Kesiapan Rumah Sakit Dalam Implementasi Sistem Pembayaran Global Budget Di Kabupaten Purworejo

Abstract

The Global Budget payment method was adopted because of the annual increase in healthcare costs, which requires for cost control to guarantee that expenditures are reasonable and resources are distributed fairly without reducing the standard of service. A global budget system provides hospitals the flexibility to utilize the budget to enhance healthcare while also providing financing stability for a predetermined period of time.  In 2018, BPJS Kesehatan initiated a pilot project to integrate the INA CBGs and Global Budget mixed-method hospital payment system (global budget). Purworejo Regency is one of the areas designated as a pilot for the Global Budget payment system's deployment. The outcomes of the Hospital performance indicators in the first semester review were less than ideal. As a consequence, it is required to conduct study into the Hospital's readiness to implement the Global budget Payment System.  A descriptive design and a qualitative methodology were used in the research. The management of four hospitals in Purworejo Regency is the topic of the study.  Observations and interviews were used to explore the readiness of hospitals in implementing the Global Budget payment system in terms of health facilities perception, Quality Control and Cost Control strategies, Global Budget calculations, and patient satisfaction through the results of the Walk Through Audit.  Through the four key variables mentioned above, the scoring technique is used to evaluate the readiness of hospitals to implement the Global Budget payment system.  The modified CCCEAR (California Community Clinic EHR Evaluation and Readiness) tool is used for the readiness assessment, which has three readiness levels: 1) not ready (score 0-33), 2) moderately ready (34-66), and 3) definitely ready (67-100).  Result :  According to a qualitative examination of data from observations and interviews, the hospital received scores of 26 from assessor II and 24 from assessor I, positioning it in the second range. This demonstrates that the hospital fits into the category of being not ready and that it has not considered about developing a more comprehensive and in-depth plan for implementing the Global Budget payment system as well as how to create capacity to enable successful adoption and implementation.  Conclusion : The hospital is not yet at its highest level of readiness to proceed with adopting the Global Budget payment system in Purworejo Regency, according to the findings of scoring on four variables of hospital readiness.