Model perhitungan ekspektasi biaya tagih bpjs kesehatan menggunakan generalized linear model= Calculation model for bpjs kesehatan bill fees with generalized linear model

Jayanto, Angela (2021) Model perhitungan ekspektasi biaya tagih bpjs kesehatan menggunakan generalized linear model= Calculation model for bpjs kesehatan bill fees with generalized linear model. Bachelor thesis, Universitas Pelita Harapan.

[img] Text (Title)
Title.pdf.pdf
Restricted to Repository staff only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (1MB)
[img]
Preview
Text (Abstract)
Abstract.pdf.pdf
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (481kB) | Preview
[img]
Preview
Text (ToC)
ToC.pdf.pdf
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (504kB) | Preview
[img]
Preview
Text (Chapter1)
Chapter1.pdf.pdf
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (509kB) | Preview
[img] Text (Chapter2)
Chapter2.pdf.pdf
Restricted to Registered users only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (573kB)
[img] Text (Chapter3)
Chapter3.pdf.pdf
Restricted to Registered users only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (635kB)
[img] Text (Chapter4)
Chapter4.pdf.pdf
Restricted to Registered users only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (547kB)
[img] Text (Chapter5)
Chapter5.pdf.pdf
Restricted to Registered users only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (473kB)
[img]
Preview
Text (Bibliography)
Bibliography.pdf
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (479kB) | Preview
[img] Text (Appendices)
Appendices.pdf
Restricted to Repository staff only
Available under License Creative Commons Attribution Non-commercial Share Alike.

Download (6MB)

Abstract

BPJS Kesehatan merupakan badan yang menyelenggarakan jaminan Kesehatan Nasional bagi seluruh rakyat Indonesia dan terbagi menjadi tiga jenis pelayanan kesehatan yaitu FKTP Non Kapitasi, FKTP Kapitasi, dan FKRTL. Dalam data FKTP Kapitasi biaya tagih tidak diketahui karena pembayaran yang dilakukan pemerintah adalah berdasarkan jumlah peserta yang terdaftar dalam FKTP Kapitasi tersebut, berbeda dengan FKTP Non Kapitasi dan FKRTL yang pembayarannya dilakukan berdasarkan besaran klaim pesertanya. Penelitian ini bertujuan untuk memprediksi biaya tagih FKTP Kapitasi dengan membangun tiga model Generalized Linear Model menggunakan data FKTP Non Kapitasi dengan mengasumsikan data berdistribusi Gaussian, Gamma, dan Inverse Gaussian. Hasil prediksi yang diperoleh berupa mean, sehingga dapat dicari batas atas dan batas bawah dari hasil prediksi tersebut. Perhitungan rata-rata biaya tagih FKTP Kapitasi memanfaatkan Teori Ekspektasi dengan mengasumsikan proposi peserta dengan klaim tidak nol adalah jumlah peserta yang melakukan klaim di FKTP Non Kapitasi, FKTP Kapitasi, dan FKRTL dibagi dengan jumlah peserta pada data kepesertaan. Hasil penelitian ini didapatkan bahwa besaran rata-rata biaya tagih kapitasi memiliki nilai yang lebih tinggi jika dibandingkan dengan nilai yang ditetapkan pemerintah.Secara keseluruhan, hasil prediksi rata-rata biaya tagih kapitasi yang didapatkan hanya dapat menggambarkan estimasi yang dapat terjadi berdasarkan data sampel./BPJS Kesehatan is a national institution who provides health insurance for every Indonesian citizen. BPJS Kesehatan divides health facility into three types which is FKTP Kapitasi, FKTP Non Kapitasi and FKRTL. FKTP Kapitasi’s data doesn’t provide bill fees which caused by the way government pay their claim is depending on the total participants registered in each FKTP Kapitasi, unlike FKTP Non Kapitasi who got paid depending on the total claim their participants made. This thesis will discuss three models of Generalized Linear Model with the assumption that the data is Gaussian, Gamma and Inverse Gaussian distributed. The model is made based on FKTP Non Kapitasi with the intention of predicting the bill fees of FKTP Kapitasi. These models provides mean as the output resulting that the upper limit and the lower limit can be count. Expectation Theory is utilized to count the average bill fee of FKTP Kapitasi assuming that non zero claim equals to total of unique participants all three data divided by total participants in the Kepesertaan data. This thesis obtained higher average bill fee than the Kapitasi payment set by the government. Overall, the average bill fee obtained only describe the sample data, not the population.

Item Type: Thesis (Bachelor)
Creators:
CreatorsNIMEmail
Jayanto, AngelaNIM01112170003angelamjayanto@gmail.com
Contributors:
ContributionContributorsNIDN/NIDKEmail
Thesis advisorSaputra, Kie Van IvankyNIDN0401038203kie.saputra@uph.edu
Thesis advisorKrisnadi, DionNIDN0316029002dion.krisnadi@uph.edu
Uncontrolled Keywords: Generalized Linear Model; BPJS Kesehatan; Kapitasi; Non Kapitasi
Subjects: Q Science > QA Mathematics
Divisions: University Subject > Current > Faculty/School - UPH Karawaci > Faculty of Science and Technology > Mathematics
Current > Faculty/School - UPH Karawaci > Faculty of Science and Technology > Mathematics
Depositing User: Users 5974 not found.
Date Deposited: 04 Aug 2021 03:45
Last Modified: 07 Mar 2022 02:40
URI: http://repository.uph.edu/id/eprint/41144

Actions (login required)

View Item View Item