Analysis of the Suitability of Real Costs Against INA-CBG’s Rates for Treatment of Inpatients with ARI at Sumber Hurip Hospital, Cirebon

Abstract

Acute Respiratory Infection (ARI) is a disease with a high incidence rate in Indonesia that requires significant healthcare expenditures. The Indonesian Case-Based Groups (INA-CBGs) system applies a fixed prospective package tariff that often does not align with the hospital’s actual costs. This study aimed to analyze the alignment between actual costs and INA-CBGs tariffs, as well as to identify the factors associated with actual costs in the inpatient treatment of ARI at Sumber Hurip Hospital, Cirebon. This research was a descriptive quantitative study utilizing secondary data from 200 medical records of hospitalized ARI patients from January to December 2024. The analysis encompassed patient characteristics, drug utilization profiles, comparisons between INA-CBGs tariffs and actual costs, and factors influencing cost variations through bivariate correlation analysis. The majority of patients were aged 18–59 years (78.5%), female (62.0%), hospitalized in class III wards (64.5%), had a 4-day length of stay (38.5%), and were categorized as mild cases (96.0%). The most frequently prescribed medication was Ambroxol tablets (43.4%) from the mucolytic class. The average INA-CBGs tariff was IDR 2,398,971.50, whereas the average actual cost was IDR 3,006,135.31, resulting in a negative discrepancy of -IDR 607,163.81. Factors significantly associated with actual costs were age, length of stay, secondary diagnoses, severity level, and ward class ( ). In conclusion, the actual costs exceeded the INA-CBGs tariffs with a negative discrepancy of IDR 607,163.81, leading to financial deficits for the hospital. Factors significantly associated with actual costs were age, length of stay (LOS), secondary diagnoses, severity level, and ward class, whereas gender showed no significant association.