Casemix system allows patients to undergo unnecessary treatment. This can make treatment more effective and patients should not stay long in the hospital undergoing treatment. Casemix is the foundation Indonesia Case-Based Groups (INA-CBG's) which is a financing system for the National Health Insurance (JKN) 2014.
Casemix grouping diagnosis of the disease is associated with the cost of care and included in the group. Characterize the group is to have clinical symptoms and the use of the same resources. Casemix used as a payment system for health care package, with cost determined previously.
"There will no longer funding on a per-service (fee for service). Financing prevent patients from undergoing this treatment and the treatment is not necessary," said the Director General of Health Services Ministry of Health, Akmal Taher.
This funding also allows patients to receive care with the same quality and price, if done at a regional hospital and is no different. This system would allow hospitals to work more effectively. This, according to Akmal, because the government only pays when maintenance is done according to the package diagnosis. When the care and treatment out of the package, then the hospital financing done.
"This system allows hospitals to work more effectively. Deviated If the loss of the hospital," said Akmal.
Losses can be reduced if the hospital and patients work together. Health workers provide services as much as possible, preferably while the patient tries to recover.
Casemix is actually not something foreign. Implementation has been done since 2006, through Indonesia Diagnose Related Group (INA-DRG). In 2009, casemix funding system used for JAMKESMAS in advanced health services. Changes occurred in 2010, which began using the name INA-CBG's. Changes as well as preparation for the application of INA-CBG's done nationally. In 2012, application of INA-CBG was first performed in 1,114 hospital.
There is no audit system
Although already in front of the eye, it's the application of INA-CBG has not possessed audit system. In fact, this system is useful for checking the quality of systems and services provided by the hospital.
"Currently, the standard INA-CBG's audit for 2014 JKN still in process. Especially for primary care, so as not to send the patient home," said Akmal.
Auditing standards used to reduce the variation of services provided. According to Akmal, through auditing standards will be able to see which hospitals can treat patients in a given time. Audit also included in the standard clinical pathways, such as length of patient hospitalization.
"There could be not necessarily indicate the quality of luxury," said Head of the Ministry of Health Financing and Health Insurance Usman Sumantri.