DOES PROVIDER PAYMENT METHOD IMPROVE THE COMPLETENESS OF MEDICAL RECORDS? A STUDY ON THE IMPACT OF THE CASEMIX SYSTEM ON MEDICAL RECORD DOCUMENTATION IN A PUBLIC SPECIALIST HOSPITAL IN WEST SUMATRA PROVINCE, INDONESIA

Abstract

In 2010, the Government of the Republic of Indonesia implemented a casemix system called INA-CBG as a provider payment method for the National Health Insurance program for the poor One of the obstacles faced in practice was the incompleteness of medical record documentation. This cross-sectional study, using quantitative and qualitative research methods, aimed to review the impact of casemix implementation on medical record documentation. The study was conducted at the National Stroke Centre Hospital, Bukittinggi, West Sumatra Province, Indonesia, which is the only government specialist hospital for stroke patients in Indonesia. We reviewed 244 and 559 medical records from 2008 and 2012, respectively. This study used chi-square test to differentiate the completeness of medical records before and after the implementation of the casemix system. Qualitative data were collected through in-depth interviews with senior doctors, the head of the medical records department, and a focus group discussion with six senior medical record officers for detailed investigations of the incompleteness of medical records. This study found that the completeness of medical records improved from 59.4% to 73.9% with casemix implementation. The variables that increased the completeness of medical records were the admission date, discharge date, length of stay, age, secondary diagnosis, and secondary procedure. In conclusion, implementation of the casemix system improved the completeness of medical records and had a positive impact on medical record documentation.