Diagnosis-related Groups

Alternatif Software INA-DRG

2009-08-25T21:32:00.000-07:00

Hello

Ini ada alternatif program aplikasi klaim Jamkesmas menggunakan INA-DRG.

Jika ada kesulitan atau pun menginginkan penjelasan lebih lanjut dapat kirim e-mail ke alamat purwakencana@yahoo.com

Edi has shared a file with you!

To view / download the file, simply click on the link below

Link: http://www.ziddu.com/download/6195410/jamkesmaszip.rar.html

Regards,
Ziddu Team
www.ziddu.com

Fitur:
* dapat entry data selengkapnya mulai dari No. RM, Nama pasien, No. SKP, nama dokter sampai BHP khusus (seperti contoh gambar berikut)

* fitur di atas menjadikan sofware ini dapat langsung membuat file MS Excel P2JK lengkap dengan nama pasien, No. SKP, nama dokter dan lainnya tanpa melakukan entry lagi di file MS Excel (seperti contoh gambar berikut)

* Dapat menampilkan data pasien yang ungroup setelah dilakukan grouping dan pentarifan (seperti contoh gambar berikut)

* Dapat pula digunakan dalam jaringan LAN dengan cara mapping.
* Semua fitur yang ada dalam software aplikasi INA-DRG Depkes diterapkan pula dalam software ini, misal mencetak detil maupun rekapitulasi, membuat file teks (.txt), proses pentarifan, dll.

Software INA-DRG Depkes dapat digunakan dalam jaringan LAN

2009-05-18T19:56:00.000-07:00

Alternatif Software INA-DRG dapat dilihat pada link berikut:
http://ina-drg.blogspot.com/2009/08/alternatif-software-ina-drg.html

Walaupun sederhana sebenarnya software aplikasi input data INA-DRG yang didisbrusikan oleh Yanmedik Depkes dapat digunakan untuk lingkup jaringan LAN. Ini dapat diterapkan untuk rumah sakit yang merasa cukup repot bila melakukan entry data yang berjumlah ratusan pasien dalam sehari. Tips dan trik ini hanyalah saran yang mungkin dapat diterapkan pada rumah sakit yang membutuhkan.
Caranya mudah kok.
Pertama tentunya sediakan 4 atau 5 komputer PC dan bangunlah sebuah jaringan LAN.
Install sofware grouper pada salah satu komputer PC saja (anggap ini sebagai server, walau menggunakan OS Win XP :-) ), sekalian juga install sofware entry data INA-DRG yang dibuat oleh DEPKES. Untuk folder database paradoks (folder DB pada INA-DRG) silakan terserah anda ingin diletakkan di mana, misal partisi D: dan jangan lupa folder tersebut di full share.
Selanjutnya install software INA-DRG pada masing-masing komputer PC yang lain sesuai prosedur, kecuali untuk setting BDE pada database grouper harus di arahkan ke folder yang dishare pada PC yang pertama tadi dengan cara di mapping (bisa dengan menggunakan windows explorer).

Alternatif Software INA-DRG dapat dilihat pada link berikut:
http://ina-drg.blogspot.com/2009/08/alternatif-software-ina-drg.html

Sekali lagi trik ini hanya saran, jika mengalami kesulitan silakan email ke purwakencana@yahoo.com.

Mengapa INA-DRG?

2009-03-04T21:38:00.000-08:00

Pilot Project INA-DRG dimulai sejak tahun 2006 yang dipengaruhi oleh faktor bahwa sistem DRG telah digunakan di banyak negara dengan dasar hukum:

Undang Undang No 40 tahun 2004 tentang SJSN
SK MENKES No 1663/MENKES/SK/XII/2005 tentang Ujicoba Penerapan System Diagnostic Related Group (DRG) Case Mix di 15 rumah sakit di Indonesia
Keputusan Ditjen Bina Pelayanan Medik No HK.00.06.1.1.214 tentang Pembentukan Kelompok Kerja Centre For Case-Mix

15 rumah sakit Pilot Project tersebut adalah:

RSU H. Adam Malik, Medan
RSU Dr. M. Djamil, Padang
RSU Dr. M. Hoesin, Palembang
RSU Fatmawati, Jakarta
RSU Persahabatan, Jakarta
RSUPN, Dr. Cipto Mangunkusumo, Jakarata
RSAB Harapan Kita
RS Jantung dan Pembuluh Darah Harapan Kita
RS Kanker Dharmais
RSU Dr. Hasan Sadikin, Bandung
RSU Dr. Kariadi, Semarang
RSU Dr. Sardjito, Yogyakarta
RSU Sanglah, Denpasar
RSU Prof. Dr. R.D. Kandaou, Manado
RSU Dr. Wahidin Sudiro Husodo, Makassar

Hasil Pilot Project adalah sistem INA-DRG yang terdiri:

23 MDC
1.077 kode INA-DRG beserta tarifnya yang terbagi dalam, 789 kode untuk rawat inap dan 288 kode untuk rawat jalan

Pelatihan Implementasi INA-DRG - Semarang 2 -5 Maret 2009

2009-03-03T17:46:00.000-08:00

Pelatihan kali ini diikuti oleh rumah sakit di lingkungan propinsi Jateng, DIY, KalBar dan Babel.
Diharapkan setelah pelatihan ini rumah sakit daerah khususnya dapat segera mengimplementasikan software untuk keperluan klaim pembayaran pasien Jamkesmas.
Memang ada banyak kendala dalam penerapan sistem pembayaran klaim INA-DRG, namun tentunya dengan usaha yang serius dan berkesinambungan diharapkan semua kendala dan kekurangan baik dalam sistem maupun software yang ada akan dapat diatasi.

Regent/Mayor Must Prepare Data of Askeskin Members

2008-04-06T21:19:00.000-07:00

Regent and mayor are requested to immediately decide number, names and addresses of poor and almost poor population in their areas as well as to control provision of poor statements (SKM/SKTM) so that it cannot be misused. Hospitals and other health facilities are not supposed to be local income sources (PAD).

It was mentioned by Minister of Health, Dr. dr. Siti Fadilah Supari, Sp.JP(K), in Coordination Meeting of JPKMM-Askeskin Program Implementation 2007 at Jakarta (4/9). It was attended by 1,518 stakeholders from center and region, and purposes to create coordination and stabilization of Askeskin Program 2007 as well as financing by provincial/district/municipal government.

The meeting is also to provide comprehension of payment standardization for health services in hospitals through Indonesia Diagnosis Related Group (Ina-DRG). Ina-DRG is a prospective payment pattern and a penetration on payment system of health services in hospitals related to health insurance mechanism. Therefore, fee at all hospitals will be the same each others. It will be a reference for PT. Askes to verify claims.

According to Health Ministerial Decree No. 989/Menkes/SK/IX/2007, government will make Ina-DRG effective starting on September 1, 2007 for 3 rd Class at government hospitals throughout Indonesia and on October 1 for other classes.

Relating to hospital delinquent claims, Minister of Health asks hospital directors to keep continuing health service to poor people and responding budget delay problems. She ensures that all unpaid claims must be paid after verification, and Ministry of Health (MOH) is attempting additional budget.

Use of drugs, except formularium, is for life saving. Therefore, she requires the use of formularium or others having similar content with it. It is as an effort to control the cost considering the limited budget. In addition, providing services should refer to the exist reference, and there should not be irrational therapy and health service. List of additional drugs has been prepared to be informed.

To all head of medical committee and Medical Advisory Board (MAB), she asks them to run their duty and function in arranging medical service standard and monitoring the implementation, conducting supervision of profession ethic, managing profession authority of functional medical staff and developing service programs.

Meanwhile, to head of provincial health office, she requires them to continuously supervise and monitor Askeskin program as well as strengthen provincial and district/municipal Coordinating Team and Safe Guarding Team in order to do their job and function well for socialization, supervision and monitoring that they could inventory problems and also formulate the solutions.

It was attended by all regents/mayors, directors of government general hospitals, minister coordinator for people's welfare, minister of domestic affairs, PERSI, ARSADA, KKI, MKDKI, Medical Advisory Board, profession organization, head of provincial health offices, management boards of PT Askes (Persero) and officials in MOH. Minister of health admitted that there are still some problems in implementing Askeskin Program.

At least, there are 4 problems needed to be solved together by stakeholders both from central and local. First, unfinished registration of Askeskin target 2007 that poor statement letter (SKTM) is still used by poor people. It causes many SKTM misuses. Many people, who are not poor, use Askeskin, and it gives disadvantages to poor people's right in getting health service.

Second, many poor people have not still got service because of limited health facilities. On the other hand, there are overloaded service, uncontrolled drug use and non optimal monitor and control of hospital medical care. All of these affect to high hospital cost.

Third, financing problem. Every year, number of Askeskin members is increasing, while its budget is limited. The realization is not efficient and claim payment is usually late. In addition, local contribution on additional budget for poor people health service and the utilization of profit as PAD have not been optimal.

Fourth, Safeguarding and Provincial/District/Municipal Coordinating Teams have not bee optimal, therefore problems on field are not discussed and solved immediately.

According to Mrs. Supari, health status of poor people is now still low, and economic problems are one cause for relating to community incapability to pay health service. ?Therefore, in the beginning of SBY-JK era, strategic policy has been made on providing free health service for poor people. Since January 1, 2005, it has been called as Program Jaminan Pemeliharaan Kesehatan Maskin (JPKMM) and familiar as Askeskin,? said her.

Askeskin Program purposes to improve access and quality of health service for poor people that there would be no poor people are difficult to get health service because of economic reason. ?This program is a part of poverty elimination,? she added.

In early 2005, program target was 36.1 million poor people throughout Indonesia . In line with local government plan and the same time with PKPS-BBM program, starting from mid 2005 to 2006, the target was increased to 60 million of poor and almost poor people. In 2007, the target is adapted from number of poor households obtaining SLT (a cash aid program), that are 19.1 million of poor households or about 76.4 million people.

Poor people get health service in stages, from out- and inpatient at health center to referral of specialistic outpatient care and inpatient care on 3 rd class of hospital. The health service including drugs and other medical needs are referred to rational service standard.

Increasing number of program members causes increasing budget need in every year. It is Rp.5,000/person/month. In 2005, the budget was Rp.2.1 trillion and increased to Rp.3.6 trillion in 2006 and to Rp.4.6 trillion in 2007.

Monitoring and evaluation since 2005 to mid 2007 have shown significant increase on health care utilization by poor people. It indicates that Askeskin program has been known and comprehended by poor people, who need health services without any fee.

For example, utilization of outpatient care in hospital increased almost five times, which was from 1.4 million visits in 2005 to 6.9 million visits in 2006; while, inpatient care increased almost three times, which was from 562,167 cases in 2005 to 1.6 million cases in 2006.

Meanwhile, during first semester in 2007, outpatients in hospital have reached 2.6 million visits, and inpatients have reached 831,139 cases. It is predicted that in second semester utilization of hospital service will increase as years before.

It covers from common cases to specific cases (catastrophic) that need much money, such as heart surgery, cancer surgery, haemodialysis, Caesar surgery, etc. For example, heart surgery increased almost eight times from 380 people in 2005 to 2,950 people in 2006, and haemodialysis increased from 4,862 people in 2005 to 5,418 people in 2006.

This information is published by Center for Public Communication, Secretariat General MOHRI. For further information, please call 021-522 3002 or send e-mail to: puskom.depkes@gmail.com.

DRG :: Diagnosis-related group :: INA-DRG

2008-04-05T02:56:00.000-07:00

Diagnosis-related group
From Wikipedia, the free encyclopedia

Diagnosis-related group (DRG) is a system to classify hospital cases into one of approximately 500 groups, also referred to as DRGs, expected to have similar hospital resource use, developed for Medicare as part of the prospective payment system. DRGs are assigned by a “grouper” program based on ICD diagnoses, procedures, age, sex, and the presence of complications or comorbidities. DRGs have been used since 1983 to determine how much Medicare pays the hospital, since patients within each category are similar clinically and are expected to use the same level of hospital resources. DRGs may be further grouped into Major Diagnostic Categories (MDCs).
The original objective of diagnosis related groupings (DRGs) was to develop a patient classification system that related types of patients treated to the resources they consumed. Since the introduction of DRGs in the early 1980’s, the healthcare industry has evolved and developed an increased demand for a patient classification system that can serve its original objective at a higher level of sophistication and precision. To meet those evolving needs, the objective of the DRG system had to expand in scope. Today, there are several different DRG systems that have been developed in the US. They include:
Medicare DRG
Refined DRGs (RDRG)
All Patient DRGs (APDRG)
Severity DRGs (SDRG)
All Patient Refined DRGs (APRDRG)
International-Refined DRGs (IRDRG)
The system was created by Robert Barclay Fetter and John Devereaux Thompson at Yale University with the material support of the former Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS). DRGs were intended to describe all types of patients in an acute hospital setting. The DRGs encompassed both elderly patients as well as newborn, pediatric and adult populations. In 1983 CMS assumed responsibility for the maintenance and modifications of these DRG definitions. Since that time, the focus of all Medicare DRG modifications instituted by CMS has been on problems relating primarily to the elderly population.
In 1987, the state of New York passed legislation instituting DRG based payments for all non-Medicare patients. Included within this legislation was the requirement that the New York State Health Department (NYHD) evaluate the applicability of Medicare DRGs to a non-Medicare population. This evaluation concluded that the Medicare DRG’s were not adequate for a non-Medicare population. Based on this evaluation, the NYDH entered into an agreement with 3M to research and develop all necessary DRG modifications. The modifications resulted in the initial APDRG, which differed from the Medicare DRG in that it provided support for transplants, high-risk obstetric care, nutritional disorders, and pediatrics along with support for other populations. One challenge in working with the APDRG groupers is that there is no set of common data/formulas that is shared across all states as there is with CMS. Each state maintains its own information.
In 1991, the top 10 DRGs overall were: normal newborn, vaginal delivery, heart failure, psychoses, cesarean section, neonate with significant problems, angina pectoris, specific cerebrovascular disorders, pneumonia, and hip/knee replacement. These DRGs comprised nearly 30 percent of all hospital discharges.[1]
The history, design, and classification rules of the DRG system, as well as its application on patient discharge data and updating procedures, are presented in the CMS DRG Definitions Manual (Also known as the Medicare DRG Definitions Manual and the Grouper Manual). A new version generally appears in October of every year. The 20.0 version appeared in 2002.