Cost effective analysis on the implementation of clinical pathway in anwar makkatutu hospital, Bantaeng District, South Sulawesi, Indonesia

The National Health Insurance (JKN) has been implemented in Indonesia since 2014, aimed to achieve Universal Health Coverage (UHC) by the year 2019. It allows the need for systems that can reduce losses for patients and hospitals through INA-CBGs. The participant number of health facilities that join with Social Health Insurance (BPJS) increased significantly. The implementation of JKN during 2014-2015 faced the problem with limited funding. These situations has leaded hospitals to take effective action as quality-cost control by using clinical pathway as a guide of medical treatment for patient. Therefore, this study will analyze comprehensively, about the availability, loyalty, conformity, and cost effectiveness after the implementation of clinical pathway.

This study used qualitative approach. Data was collected through observations, in-depth interviews, document reviews, and also Focus Group Discussion (FGD). Respondents were selected purposively, consist of medical and managerial staff. This study was a pilot project which was conducted in Bantaeng district Hospital, one of public hospital in South Sulawesi

This study found that, Bantaeng District Hospital still did not implement clinical pathway up to date in the first month of the implementation. Currently, only 3 out of 5 cases was assess which already have clinical pathway guidance since August because the availability of cases between June and October. The effectiveness of cost analysis still lack because the less of multidisciplinary participation among medical personnel, lack of leader driven strategy in arrangement process, also less of awareness and socialization about the availability of clinical pathway document within medical personnel in the initial stage of implementation.

Quality-cost control system through clinical pathway implementation can reduce the Medical Errors, Length of Stay, Unnecessary Expenditure, also increasing Satisfaction and Quality of service. Therefore, the hospital needs to provide clinical guidance through clinical pathway document to ensure patients to get the required services according to their condition and the cost accordance to the treatment received by the patients.