Utilization Review (UR)

RSUD NGIMBANG
Bulan Pelayanan
Januari - Maret 2018

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 JUMLAH KASUS
Bulan Pelayanan Januari – Maret 2018
Bulan RJTL RITL
Pelayanan Klaim Pending Jumlah Klaim Pending Jumlah
JANUARI 2.557 0 2.557 506 0 506
FEBRUARI 2.270 31 2.301 376 75 451
MARET 2.089 328 2.417 469 86 555
Total 6.916 359 7.275 1.351 161 1.512

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 JUMLAH BIAYA
Bulan Pelayanan Januari – Maret 2018
Bulan RJTL RITL
Pelayanan
Klaim Pending Jumlah Klaim Pending Jumlah
JANUARI 1.420.414.700 0 1.420.414.700 1.740.410.300 0 1.740.410.300
FEBRUARI 1.083.118.800 9.364.300 1.092.483.100 1.275.303.900 265.276.600 1.540.580.500
MARET 976.920.000 65.849.200 1.042.769.200 1.569.112.800 389.504.400 1.958.617.200
Total 3.480.453.500 75.213.500 3.555.667.000 4.584.827.000 654.781.000 5.239.608.000

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 PERBANDINGAN BIAYA RS dengan INA-CBG’s
Bulan Pelayanan Januari – Maret 2018
Bulan RJTL RITL
Pelayanan Biaya Riil RS Biaya Setuju Biaya Riil RS Biaya Setuju
JANUARI 1.098.898.683 1.420.414.700 1.974.619.582 1.740.410.300
FEBRUARI 814.012.505 1.083.118.800 1.465.226.464 1.275.303.900
MARET 758.056.327 976.920.000 1.758.347.999 1.569.112.800
Total 2.670.967.515 3.480.453.500 5.198.194.045 4.584.827.000

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 Kasus RJTL
3000 2557
2270 2089
2000
kasus RJTL
1000

0
JANUARI FEBRUARI MARET

Biaya RJTL
1,500,000,000

1,000,000,000
biaya RJTL INA-CBGs
500,000,000 biaya RJTL RS

0
JANUARI FEBRUARI MARET
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 UC RJTL Januari – Maret 2018
600,000 555,500
477,145 467,650
400,000
223,838 223,838 223,838 RSUD Ngimbang
200,000 UC Standart

0
JANUARI FEBRUARI MARET

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 Kasus RITL
600 506 469
376
400
kasus RITL
200

0
JANUARI FEBRUARI MARET

Biaya RITL
2,500,000,000
2,000,000,000
1,500,000,000
biaya RITL INA-CBGs
1,000,000,000
biaya RITL RS
500,000,000
0
JANUARI FEBRUARI MARET
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 UC RITL Juli – September 2016
5,000,000 4,652,528 4,652,528 4,652,528
4,000,000 3,439,546 3,391,766 3,345,656
3,000,000
RSUD Ngimbang
2,000,000
UC Standart
1,000,000
0
JANUARI FEBRUARI MARET

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 10 Diagnosa Terbanyak Rawat Inap
No. Diagnosa Jumlah Biaya
1. Anaemia, unspecified 58 152,878,500

2. Typhoid fever 57 133,508,600

3. Fetus and newborn affected by caesarean delivery 55 187,276,400

4. Melaena 53 93,365,500

5. Essential (primary) hypertension 48 95,153,100

Peptic ulcer, unspec as acute or chronic without
6. 45 104,430,300
haemorrhage or perforation
7. Premature rupture of membranes, unspecified 40 130,507,400
Unilateral or unspecified inguinal hernia, without
8. 36 157,705,100
obstruction or gangrene
Benign neoplasm, connective and other soft tissue,
9. 34 122,013,000
unspecified
10. Gastro-oesophageal reflux disease without oesophagitis 32 97,227,200

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 10 Diagnosa Terbanyak Rawat Jalan
No. Diagnosa Jumlah Biaya
1. Presence of intraocular lens 863 156,668,200
2. Follow-up examination after surgery for other conditions 781 144,400,300
3. Senile incipient cataract 583 2,126,873,700
4. Gastro-oesophageal reflux disease without oesophagitis 345 87,947,400
5. Low back pain, site unspecified 336 64,602,000
6. Primary arthrosis of other joints, unspecified site 242 44,122,300
7. Epilepsy, unspecified 219 40,065,100
8. Essential (primary) hypertension 202 36,866,300
9. Other specified surgical follow-up care 190 53,090,500
10. Intracerebral haemorrhage, unspecified 163 22,331,000

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 10 Tindakan Terbanyak
Nomor Diagnosa Jumlah
1. Other transfusion of whole blood 127
2. Cesarean section of other specified type 79
3. Other manually assisted delivery 73
4. Nonexcisional debridement of wound, infection, or burn 44
5. Other local excision or destruction of lesion or tissue of skin and 40
6. Other gastroscopy 39
7. Unilateral repair of inguinal hernia, not otherwise specified 37
8. Transurethral removal of obstruction from ureter and renal pelvis 30
9. Removal of urethral stent 26
10. Excision of hemorrhoids 26

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 10 Kunjungan Poli Terbanyak
Nomor Poli Jumlah
1. MAT 1903
2. SAR 1038
3. INT 973
4. FIS 954
5. BED 474
6. OBG 457
7. PAR 295
8. URO 291
9. JAN 256
10. ANA 184

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 JUMLAH SEVERITY LEVEL
Bulan Pelayanan Januari – Maret 2018
Bulan
Sev 1 % Tot RITL Sev 2 % Tot RITL Sev 3 % Tot RITL
Pelayanan

JANUARI 366 72,2% 102 20,1% 39 7,7%

FEBRUARI 371 81,9% 55 12,1% 27 6%

MARET 413 74,5% 109 19,7% 32 5,8%

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 Pasien Meninggal / Pulang APS
No. Keterangan Januari Februari Maret

1. Meninggal 33 22 36

2. Pulang APS 22 29 20

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Terima Kasih

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