PENGEMBANGAN SISTEM INFORMASI PEMBAYARAN RAWAT INAP PASIEN KELUARGA MISKIN BERBASIS INA-DRG CASEMIX GUNA MONITORING PEMBIAYAAN KESEHATAN DI RUMAH SAKIT UMUM DAERAH DOKTER SOEDARSO KALIMANTAN BARAT (Payment Information System Development for Poor Family Patients at the Inpatient Unit based on INA_DRG Case Mix to Support Health Financing at Doctor Soedarso Public Hospital in West Borneo)

Abstract

Undang-Undang Dasar 1945 pasal 28 H menyatakan bahwa setiap orang berhak hidup sejahtera lahir dan batin, bertempat tinggal, dan mendapat lingkungan yang baik dan sehat serta berhak memperoleh pelayanan kesehatan. Pemerintah telah melakukan kebijakan pendanaan kesehatan bagi masyarakat miskin yang disebut Program Jaminan Kesehatan Masyarakat (Jamkesmas), dengan menerapkan sistem tagihan/klaim bersifat prospective payment system berdasarkan tarif paket Indonesia Diagnosis Related Group (INA-DRG). Berdasarkan studi pendahuluan menunjukkan bahwa monitoring pembiayaan kesehatan pasien miskin yang sedang dirawat di rumah sakit belum optimal karena tidak tersedia informasi yang akurat, lengkap, tepat waktu dan mudah diakses. Tujuan penelitian ini adalah menghasilkan sistem informasi pembayaran rawat inap pasien keluarga miskin berbasis INA-DRG casemix guna monitoring pembiayaan kesehatan. Pengembangan sistem berdasarkan langkah-langkah FAST (Framework for the Application of Systems Thinking). Desain penelitian ini adalah one group pre and post test. Variabel penelitian adalah keakuratan, ketepatan waktu, kelengkapan, dan aksesibilitas informasi. Analisis data dilakukan dengan metode content analysis (analisa terhadap hasil uji sistem), analisis deskriptif (analisis terhadap hasil wawancara) dan analisis analitik (menguji informasi yang dihasilkan sistem sebelum dan sesudah dilakukan pengembangan sistem informasi). Dari hasil penelitian dapat disimpulkan bahwa pengembangan sistem informasi pembayaran rawat inap pasien keluarga miskin berbasis INA-DRG casemix guna monitoring pembiayaan kesehatan mampu mengatasi permasalahan pada sistem informasi sebelum dikembangkan. Hasil analisis menunjukkan skor rata-rata tertimbang sebelum pengembangan sistem adalah 2,09, dan sesudah dilakukan pengembangan sistem adalah 3,94, artinya ada peningkatan persepsi responden terhadap sistem informasi sesudah dilakukan pengembangan. Dari sisi kualitas informasi antara sistem lama dan sistem yang dikembangkan mempunyai perbedaan yang signifikan, hal ini ditunjukkan dengan hasil uji statistik Sign Test, dimana probabilitas 0,0001 (p<0,05), artinya ada perbedaan kualitas informasi yang signifikan antara sistem yang lama dengan sistem yang baru. Kesimpulan sistem informasi yang diusulkan lebih baik dari sistem informasi lama. Saran untuk pengembangan sistem adalah perlu penambahan fungsionalitas yang dapat menentukan tingkat keparahan penyakit (level severity) dan untuk diagnosa yang ungrouper. The article 28 H within the Constitution 1945 states that each person has a right for prosperous life physically and spiritually, for living, for obtaining good and healthy environment, and for obtaining health services. Indonesia government has implemented a policy of health financing for poor people called as the Program of Public Health Insurance. This program uses a claim system through prospective payment system in which it is based on the tariff of Indonesia Diagnosis Related Group (INA-DRG). The previous study showed that the monitoring of the health financing for poor family patients who were hospitalized at a hospital had not been done optimally because there was no available information that was accurate, complete, timely, and easy to access. The objective of this research was to result a payment information system for poor family patients at the Inpatient Unit based on INA-DRG case mix to monitor health financing. Development of the system was based on the steps of FAST (Framework for the Application of Systems Thinking). Design of this research was one group pre and posttest. The research variables were accurateness, timeliness, completeness, and accessibility of information. Data were analyzed using the methods of content analysis (analysis towards the test result of the system), descriptive analysis (analysis towards the result of interview), and analytic analysis (comparing information resulted by the system between before and after developing the information system). Development of the system could overcome the problems on the old system. The score of the considered average on the old system was equal to 2.09 and on the new system was equal to 3.94. It means that the respondents’ perception towards the new system was really good. Based on statistical analysis using Sign Test, there was any differences between the old and the new system with p value = 0.0001 (p < 0.05). This means that quality of information between the old and the new system was really different. As a conclusion, the new system is better than the old system. To improve the system, it needs to add functionality that could determine a severity level of a disease and could diagnose an ungrouper.