The discrepancy between hospital and INA-CBGS fare of top five diseases at Pediatric Intensive Care Unit Sanglah Hospital

Abstract Pediatric intensive care unit (PICU) is an emergency life-threatening treatment ward that requires rigorous and invasive monitoring to restore or maintain the body normal function. PICU operational fares are high. Sanglah General Hospital (RSUP) Sanglah is a type A hospital in Bali that serves and treats BPJS participants in outpatient and inpatient. We estimated there are fare discrepancy between hospital and INA-CBG's fare in the PICU Sanglah Hospital. The aim of this study was to describe the fare discrepancy between hospital and INA-CBG's fare of the five most diseases in the PICU Sanglah Hospital. A cross-sectional descriptive study, conducted at PICU ward Sanglah Hospital. Male patients admitted at PICU was slightly higher compared to female patients (54.8% versus 45.2%). INA-CBG’s fare is lower than the fare of the hospital in the diagnosis category of sepsis and diabetic ketoacidosis Rp. 53.394.518 and Rp. 1.598.550, respectively. Sepsis has the longest LOS than any other diagnosis. There is a discrepancy between hospital and INA-CBG’s rate on top five most common diseases in PICU. Keywords: pediatric intensive care unit; insurance; BPJS; INA-CBG’s