Berbagai Faktor yang Berhubungan dengan Beban Biaya Obat Pasien Rawat Inap Program Askeskin, di Cirebon Tahun 2005

Askes—the health insurance corporation—pay hospitals according to predetermined prices, but the hospital must finance the costs of those non-covered drugs and medical supplies prescription because of prohibition of charging the poor. In Gunung Jati Hospital, funding for the poor from local governments which is the responsibility of local governments is not available. The hospital should finance the gap which in turn putting high financial burden to the hospi-tal. Askeskin removes financial barriers to access inpatient care producing an increase of 153% of the third class hospital inpatient from the level of 2004. The objective of this study is to know the factors related to the high financial burden to the hospital in order to finance non covered drugs and medical supplies. The study used survey method complemented by in depth interview in the qualitative part of the study. This study concludes that the average costs of non-covered services are more than twice more expensive among patients coming from out of Cirebon and hospitalized in surgical wards. In addition, length of stay positively correlated with higher burden to the hospital. Inconsistencies and misunderstanding among policy makers regarding vision and mission of caring the poor resulting to no allocation of fund to the hospital. The researchers suggest that a forum is established to delineate local government responsi-bility and funding for non-covered services to complement the national program of Askeskin. In addition, effective communication to physicians to prescribe from formularium would reduce the financial burden of the hospital