INA CBG Research Articles

ANALISIS PERHITUNGAN UNIT COST PADA TINDAKAN TONSILEKTOMI DENGAN METODE ACTIVITY BASED COSTING (STUDI KASUS DI RUMAH SAKIT PKU MUHAMMADIYAH YOGYAKARTA)

Background: Private hospitals should strive to have the technical capability to manage and calculate costs based on the condition that both hospitals and facilities that can use the Indonesian Case Based Group (INA CBG) appropriately. RS PKU Muhammadiyah Yogyakarta as one of the private hospitals that participate and support the government's program of the Sistem Jaminan Sosial Nasional.Calculating the unit cost of a tonsillectomy was done as a study of the correspondence between the cost of services and a health claim
 Methods:The study was a descriptive qualitative case study design. Tonsillectomy unit cost calculation using activity based costing (ABC) with the goal difference obtained unit costs plus a margin to claim CBG INA in 2012.
 Result: Based on the calculation, the unit cost of services tonsillectomy with activity-based costing method is Rp. 2.265.732. ABC unit cost calculations result in a greater cost than the claims of INA CBG so get the difference in cost of Rp. 785.034.
 Conclusions: There is a negative difference between the calculation of service bi tonsillectomy ABC method with INA CBG claim. So that needs to be done by the hospital cost efficiency.

Faktor-Faktor Penyebab Pending Klaim BPJS Rawat Inap Di RSUD Dr. Pirngadi Kota Medan Tahun 2022

BPJS claims are submissions for patient care costs for BPJS participants in claiming that there are problems pending claims which are influenced by several factors. The implementation of BPJS claims in submitting files is still delayed so it must be pending, and there are still patient BPJS claim files that are returned for repair, as a result of delays in submitting BPJS claims causing delays in disbursing funds that should be received by the hospital. the factors that cause pending BPJS claims at RSUD Dr. Pirngadi Medan City. The purpose of this study was to determine the factors causing pending claims of BPJS Inpatients at RSUD Dr. Pirngadi Medan City in 2022. This type of research uses a qualitative descriptive method, in this study the population used by officers in the medical record amounted to 4 people and 49 pending files. The results of this study indicate that the cause of pending BPJS claims is caused by differences in perceptions between INA CBG's officers and Verifiers in filling out patient diagnoses, causing obstacles for hospitals, incomplete BPJS claim requirements, diagnoses that are not in accordance with the action, drugs that are not in accordance with diagnostics and the hospital network which is sometimes slow, resulting in errors in the INA-CBGs application and the computer takes a long time to load. Suggestions from this study should be routine checking of the completeness of medical record documents, so that the requirements for submitting BPJS claims have been filled out correctly. The hospital network is further developed so that the work using computer networks is more effective. To equate the perception between the coder and the verifier, it is recommended that officers collaborate more often with doctors regarding diagnosis and disease codes.

ANALISIS BIAYA MEDIS LANGSUNG DAN TARIF INA-CBG’s PASIEN DIABETES MELITUS TIDAK TERGANTUNG INSULIN DI RSUD ANUTAPURA PALU

Diabetes mellitus is a long-term disease with an increasing prevalence. Diabetes mellitus is one of the main causes of human morbidity and death and has a significant impact on health financing. Indonesia itself has implemented a national health insurance program that prioritizes effectiveness and cost efficiency. This study aims to determine the average direct medical costs, INA-CBG's rates, the suitability of direct medical costs and INA-CBG's as well as the influence of treatment class, severity, number of secondary diagnoses, and length of stay on the direct medical costs of diabetes mellitus patients at Anutapura Hospital Palu. This research is a descriptive observational study with retrospective data collection from medical records and files detailing patient care costs at Anutapura Hospital Palu in 2020 from the hospital's perspective. The sample used was BPJS inpatients with a primary diagnosis of type 2 diabetes or non-insulin dependent diabetes mellitus (DMTTI) who met the inclusion and exclusion criteria, totaling 132 patients. Data were analyzed descriptively and to see the influence of variables on total costs, the Independent sample t-test and Mann-Whitney test were used. The research results show that the average direct medical costs are IDR 2,751,449, the average INA-CBG's rate is IDR 4,505,508, so there is a mismatch between direct medical costs and INA CBG's. There is a significant influence partially or simultaneously and in a positive direction from the variables treatment class, severity, number of secondary diagnoses, and length of stay on direct medical costs.

Comparative Analysis of Real Costs and INA CBG's Rates in BPJS Kesehatan Patients with Schizophrenia

Background: Schizophrenia is the most severe mental disorder because its risk of death is to 2-3 times higher. Objective: To determine the average real costs, the difference between real costs and INA-CBG rates of inpatients with schizophrenia, and the factors that affect real costs. Methods: The study was conducted retrospectively from the hospital perspective using the total sampling method from January 2020-December to 2021. The study sample included inpatients patients and the real costs of the hospital. The data obtained were analyzed using the Mann-Whitney U-test and multiple linear regression tests. Results: About 112 patients met the inclusion criteria. The average real cost of inpatients with schizophrenia at Tombulilato General Hospital from January 2020 to December 2021 is Rp. 9,895,102 and the average INA-CBG rate of inpatients with schizophrenia was Rp. 14,820,778. There was a difference between the real costs and INA-CBG rates (p = 0.002), with the highest average hospital real cost component in the inpatient room (Rp. 3,397,723 (34.34%). The factor that affected the real costs of inpatients with schizophrenia patients is the length of stay (p = 0.000). Conclusion: The real costs of the hospital were lower (p = 0.002) than those of the INA-CBG. The highest real cost of the hospital was the inpatient room (34.34%), and the factor that affected the real costs was the length of stay (p = 0.000).

Ketentuan Kodefikasi Pneumonia Kasus Rawat Inap pada Pasien Jaminan Kesehatan Nasional (JKN) berdasarkan ICD 10

Pneumonia is a disease that attacks the respiratory system due to infection from viral/bacterial aspiration and radiation and other causes, if not treated properly it can worsen the patient's condition, causing an increase in treatment costs. In the era of the National Health Insurance (JKN), the Indonesian Case Base Groups (INA CBG's) system was an important element in the submission and payment of claims for payment of health services that had been carried out by health care facilities, based on the ICD 10 code for diagnosis and ICD 9 CM for the procedure in processing claim. Coder staff must proficient in codification and clinical pathways for each disease because the Health Insurance Administration Agency (BPJS) has rules for every diagnosis. Based on the dispute claim, the INA CBG claim problems in 2018 are determined for the diagnosis of pneumonia as follows: (1) pneumonia whose cause is not specified can be coded J18.9, (2) pneumonia with pulmonary TB must use the join code to A16.2, (3) pneumonia with COPD using the merge code to J44.0, except for acute exacerbations of COPD, coded separately (4) pneumonia with septicemia is coded separately unless medical investigations reveal Streptococcus pneumonia using combined code A40.3, (5) pneumonia with typhoid fever using the combination code A01.0† J17.0* and (6) pneumonia with asthma were coded separately. These provisions must be understood by coders in coding cases of pneumonia to avoid suspension so that the claim process runs smoothly and works efficiently

Analysis of Hemodialization Services (HD) Based on the Comparison of the calculation of Wangaya Hospital Rates with Ina CBG's Rate

Analysis of Hemodialization Services (HD) Based on the Comparison of the calculation of Wangaya Hospital Rates with Ina CBG's Rate

ACTIVITY BASED COSTING METHOD IN DETERMINING UNIT COST OF LITHOTRIPSY FOR TREATMENT OF URINARY BLADDER CALCULUS AT VITA INSANI HOSPITAL PEMATANGSIANTAR

Objective: To determine the unit cost of lithotripsy for treatment of urinary bladder calculus at Vita Insani Hospital Pematangsiantar. Material & Methods: This study is a descriptive quantitative study, in which the data was obtained from the finance division of Vita Insani Hospital. The research object is the unit cost of accommodation that occurs in patients with urinary bladder calculus with lithotripsy cases from January 2020 to December 2020. Results: The unit cost of lithotripsy for urinary bladder calculus services at Vita Insani Hospital Pematangsiantar which is calculated using the activity-based costing (ABC) method is Rp 4.167.009. There is a difference in cost among the ABC method, hospital calculations, and INA CBG’s rates with the following details: the amount calculated for the hospital is Rp 4.996.718, while the calculation using ABC method is Rp 4.167.009; the difference in costs is Rp 829.709. INA CBG’s rates Rp 6.137.500, and compared to calculation of hospital, the difference cost is Rp 1.140.782. Compared to the INA CBG’s rates, to the unit cost of the ABC method, there is a difference, amounting Rp 1.970.491. Conclusion: The results of unit cost lithotripsy for treatment of urinary bladder calculus through the ABC method are lower compared to hospital calculation and INA CBG’s rates.

Cost consequences analysis of hypertensive outpatients: a study in a private hospital in Yogyakarta special province

Background: Hypertension is a chronic disease that requires long-term treatment and has an impact on the cost of treatment. The costs will be greater given the loss of productivity, family burden, and social life impacted by hypertension based on patient’s perspective. Objective: The purpose of the study was to determine the costs and clinical outcome of antihypertensive therapy from the patient's perspective and to identify the discrepancies between the costs and the INA-CBGs (Indonesia Case Based Groups) tariff. Methods: The research was an observational study with a cross-sectional design. The targeted population was outpatients who had received antihypertensive therapy for at least 1 month at a private hospital in Yogyakarta. The costs included direct medical costs, direct non-medical costs, and indirect costs, while the clinical outcomes were patient’s blood pressure. The descriptive analysis was carried out to describe the characteristics of the research subjects, the clinical outcome, and the cost. Analysis of the discrepancies between the costs and the INA-CBGs tariff used the Mann-Whitney test and One-Sample t-test. Results: The results showed that the average direct medical costs, direct non-medical costs, and indirect costs from the patient’s perspective were IDR359,408.00, IDR24,617.00, and IDR 40,583.00, respectively. There was a significant difference between the real costs and the rate of INA-CBGs based on the results of statistical tests, while the cost discrepancy was IDR5,287,045.00. Conclusion: The direct non-medical costs and indirect costs of hypertensive outpatients were less than the direct medical costs. A significant difference occurred between the real costs and INA CBG’s tariff. Keywords: hypertension, cost consequences, pharmacoeconomics, patient’s perspective

Comparative Analysis of Actual Cost and INA CBG Rate in Diabetic Gangrene Inpatients

Background: Diabetic gangrene is a complication of diabetes mellitus that imposes a substantial financial burden on patients and their families as well as the health care system. Objective: To determine the total cost of disease, and the difference between real cost and INA CBG rate for diabetic gangrene inpatients from January - December 2017 at Universitas Airlangga Hospital, Surabaya Methods: The study was conducted retrospectively by using a total sampling method. The perspective used was the hospital perspective. This study's direct medical costs were laboratory, drug and consumable medical device costs, medical equipment rental, radiology examination, red cross, oxygen, service, and room costs. Data analysis was performed using an independent samples t-test. Results: The results showed that 148 patients met the inclusion criteria. The total real cost of diabetic gangrene inpatients at Universitas Airlangga Hospital in 2017 was IDR 1,339,949,381, and the total INA CBG rate for inpatients with diabetic gangrene was IDR 1,365,047,500. The difference was (p = 0.000) between real cost and INA CBG rate. Conclusion: There is a difference between the actual cost and the INA CBG rate for diabetic gangrene inpatients.

COST EVALUATION OF STROKE THERAPY COMPARED TO INA-CBGs ON INPATIENTS AT ANUTAPURA HOSPITAL

ABSTRACTStroke is the third cause of death in the world after heart disease, cancer, and disability including disability categorized based on its severity: mild (I), moderate (II), and severe (III) severity. This study aims to determine the difference total cost of ischemic and hemorrhagic stroke therapy, each, with INA-CBGs rates. The method of data collection was conducted retrospectively taken from medical record data, and on patient medical expenses. The subject were ischemic and hemorrhagic stroke patients hospitalized from 2016-2017 at Anutapura Hospital who met the inclusion and exclusion criteria. There were 134 patients who met the inclusion criteria, 68% were ischemic stroke patients and 32% were hemorrhagic stroke patients. The result of research showed that there were significant differences in costs (p <0.05) between hospital real costs and INA-CBGs rates. The average total real cost of treatment for ischemic stroke therapy was IDR 7,360,196.70 and the cost of the INA-CBGs was IDR 7,427,251.65 for 91 inpatients; and the average total cost of patients with hemorrhagic stroke therapy took IDR 10,606,834.34 with average of INA CBG’s rate at IDR 4,399,393.02 for 43 inpatients. The conclusion is both of stroke therapy proved significant difference compared to BPJS claimed amount of money.Keywords: pharmacoeconomic, cost analysis, ischemic stroke, haemorrhage stroke, INA-CBG’s rate.

The Analysis of Differences in Hospital Rill Rates and INA-CBG's Rate on Sectio Caesare Action in RSU. Imelda Pekerja Indonesia Medan 2019

The Indonesian government has developed a Health Insurance program National Social Security Administering Bodies (BPJS) Health. One of the ways to pay for health services for hospitals in Era JKN is the Indonesian Case Base Groups (INA-CBG's) payment system, namely the amount of claim payment by BPJS Health to the hospital for the package services based on diagnosis of disease and procedures. This study aims to analyze hospital real rates and INA CBG rates on the action of sectio caesarea and to find out the efforts made hospitals to cover INA-CBG's shortfall in claims costs. Types of research Qualitative descriptive conducted by in-depth interviews. Research sites at the hospital. Imelda Indonesian Worker having his address at Jalan Bilal No. 24 Kelurahan Pulo Brayan Darat I, East Medan District. The research was carried out since months January 2019 until finished. The population in this study is claim data delivery of inpatients who performed sectio casearea at month March and April as many as 143 cases The samples in this study were all population of 143 cases. The results showed that the difference in real rates hospital and INA-CBG rates on Sectio Caesaria at RSU. Imelda Worker Indonesia Medan in 2019 amounted to 73% of the real hospital rates exceeding the tariff INA-CBG's with a total difference in costs reaching IDR 199,661,028. and 39% real hospital fee less than INA-CBG's package rate. Efforts are conducted by the RSU. Imelda Indonesian workers to cover the shortage of costs INA-CBG's claims include using students who come from schools Imelda's own foundation, set the Sectio Caesare service package on general patients and providing supporting facilities. Suggested to RSU. Imelda Indonesian workers evaluate the financial risks received from services Sectio Caesare and evaluating the distribution of INA-CBG's claim costs for services Sectio Caesare is up to standard.

Discrepancy of Real Tariffs with INA-CBG’S for Dengue Haemorrhagic Fever Patients in a Hospital in Sidoarjo 2019

Dengue Hemorrhagic Fever (DHF) patients in Indonesia reached 129,650 cases with a death toll of 1,071 people in 2015. DHF puts an economic burden on the community and government. This study aims to determine the difference in real cost tariffs and INA CBG's for DHF in a hospital in Sidoarjo, East Java. This cross-sectional study applied a descriptive design, conducted from January to December 2019. The data in this study consisted of characteristic data and differences in real hospital tariffs and INA CBG tariffs for DHF in the hospital treatment room. 625 hospitalized cases were included in this study. This hospital underwent a deficit (loss) of 30% from the difference between the total INA CBG's package tariffs and the total real hospital tariffs in 2019. There is a negative difference between the real hospital tariffs and the tariffs according to INA CBG's in the treatment of dengue fever in a hospital in Sidoarjo which produces losses for the hospital.

Analysis of Differences between INA CBG’s Rates and Hospital Real Rates in Hemophilia Patients at RSUD Zainoel Abidin Banda Aceh

INA CBG’s rate is system of health financing packages from government based on cased and hospital services. Real tariff are the actual costs incurred by hospitals service based to local governments. During this time there are differences between INA CBGs rated and hospital rates. Hemophilia is a high-cost disease paid by INA CBGs. The aim of this study was to analyze the differences of INA CBGs and real rates in Hemophilia Patients at RSUDZA Banda Aceh. The research used quantitative analyticmethod. Data collection was carried out by taking secondary data from visits of hemophilia patients at RSUDZA in January-Desember 2019. The study population was all hemophilia patients in RSUDZA in 2019 with purpousive random sample of 100 people. There was a significant difference between INA CBGs rated and hospital rates rates in Hemophilia Patients at RSUDZA Banda Aceh.which indicated by p-value 0,000. Differences between INA CBGs and real rates of hospital are Rp.-431.095.538 or -25%. Differences of INA CBGs rated dan real rates causes’ hospital loss, but hospital needs to re-review the calculation of more efficient service cost to improve the quality of service.

Perhitungan Tarif INA-CBG Terhadap Tarif Real Rumah Sakit Dengan Menggunakan Metode Activity Based Costing Pada Pasien PPOK

ABSTRACT
 
 
 
 
 Chronic Obstructive Pulmonary Disease (COPD) is a disease with limit airway characteristics that not completely reversible. Airway limitation usually progressive and correlates with inflammation response due to harmful material or gas. The Burden Of Disease Study under auspices of The World Health Organization stated that COPD is the cause of death, who previously ranked 6th and in 2020 it can become 3rd as the most common cause of death. Respira Lung Hospital Yogyakarta accepts general patient and patient with insurance, also they already cooperate with BPJS, with the result that replacement of BPJS patient’s payments are adjusted to Indonesia Case Base Groups rates in accordance with type classification and regionality. This study has the goal to count unit cost using Activity Based Costing (ABC) method in Chronic Obstructive Pulmonary Disease patient’s care and to compare it with real cost and INA-CBG’s fare.This research is using descriptive qualitative with case study design in Respira Lung Hospital Yogyakarta, the chosen cases are patients that already diagnosed ICD X : J-4-17-III (Chronic Obstructive Pulmonary Disease). Result : The result of unit cost calculation on Chronic Obstructive Pulmonary Disease patient with ABC method is Rp 4.851.150,00 consist of direct cost Rp 1.735.050,00 and overhead cost Rp 3.116.100,00. According to unit cost calculation for Chronic Obstructive Pulmonary Disease patient it counts Rp 4.851.150,00 and has difference Rp 2.134.450,00 with real cost in Respira Lung Hospital Yogyakarta and Rp 1.442.814,00 with INA CBG’s fare.
 Keyword: Activity Based Costing (ABC), Chronic Obstructive Pulmonary Disease, Unit Cost
 
 
 

The comparison of the unit cost of hemodialysis with ina cbg rates in Muhammadiyah Siti Aminah Hospital

Health services in Indonesia have led to the National Health Insurance. Hospitals that serve BPJS participants are paid using a package system based on INA CBG rates. Payment of claims to advanced health facilities is differentiated by type of hospital. Type D hospitals have the lowest INA CBG rates, so they must calculate the unit cost of each procedure given based on the diagnostic group. The purpose of this study was to determine the comparison of the unit cost of hemodialysis measures with INA CBG rates and to find out if there are non-value-added activities in services. This type of research was a qualitative case study. The subject of the study was Muhammadiyah Siti Aminah General Hospital. The object used was all activities that support the occurrence of hemodialysis outpatient services. Data analysis used Activity Based Costing Baker modification. The results shows a unit cost of HD action in 2018 of Rp. 724.725. INA CBG rate for hemodialysis action in Type D Hospital is Rp. 737.700,-. So that a positive difference is obtained between the INA CBG rate and the HD unit cost of Rp. 12,975 -. RSUMSA has not been able to conduct supporting examinations in accordance with the specified standards because the costs incurred will be very high and will cause losses because they exceed INA CBGS tariffs and no potential non-value added activities are found.
 Keywords: Unit Cost; Hemodialisis; Tarif INA CBG

COMPARATIVE OF REAL COST AGAINST THE PRICE OF INA-CBG’S BREAST CANCER AND ITS AFFECTING FACTORS IN JKN PROGRAM ERA

This study aims to determine differences in real cost and INA CBG's rate and to find out the factors that influence the difference between the real cost and INA CBG's rate in patient with breast cancer in JKN Era at Sultan Agung Islamic Hospital between January 2017 and October 2017. This type of research is a non-experimental (observational) study, data taken retrospectively from hospital financial data and medical records of patients. Data analysis using Mann-Whitney is used to determine the suitability of real costs with INA CBG rates. and the Kruskal-Wallis test is used to find out what factors affect real costs. There was difference between the real cost and the INA CBG's rate for class 1 of Rp (-9,861,600), class 2 of Rp (30,643,000), and class 3 of Rp (146,724,100). The factors that influence the real costs were nursing class (p = 0.014) and Length of stay (p = 0.000). The conclusion of this study is that there is a difference between the real cost in patient with breast cancer in JKN Era at Sultan Agung Islamic Hospital between January 2017 and October 2017.

Cost Reduction Using the Time Driven Activity-Based Costing Method for Chemotherapy Treatment Costs for Breast Cancer Patients in the Era of National Health Insurance (JKN) at Airlangga University Hospital

Breast Cancer is one of the leading cause of death in Indonesia after cervical cancer. Indonesian Breast Cancer patients should get managed well in order to make eficient and sufficient treatment without reducing the quality. The National Health Insurancewell known as Jaminan Kesehatan Nasional (JKN) supporting Breast Cancer treatment via BPJS stands for Badan Penyelenggara Jaminan Sosial (Indonesian Government Insurance Coverage). Generally, the payment method in BPJS are divided based on INA CBG’s and outside INA CBG’s which the payment depends on hospital class. INA CBG’S packages including consultation, accommodation, medical, medical treatment (operation andnon-operation). Packages outside of INA CBGS’S include anticancer drugs, health aids, chronic drugs, ambulances and CAPD. This package encourages hospitals to be able to make efficiencies so it is not going to make financial loss for Hospital. The research goal is giving best treatment to Breast Cancer patient without financial loss for the hospital. Measurement Used Time Driven Activiy Based Costing. Moreover The Benefit of this research are (1). Reducing cost (direct and indirect) without decreasing patients quality treatment. (2). Reducing patient treatment time at the hospital since the patient get direct doctors’ therapy. To date The Results of this reseach are (1). Day care treatment can be compressed into two days and (2) Reducing length of stay.

Faktor - Faktor yang Mempengaruhi Komitmen Dokter di Puskesmas untuk Tidak Merujuk Kasus Non-Spesialistik Pasien BPJS di Kota Semarang

Patients who should be able to be treated at the health center (puskesmas) but because of some matters referred to and handled in a hospital, it is a waste of health costs. Hence, BPJS will pay more according to INA CBG's tariff. 3 Advanced Health Facilities, in this case a hospital, is also object to having to deal with non-specialist cases, while the case can actually be completed at the first health facility. Handling non-specialist cases in hospitals leads to health services being less well targeted. The hospital will be very busy handling patients who are not supposed to, while patients who really need treatment in the hospital can be neglected. 2 This study aims to analyze factors which influence the commitment of doctors not to refer to non-specialist cases in health centers in the city of Semarang The study was conducted with a cross sectional quantitative research design. The data were collected by calculating the total results of the questionnaire measurements on each variable with a Likert scale on 73 doctors in 37 health centers spread across the city of Semarang. The study was conducted during March to May 2018. The results showed that the number of non-specialist cases of BPJS Health participant patients was still relatively high. This has to do with the commitment of doctors at the health center not to refer to non-specialist cases. The most influence factor to the commitment of doctors not to refer to non-specialist cases was the doctor's perception of the completeness of facilities and infrastructure and the doctor's perception of his competence

PERBANDINGAN BIAYA RIIL DENGAN TARIF INA-CBG’S PENYAKIT STROKE PADA ERA JAMINAN KESEHATAN NASIONAL DI RS ISLAM SULTAN AGUNG

The implementation of INA CBG's system is not yet optimal because INA CBG’s rate in fact not yet fulfill hospital real cost. The purpose of this research was to compare the INA-CBG’s rate and real cost and also to look the factors affecting has difference the big real cost in patient with stroke in JKN era at Sultan Agung Islam Hospital between January 2017 and October 2017.Research using descriptive analysis, the data were analysed by Mann-Whitney test was used to compare real cost and INA-CBG’s rate. And the Mann-Whitney followed Kruskal-Wallis to determine the components of the factors affect real costs.There was a difference between the real cost and the INA-CBG's rate for hospitalization of (Rp -12,184,500) and outpatient care of (Rp -1,949,300). Factors that affect the real cost are type of nursing class (0,009), LOS (0,019) and age (0,045).The conclusion of this study is that there was a difference between the real cost and INA-CBG’s rate in patient with stroke in JKN era at Sultan Agung Islam Hospital between January 2017 and October 2017. Factors that affect the big real cost are type of nursing class, LOS and age.

Factors Affecting The Cost Gap Between INA CBGs Tariff and Hospital Tariff for Patients with Dengue Hemorrhagic Fever in Ngawi Regional Public Hospital, East Java

Background: Dengue Hemorrhagic Fever (DHF) has a high cost burden. Payment for hospital treatment was paid by Health insurance (BPJS) with a case based payment method in the era of the National Health Insurance. This method allowed the hospital to gain profit or loss. This study aimed to analyze the factors that influence the differences in Indonesian Cased Based Groups (INA CBGs) with the medical service costs for DHF in dr. Soeroto hospitals, Ngawi Regency. Subjects and Method: This study used an observational analytic study with a cross-sectional approach conducted at dr. Soeroto Hospital, Ngawi Regency, East Java in September - October 2019. A sample of 200 subjects was selected by using simple random sampling. The dependent variable was the difference in rate. The independent variables were class of care, length of stay, age, blood transfusion, comorbidity and complications. Data analysis was using multiple linear regression with Stata 13. Results: INA CBG rates (mean= Rp 6,120,000; SD= Rp 2,330,000) was lower than the cost of hospital treatment (mean= Rp 7,070,000; SD= Rp 4,650,000). There is a negative relationship between the difference in rates and it was statistically significant on the length of stay (b= 0.73; Cl 95%= -1,131,915 to -329,501; p= <0.001), patients’ age (b= 0.41; Cl 95%= -707,099 to -110,293; p= 0.008), blood transfusion action (b= 0.79; Cl 95%= -1,549,446 to -34,190; p= 0.041), and comorbidity (b= 1.14 ; Cl 95%= -1,817,112 to -474,641; p= 0.001). While there was a statistically insignificant relationship between classes of care (b= 0.42; Cl 95% = -931,443 to 82,607; p= 0.100) and complication (b= 0.34; Cl 95%= -1,093,208 to 408,223; p= 0.369). Conclusion: Difference in INA CBG rates and hospital medical service costs were affected by the class of care, length of stay, age, blood transfusion, comorbidity and complications. Keywords: INA-CBG’s rates , hospital rates, care cost, dengue hemorrhagic fever. Correspondence: Betty Nurizky Ariwardani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Email: bettyna175@gmail.com. Mobile: 082233243164. Journal of Health Policy and Management (2019), 4(3): 204-213 https://doi.org/10.26911/thejhpm.2019.04.03.08