Penetapan Tarif Ambulans Untuk Evakuasi Medis Berbasis Unit Cost

2021 ◽  
Vol 7 (1) ◽  
pp. 167-173
Author(s):  
Kelvin Riupassa ◽  
Narizma Nova ◽  
Endah Lestari ◽  
Sri Juniarti Azis ◽  
Wahyu Sulistiadi

Background: An ambulance is a vehicle designed to be able to handle emergency patients, provide first aid and carry out intensive care while on the way to a referral hospital. Ambulance operations require a large amount of funds obtained from APBD funds through tariffs that were passed through the DKI Jakarta Governor Regulation five years ago. For this reason, a new tariff is required to adjust to current conditions. Objectives: The purpose of this study is to calculate the unit cost of ambulance services in DKI Jakarta to be a consideration in the tariff setting policy in DKI Jakarta province. Research Metodes: This study uses a quantitative descriptive approach to obtain information about the unit cost of the Jakarta ambulance production unit. The method used is the calculation of real cost using the basis of the causes of costs. This research was conducted at the DKI Jakarta Emergency Ambulance using secondary data on investment costs, operational costs and maintenance costs in 2018. Results: The total cost of emergency ambulance in 2018 is known that the proportion of three cost components, namely operational costs, is 76%, followed by investment costs of 20% and maintenance costs of 3%. The calculation of the total cost of medical evacuation using the double distribution method is Rp. 98,915,016,805.00 divided by the number of medical evacuations in 2018 of 37,564 activities, the unit cost of medical evacuation for the AGD of DKI Jakarta Health Office is Rp. 2,633,215.00 without subsidies. APBD costs, while if the subsidy component is included in the calculation, the unit cost for one trip to the AGD of the Health Office is Rp. 604,071.00. This is still far above the current tariff of Rp. 450.00, so the cost recovery rate (CRR) is still below. 100%. Conclusion: From the three cost components consisting of investment, operational and maintenance costs,the largest proportion was operational costs at 76%. The Cost Recovery Rate has not reached 100% so that the existing rates have not covered the costs incurred.   Keywords: ambulance; price fixing; unit cost

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Anna Aurelia ◽  
Eka Pujiyanti

Abstrak Rumah Sakit X merupakan salah satu rumah sakit kelas C di Jakarta Selatan yang mengalami lonjakan pasien sejak diber­lakukannya rujukan berjenjang oleh BPJS. Pasien Acute Coronary Syndrome (ACS) merupakan pasien dengan kegawatdaru­ratan medis yang membutuhkan penanganan intensif di ICU. Tujuan penelitian ini adalah menganalisis biaya pelayanan pasien ACS dengan rawat inap di RS X pada tahun 2015 menggunakan metode Activity Based Costing. Hasil penelitian menyatakan bahwa biaya satuan untuk menyelenggarakan pelayanan pasien ACS dengan rawat inap di RS X pada tahun 2015 adalah Rp 6.083.444,-. Diperoleh hasil analisis Cost Recovery Rate untuk pasien umum adalah 227.98 % dan pasien BPJS adalah 71.38 %. Disarankan agar Rumah Sakit X mengembangkan clinical pathway untuk penyakit ACS sebagai panduan tindakan dan hari rawat pasien, dan merekrut dokter tetap untuk pengendalian biaya operasional.Abstract X Hospital is a Class C Hospital in South Jakarta, which experiencing a substantial increased number of patients since the BPJS has implemented the referral system. Acute Coronary Syndrome (ACS) patient is a patient with a medical emergency require intensive treatment in the ICU. The purpose of this study was to analyze the cost for hospitalized ACS patients at X Hospital in 2015 using activity based costing. The study revealed that the unit cost of hospitalized ACS patients at X Hospital in 2015 was Rp 6.083.444,-. The Cost Recovery Rate for patients with fee-for-service was 227.98% and for BPJS patient was 71.38%. This study suggested the hospital to develop clinical pathway for ACS guidance, as well as recruiting full time doctors.


2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Supriadi Supriadi

ABSTRACT. This research is motivated by the thought that Hemodialysis Unit at ABC hospital whichopened in 2005 , is a unit that produces , but in the determination of rates of hemodialysis services have notbeen done in detail , which includes only the cost component of operating costs of direct material regardless ofpersonnel costs , telephone and general logistics costs . The issue is whether income rates that have not beencalculated in detail to cover the costs incurred by the unit or how hemodilisia Cost Recovery Rate ( CRR ) ofthe Hemodialysis Unit.This study is a qualitative study using secondary data from monthly reports of severalABC RS unit to calculate total revenue and total cost Haemodialysis Unit. The data used is the data of2006,2007and2008.The results showed CRR Haemodialysis Unit 2006 = 41.69 % , 2007 = 71.36 % and2008 = 83.11 %.Based on the results obtained during the 3 years that CRR is still below 100 % , it indicatesthat the income earned Haemodialysis Unit for 3 years has not been able to cover the costs incurred for theoperation of the unit.Cost Recovery Rate Unit Hemodialisa Rumah Sakit ABC Tahun 2006-2008SupriadiVolume 1, Nomor 1, pp 78-9283Keywords : Cost Recovery Rate, income, rates


2018 ◽  
Vol 39 (3) ◽  
pp. 1211
Author(s):  
Flávio De Moraes ◽  
Marcos Aurélio Lopes ◽  
Francisval De Melo Carvalho ◽  
Afonso Aurélio de Carvalho Peres ◽  
Fábio Raphael Pascoti Bruhn ◽  
...  

This study investigates the cost-effectiveness of 20 demonstration units (DUs) belonging to the "Balde Cheio" program. The units in question are from the state of Rio de Janeiro, Brazil, dating from January to December 2011, and are sorted according to the scale of production (small, medium and large). The data were analyzed using Predictive Analytical software (PASW) 18.0. The scale of production influenced the total cost of milk production, and therefore profitability and cost-effectiveness. The large-scale stratum showed the lowest total unit cost. The positive results in medium and large scales in milk production lead to optimal conditions for long-term production, with the capitalization of cowmen. The items regarding the effective operating cost (EOC) with the biggest influence on the costs of dairy activity in the small scale stratum were food, energy and miscellaneous expenses. In the medium scale, these were food, labor force, and miscellaneous expenses. Finally, in the large scale, they were food, labor force and energy. In the small and large scale, the items regarding the total cost with the biggest influence on the costs of dairy activity were food, labor force, and return on capital, while in the medium scale, they were food, return on capital, and labor force. The average break-even point of 14 of the DUs was higher than the average daily production.


2014 ◽  
Vol 48 (4) ◽  
pp. 699-705 ◽  
Author(s):  
Caroline Rife Nobrega ◽  
Antônio Fernandes Costa Lima

To identify the direct cost of procedures related to an outpatient chemotherapy treatment for women with breast cancer. Method: This is a quantitative research, using the case study methodology, performed in an outpatient chemotherapy of a private hospital. The total cost was calculated by multiplying the time spent by professionals involved in therapeutic procedures, the unit cost of direct labor, adding to the cost of materials, drugs and solutions. For performing the calculations, we used the Brazilian currency (R$). Results: The average total cost per chemotherapy session corresponded to R$ 1,783.01 (100%), being R$ 1,671.66 (93,75%) spent with drugs, R$ 74,98 (4.21%) with materials, R$ 28.49 (1.60%) with labor and R$ 7.88 (0.44%) with solutions. Conclusion: The results may support discussions and decision making for the management of costs related to chemotherapy aimed at reducing expenses and eliminating waste without harm to the care provided. 



1998 ◽  
Vol 30 (7) ◽  
pp. 1295-1311 ◽  
Author(s):  
I M Johnstone

The author develops a simulation model to estimate the optimum timing and maximum impact of full rehabilitation of New Zealand housing stock. The model is based on the theories of classical population dynamics. Data used in the model include empirical estimates of the mortality of New Zealand housing stock, assumed schedules of depreciation of dwelling services, and assumed schedules of annual maintenance costs. The dwelling service years provided by dwellings serve as a proxy for benefits of rents or imputed rents (excluding rent for land). The cost to construct one dwelling and fractions thereof serve as a proxy for costs of maintenance, rehabilitation, replacement, and new construction. Optimum timing of rehabilitation can increase the quantity of benefits provided by the housing stock per unit total cost but a reduction in the growth rate of new dwellings has a greater impact in achieving the same objective. A stationary and stable housing stock can provide 45% more dwelling services per unit total cost than a housing stock which doubles in size every 35 years.


Author(s):  
Conor Teljeur ◽  
Paul Carty ◽  
Máirín Ryan

IntroductionEconomic models contain several parameters ordinarily subject to uncertainty. Unlike most other model parameters, costs can constitute numerous distinct components. For example, a surgical intervention can require a variety of disposables and reusable equipment. A micro-costing output may be disaggregated or presented as a total cost. Uncertainty could be applied to individual cost components or to total cost. We aimed to explore how disaggregation of cost data may impact on uncertainty using a case study.MethodsA set of simulations using hypothetical scenarios were developed with uncertainty set at ± 20 percent. The simulations investigated the impact of number of cost components, balance between components, and correlation between them. A cost-utility model from an assessment of robot-assisted radical prostatectomy was analyzed; procedure cost was divided into 32 individual cost components or treated as a total cost.ResultsBased on five equal cost components, uncertainty reduces from ± 20 percent for correlated variables to ± 9 percent for uncorrelated variables. With increasing numbers of uncorrelated cost components, the uncertainty in the total cost decreases markedly. The uncertainty around total robot-assisted surgery procedure equipment costs was ± 19.7 percent when components were correlated and ± 9.4 percent when uncorrelated. The impact on uncertainty in the incremental cost effectiveness ratio (ICER) was negligible but the ranking of parameters in the univariate sensitivity analysis changed.ConclusionsAnalyzing uncertainty by aggregated or disaggregated costs can have implications for presenting uncertainty in costs to decision makers. Applying uncertainty to aggregated costs essentially implies that variation in the cost of individual components is perfectly correlated. By disaggregating cost components they are being treated as uncorrelated, which can substantially reduce uncertainty in the total cost. In this case study we found that although the reduction in uncertainty could be clearly seen in the cost parameter, it had a negligible impact on uncertainty in the ICER.


Author(s):  
Sutini ◽  
Bambang Riyanto ◽  
Bagus Hario Setiadji

<p>The port is the final destination of cruise ships as well as loading and unloading places and passengers. In addition, the Port is also a process of loading and unloading and shiploading. Before the ship is docked when the port is full of vessels first anchor / anchored anchor. For the process of relying first wait for the queue to dock, in the process of a long side there are some ships that do not dock at the port but do unloading by way of anchor / anchored anchors with the ship system to ship. From the description above in terms of this research is related to the process of loading and unloading costs at the port of Tanjung Emas Semarang. This study will analyze the influence of ship movement on loading and unloading costs when entering the port of Tanjung Emas entrance in Semarang, the emphasis of this study is on the analysis of loading and unloading costs, ship's cost and port docking costs. Approach with random sampling model is to get samples from each ship in ship-to-shipment and ship-to-shore transfer process, ship loading and ship loading and unloading process takes a long time so it costs quite expensive. The completion of the results of the analysis in this study is applied to the system of relocation, movement and loading and unloading using the method of ship to ship and ship to shore associated with the total cost that will be carried each ship / company. From the analysis it is known that the cost of the vessel shipage is Rp. 4.107.308.172,- loading and unloading costs Rp. 250,257,336,550, - and dredging cost Rp. 10.676.000.000,- therefore the large cost of loading and unloading, the cost of dredging and dredging costs is closely<br /> related to the operational costs of ships and companies.</p><p><strong>Keywords : Movement Cost of Ship Shipment, Loading and Dredging</strong></p><p>Pelabuhan merupakan tujuan akhir dari pelayaran kapal juga sebagai tempat bongkar muat dan naik turunnya  enumpang. Disamping itu Pelabuhan juga sebagai proses tempat bongkar muat dan penyandaran kapal. Sebelum kapal sandar apabila di pelabuhan penuh kapal terlebih dahulu anchor / berlabuh jangkar. Untuk proses penyandaran terlebih dahulu menunggu antrian untuk sandar, dalam proses penyandaran ada beberapa kapal yang tidak sandar di pelabuhan tetapi melakukan bongkar muat dengan cara anchor / berlabuh jangkar yaitu dengan sistem ship to ship. Dari uraian diatas dalam hal penelitian ini terkait dengan proses penyandaran dan biaya bongkar muat di pelabuhan Tanjung Emas Semarang. Studi ini akan melakukan analisis mengenai pengaruh olah gerak kapal terhadap biaya bongkar muat pada saat memasuki alur masuk Pelabuhan Tanjung Emas Semarang, titik berat studi ini ditekankan pada analisis biaya bongkar muat, biaya olah gerak kapal dan biaya sandar di pelabuhan. Pendekatan dengan model sampel acak adalah untuk mendapatkan sampel dari masingmasing kapal dalam proses penyandaran ship to ship dan ship to shore, proses bongkar muat ship to ship dan ship to shore membutuhkan waktu yang cukup lama sehingga membutuhkan biaya yang cukup mahal. Penyelesaian dari hasil analisis dalam studi ini diterapkan untuk sistem penyandaran, olah gerak dan bongkar muat yang menggunakan method ship to ship dan ship to shore yang berhubungan dengan total biaya yang akan ditangung masing-masing kapal / perusahaan. Dari hasil analisis diketahui bahwa biaya penyandaran kapal sebesar Rp. 4.107.308.172,- biaya bongkar bongkar muat Rp. 250.257.336.550,- dan biaya pengerukan Rp. 10.676.000.000,- oleh karena itu besar biaya bongkar muat, biaya penyandaran dan biaya pengerukan sangat berhubungan dengan biaya operasional kapal dan perusahaan.</p><p><strong>Kata kunci : Biaya Olah Gerak Kapal, Bongkar Muat dan Pengerukan</strong></p>


Author(s):  
Sukanta Sukanta

In determining the cost of production and sales of a product unit is often faced with problems in making decisions. Determination of the cost of the production unit can be done more quickly and there is a standardized calculation method correctly and correctly. The purpose of this research is to determine and calculate the cost of production per unit of product in a certain amount based on the imposition of production costs. Imposing production costs. The production cost calculation is determined on these production cost components, both by direct and indirect costing in accordance with the organizational structure approach of the company concerned. The result of the research shows that the calculation of the unit cost for the Inner tube product based on the current experience and knowledge of the company is Rp. 15,200 per unit, while the results of research using the distribution method of the production unit cost of Rp. 13,045 per unit. Thus, there is a difference in the unit cost of the product that is 20% cheaper than it is currently in the company


2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Giza E. E. Arikalang ◽  
Edward Nangoy ◽  
Christi D. Mambo

Abstract: Calculation of unit cost could give some information to healthcare policy. Broncho-pneumonia is a lung inflammation disease that occurs in around 30% of babies with high mortality risk. This study was aimed to determine the general depiction of unit cost calculation for bronchopneumonia among pediatric patients at Prof. Dr. R. D. Kandou Hospital according to clinical pathway. This was an observational retrospective study. Samples were obtained by using random sampling as many as 42 samples that fulfilled inclusion criteria. Processed data included patients’ demography, treatment, and the average of direct cost calculation. The results showed that the implemented therapy consisted of antibiotic, non-antibiotic, fluid therapy, ancillary laboratory examination, radiology, and ancillary diagnostics. Total cost for drugs was Rp. 8,822,455; laboratory Rp. 28,568,725; radiology Rp. 9,912,400; and ancillary diagnostic examination Rp. 7,110,000. Compared to the cost covered by BPJS, the hospital had some excess as follows: drug unit Rp. 958,549, radiology Rp. 1,771,517, and ancillary diagnostic examination Rp. 581,852. For ancillary laboratory examination in the hospital, there was a difference as much as Rp. 1,341,276 less than the the BPJS coverage. Conclusion: There was an excess difference within drug unit, radiology, and ancillary examinations for pediatric bronchopneumonia, while laboratorium unit possess lesser cost than BPJS.Keywords: bronchopneumnonia, cost unitAbstrak: Perhitungan biaya satuan merupakan salah satu informasi masukan dalam pembuatan kebijakan pelayanan. Bronkopneumonia ialah penyakit radang paru yang terjadi pada sekitar 30% anak balita dengan risiko kematian yang tinggi. Penelitian ini bertujuan untuk mendapatkan gambaran perhitungan biaya satuan pada pasien bronkopneumonia anak di RSUP Prof. Dr. R. D. Kandou berdasarkan clinical pathway. Jenis penelitian ialah observasional retrospektif. Sampel penelitian dikumpulkan dengan metode random sampling berjumlah 42 sampel yang memenuhi kriteria inklusi. Data meliputi data demografi pasien, gambaran pengobatan, dan penghitungan rata-rata biaya langsung. Hasil penelitian mendapatkan bahwa terapi yang digunakan ialah antibiotik, non antibiotik, terapi cairan, serta penunjang laboratorium, radiologi, dan penunjang diagnostik. Total biaya untuk obat Rp. 8.822.455, laboratorium Rp. 28.568.725, radiologi Rp. 9.912.400, dan penunjang diagnostik Rp. 7.110.000. Bila dibandingkan dengan biaya tanggungan BPJS, rumah sakit memiliki selisih lebih pada unit obat sebanyak Rp. 958.549, radiologi Rp. 1.771.517, dan penunjang diagnostik Rp. 581.852. Untuk penunjang laboratorium, terdapat selisih kurang sebesar Rp. 1.341.276. Simpulan: Pada pengobatan bronkopneumonia anak terdapat perbedaan selisih lebih pada unit obat, radiologi, dan penunjang diagnostik, serta terdapat selisih kurang pada unit laboratoriumKata kunci: bronkopneumonia, perhitungan biaya satuan


2019 ◽  
Vol 31 (3) ◽  
pp. e100016 ◽  
Author(s):  
Yu-Chen Yeh ◽  
Xin Yu ◽  
Congpei Zhang ◽  
Wei Hao ◽  
Fen Du ◽  
...  

BackgroundOver 10 million Chinese are affected by schizophrenia. The annual cost of schizophrenia in China was estimated at US$2586 per patient.AimsThe study has two aims: (1) to conduct a targeted literature review of the economic literature on oral ziprasidone in China, and (2) to develop an inpatient economic model that compared the cost of intramuscular ziprasidone with other regimens including electroconvulsive therapy (ECT) for the management of acute agitation in patients with schizophrenia from a hospital’s perspective in China.MethodsA targeted literature review was conducted using PubMed and the Chinese literature databases for studies published between January 2007 and December 2017. Studies that assessed costs associated with oral ziprasidone treatment for schizophrenia in China were summarised. In the inpatient economic model, cost measures included hospital room and board, antipsychotics, ECT and medications for the management of extrapyramidal symptoms (EPS). Input for standard antipsychotic regimens and unit cost were obtained from the literature. Hospital length of stay (LOS), utilisation of ECT and incidence of EPS were derived from the literature and supplemented/validated with a survey of psychiatrists in China. Cost was presented in 2017 Chinese yuan.ResultsThe average estimated LOS was 29 days with ziprasidone, 33 days with risperidone+benzodiazepine, 32 days with olanzapine, 35 days with haloperidol and 29 days with ECT. The cost of antipsychotics was ¥1260 with ziprasidone, ¥137 with risperidone+benzodiazepine, ¥913 with olanzapine and ¥210 with haloperidol; ECT treatment cost ¥785. The base-case analysis suggested that higher antipsychotic cost with ziprasidone was offset by savings with shorter LOS. Using intramuscular ziprasidone for acute management was associated with a total cost of ¥11 157, the lowest among all antipsychotic regimens (¥11 424 with risperidone+benzodiazepine, ¥11 711 with olanzapine and ¥11 912 with haloperidol) and slightly higher than ECT (¥10 606). The cost of antipsychotics and ECT accounted for 1 %–11 % of the total cost. Varying LOS between the lower and upper bounds of the 95% CI, the total cost was comparable between these regimens.ConclusionsOverall, the cost for the management of acute agitation was similar between intramuscular ziprasidone and other antipsychotics. Compared with other antipsychotics, the higher medication cost of intramuscular ziprasidone can be offset by savings with shorter hospital stay. The results from this economic analysis were complementary to the findings in the published literature assessing the economic outcomes of oral ziprasidone.


Sign in / Sign up

Export Citation Format

Share Document