Path Analysis Factors of Changes in Rates of INA-CBGs for Inpatients at Hospitals

Abstract

In the Indonesian Case Based Groups (INA-CBGs),
the diagnosis code is used as the basis for determining
the rate for health services. Inaccurate diagnosis codes
can cause changes to some or all the INA-CBGs codes
resulting in differences in rates. This type of research was
an observational analytic study with a cross sectional
design. One hundred inpatient medical records were
analyzed with Multiple Logistic Regression test and
analyzed pathways. The results showed that there was
a correlation between the diagnosis code and the CMG
code (b=19.097; 95%CI=16.438 to 25.911; p=0.017),
specific CBG code (b=22.059; 95%CI=20.838 to 38.205;
p<0.001), severity level code (b=19.881; 95%CI=11.990
to 29.904; p=0.006). In addition, there is also a correlation
between CMG code (b=9.462; 95%CI=-1.135 to 12.325;
p=0.002), specific CBG code (b=37.383; 95%CI=25.361
to 45.308; p<0.001) and severity level code (b=6.241;
95%CI=-1.913 to 9.146; p=0.07) with INA-CBGs rates.
The inaccuracy of the INA-CBG rates is due to the error
in determining the main diagnosis, the diagnosis code that
does not comply with the ICD-10 and incomplete medical
information.