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.
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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: | Creators NIM Email ORCID Jayanto, Angela NIM01112170003 angelamjayanto@gmail.com UNSPECIFIED |
Contributors: | Contribution Contributors NIDN/NIDK Email Thesis advisor Saputra, Kie Van Ivanky NIDN0401038203 kie.saputra@uph.edu Thesis advisor Krisnadi, Dion NIDN0316029002 dion.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 |