Hubungan Ketepatan Kode Diagnosa Obstetric Terhadap Kelancaran Klaim BPJS di RSUD Sawerigading Kota Palopo Sulawesi Selatan

Abstract

Abstract

The accuracy od code diagnosis can affect the of health care financing specifically analysis in the smooth process of claiming, national repot morbidity and mortality, healthcare data tabulation servces for the evaluation prosess of planning medical process of planning medical servicel for the evaluation process of planning medical services, to determine the type of services that must be planned and developed according to the needs of the time and for epidemiological and clinical studies. To known relation about the accuracy obstetric code diagnosis with the continuty of BPJS claim in Sawerigading Hospital in Palopo City-South Sulawesi. The research is quantitative with cross sectional design. The population was 182 obstetric medical records in April 2016 and taken samples of 44 medical records. Analyzed using univariate and bivariate analysis using Chi Square. The result of 44 medical recodrs examined were known that inaccurate obstetric diagnosis code and not smooth BPJS claim was 18 (66,7%) and inaccurate obstetric diagnosis code and smooth BPJS claim was 9.(33,3%). However, it was known accurate obstetric diagnosis code and not smooth BPJS claim is was 3 (17,6%) and obstetric diagnosis code and smooth BPJS claim 14 (82,4%). Odds Ratio = 9 and p.value = 0,004 < 0,05. There is association beetwen obstetric diagnosis code accuracy and the the continuty of BPJS claim in sawerigading hospital in Palopo City-South Sulawesi. 

Keywords : Diagnosis Code, Medical Resume, BPJS’s claim

Abstrak

Ketepatan kode diagnosa dapat berpengaruh terhadap analisis pembiayaan pelayanan kesehatan khusus dalam kelancaran proses pengklaiman, pelaporan nasional morbiditas dan mortalitas, tabulasi data pelayanan kesehatan bagi proses evaluasi perencanaan pelayanan medis, menentukan bentuk pelayanan yang harus direncanakan dan dikembangkan sesuai kebutuhan zaman dan untuk penelitian epidemiologi dan klinis. Mengetahui hubungan ketepatan kode diagnosa obstetric terhadap kelancaran klaim BPJS di RSUD Sawerigading Kota Palopo-Sulawesi Selatan. Jenis penelitian ini bersifat kuantitatif dengan desain penelitian cross sectional. Populasi adalah 182 rekam medis obstetric bulan April 2016 dan diambil sampel 44 rekam medis. Analisis data menggunakan analisis univariat dan analisis bivariat dengan uji Chi Square. Dari 44 rekam medis yang diteliti diketahui kode diagnosa obstetric yang tidak tepat terhadap klaim BPJS yang tidak lancar sebanyak 18 (66,7%) dan kode diagnosa obstetric yang tidak tepat terhadap klaim BPJS yang lancar sebanyak 9.(33,3%). Namun ditemukan juga kode diagnosa obstetric yang tepat terhadap klaim BPJS yang tidak lancar sebanyak 3 (17,6%) dan kode diagnosa obstetric yang tepat terhadap klaim BPJS yang lancar 14 (82,4%). Nilai Odds Ratio = 9 dan nilai p.value = 0,004 < 0,05. Ada hubungan ketepatan kode diagnosa obstetric terhadap kelancaran klaim BPJS di RSUD Sawerigading Kota Palopo-Sulawesi Selatan.

Kata kunci : kode diagnosa, resume medis, klaim BPJS