajasa Reswara Sanjaya University
Oke Andikarya Adhirajasa Reswara Sanjaya University

DOI:

https://doi.org/10.55606/ijhs.v5i2.5664

Keywords:

Cost Recovery Rate, Hemodialysis, Hospital Tariffs, INA-CBG, Operational Costs

Abstract

The increasing prevalence of Chronic Kidney Disease (CKD) has led to a rising demand for hemodialysis services, most of which are financed by the Indonesian National Health Insurance (BPJS Kesehatan) through the INA-CBG tariff system. However, the discrepancy between INA-CBG tariffs and the actual service costs—particularly due to the use of single-use dialyzers—poses financial challenges for private hospitals. This study aims to analyze the operational costs, tariff differences, and financial feasibility of single-use hemodialysis services at Siaga Medika Banyumas General Hospital. A qualitative descriptive-exploratory approach was employed through in-depth interviews, observations, and document analysis involving five key informants. The results indicate that the largest cost component comes from medical consumables, especially dialyzers. A comparison revealed that the actual service cost was IDR 660,138, which is lower than the INA-CBG tariff of IDR 875,000 and the hospital’s own tariff of IDR 1,877,536. The cost recovery rate (CRR) analysis yielded 132.54% for BPJS patients and 284.4% for general (non-BPJS) patients, indicating profitability. The hospital’s strategies include logistics efficiency, adjustments in non-BPJS tariffs, and resource optimization. The study concludes that the single-use hemodialysis service at Siaga Medika Banyumas General Hospital is financially viable, although it requires strict cost management and more accurate tariff policy support to ensure service sustainability.

Downloads

Download data is not yet available.

References

[1] D. Asmadi, S. Rahmawati, M. Akbar, and Hidayaturrahmi, “Analisis Biaya Layanan Rawat Inap Rumah Sakit Menggunakan Metode ABC: Studi Kasus,” Jurnal Kesehatan Tambusai, vol. IV, no. 1, pp. 174–183, 2023.

[2] A. Azzahra and W. Supadmi, “Biaya medis langsung pada pasien penyakit ginjal kronik di Rumah Sakit PKU Muhammadiyah Bantul,” Jurnal Kefarmasian AKFARINDO, vol. 9, no. 1, pp. 32–38, 2024.

[3] W. Fibionisa, Y. Ramadhan, and M. Nugroho, “Comparison Analysis of Rates by Unit Cost and INA-CBGs Rates in Hemodialysis Services at Hospital X,” European Journal of Business and Management Research, pp. 108–114, 2023, doi: 10.24018/ejbmr.2023.8.5.1872.

[4] S. Haslinur, I. Saputra, D. Syahrizal, Bakhtiar, and S. Usman, “Analysis of Differences between INA CBG's Rates and Hospital Real Rates in Hemophilia Patients at RSUD Zainoel Abidin Banda Aceh,” Budapest International Research and Critics Institute-Journal (BIRCI-Journal), vol. 3, no. 3, pp. 1758–1763, 2020, doi: 10.33258/birci.v3i3.1107.

[5] A. Holly, A. Maidin, and Syamsuddin, “Comparison analysis of hemodialysis unit profitability based on hospital rates, unit cost and Indonesia case base groups using realist evaluation analysis at Siloam Hospitals Balikpapan Indonesia in 2018,” International Journal of Advanced Research (IJAR), vol. 7, no. 4, pp. 706–712, 2019, doi: 10.21474/IJAR01/8875.

[6] P. Kondoallo and J. Mulyadi, “Peran Kinerja Pelayanan pada Pengaruh Investasi, Biaya Operasional Kinerja Keuangan terhadap Pendapatan,” JRAP (Jurnal Riset Akuntansi Perpajakan), vol. 6, no. 1, pp. 13–24, 2019, doi: 10.35838/jrap.v6i01.391.

[7] R. Margina and G. Prena, “Analisis unit cost layanan hemodialisis dengan pendekatan activity-based costing sebagai strategi peningkatan laba rumah sakit,” Al Qalam: Jurnal Ilmiah Keagamaan dan Kemasyarakatan, vol. 18, no. 4, pp. 2548–2560, 2024, doi: 10.35931/aq.v18i4.3617.

[8] Menteri Kesehatan Republik Indonesia, Peraturan Menteri Kesehatan Republik Indonesia Nomor 85 Tahun 2015 Tentang Pola Tarif Nasional Rumah Sakit. Jakarta: Kemenkes RI, 2015.

[9] Menteri Kesehatan Republik Indonesia, Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/1634/2023 Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Penyakit Ginjal Kronik. Jakarta: Kemenkes RI, 2023.

[10] Menteri Kesehatan Republik Indonesia, Peraturan Menteri Kesehatan Republik Indonesia Nomor 3 Tahun 2023 tentang Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan. Jakarta: Kemenkes RI, 2023.

[11] Perkumpulan Nefrologi Indonesia, 13th Report Of Indonesian Renal Registry. Jakarta: PERNEFRI, 2020.

[12] E. M. Putri, T. Tandela, O. I. Mawarni, A. D. Akhwan, and F. Prasetyawan, “Analysis of Direct Medical Costs in Hemodialysis Patients,” International Journal of Asian Business and Development (Metropolis), vol. 1, no. 1, pp. 71–80, 2025.

[13] Rosiana, P. Sarnianto, and Y. Anggriani, “Analisis Komparatif Biaya Hemodialisis Pada Pasien dengan Penyakit Ginjal Kronis di Rumah Sakit X Kabupaten Banyumas,” Jurnal Ilmiah Kedokteran: Medika Tadulako, vol. 6, no. 2, pp. 122–131, Mei 2019.

[14] G. B. Rosmila, R. Yaya, and F. Pribadi, “The Comparison Of The Unit Cost Of Hemodialysis With Ina Cbg Rates In Muhammadiyah Siti Aminah Hospital,” Archives of Business Research, vol. 8, no. 5, pp. 80–95, 2020, doi: 10.14738/abr.85.8210.

[15] S. V. Soetedja, A. Nurwahyuni, and A. Intan, “Biaya Pelayanan Hemodialisis Pasien Gagal Ginjal Kronis di Era JKN: Literature Review,” Media Publikasi Promosi Keseharan Indonesia, vol. 5, no. 10, pp. 1213–1218, 2022, doi: 10.56338/mppki.v5i10.2712.

[16] Sumiati, E. Witcahyo, and A. Ramani, “Analisis Biaya Satuan (Unit Cost) dengan Metode Activity Based Costing (ABC) di Poliklinik Jantung RSU dr. H. Koesnadi Bondowoso,” Jurnal Ekonomi Kesehatan Indonesia, vol. 4, no. 2, pp. 1–9, 2019, doi: 10.7454/eki.v4i2.2956.

[17] E. Sunariyanti, J. Supriyanta, S. N. Rangkuti, D. Pratiwi, and A. A. Setiawan, “Review artikel: perbandingan biaya rill dengan tarif INA-CBG's pada perawatan gagal ginjal kronik di Indonesia: tinjauan sistematik,” Jurnal Farmagazine, vol. 12, no. 1, pp. 8–16, 2025.

[18] P. Swandayana, Sismulyanto, and M. Putra, “Analisis Determinan yang Mempengaruhi Tarif Riil Rumah Sakit Pada Pelayanan Hemodialisa,” Journal of Telenursing (JOTING), vol. 5, no. 2, pp. 3461–3469, 2023, doi: 10.31539/joting.v5i2.7430.

[19] R. Verdika, Nurdin, and D. Kusnadi, “Analisis Perbandingan Biaya Satuan Pelayanan Hemodialisa dengan Metode Activity Based Costing (ABC) terhadap Tarif Rumah Sakit dan Tarif INA-CBG serta Cost Recovery Rate (CRR),” Jurnal Ilmiah Multi Disiplin Indonesia, vol. 1, no. 12, pp. 1907–1922, 2022.

[20] R. Wardani et al., “Analisis Penyebab Terjadinya Selisih Tarif BPJS Kesehatan dengan Tarif Rumah Sakit di RSUD Simpang Lima Gumul Kediri,” Jurnal Pengabdian Kepada Masyarakat, vol. 4, no. 1, pp. 149–164, 2024.