The sensitivity of hospital coding to prices: evidence from Indonesia

Martin Chalkley, Budi Hidayat, Royasia Viki Ramadani, María José Aragón

Research output: Contribution to journalArticlepeer-review


This study examines a newly introduced DRG system in Indonesia. We use secondary data for 2015 and 2017 from Jaminan Kesehatan Nasional (JKN), a patient level dataset for Indonesia created in 2014 to record public and private hospitals’ claims to the national health insurance system to investigate whether there is an association between changes in tariffs paid and the severity of inpatient activity recorded in hospitals. We find a consistent small, positive and statistically significant correlation between changes in tariffs and changes in concentration of activity, indicating discretionary but limited coding behaviour by hospitals. The results indicate that reducing price differentials may mitigate discretionary coding, but that the benefits of this are limited and need to be compared to the potential risk of having to rebase all prices upwards.

Original languageEnglish
Pages (from-to)147-162
Number of pages16
JournalInternational Journal of Health Economics and Management
Issue number2
Publication statusPublished - Jun 2022


  • 18 (Government Policy · Regulation · Public Health)
  • C1 (Econometric and Statistical Methods and Methodology: General)
  • Clinical coding
  • Diagnosis-related groups
  • Health
  • I13 (Health Insurance
  • Indonesia
  • Insurance
  • Prospective payment system
  • Public and Private)


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