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.

本研究考察了印度尼西亚新引入的 DRG 系统。我们使用来自 Jaminan Kesehatan Nasional (JKN) 的 2015 年和 2017 年二手数据，这是一个印度尼西亚的患者级别数据集，于 2014 年创建，用于记录公立和私立医院对国家医疗保险系统的索赔，以调查关税变化之间是否存在关联支付的费用以及医院记录的住院患者活动的严重程度。我们发现关税变化与活动集中度变化之间存在一致的小、正和统计上显着的相关性，表明医院的编码行为是随意但有限的。结果表明，减少价格差异可能会减轻可自由支配的编码，但这样做的好处是有限的，需要与必须将所有价格重新上调的潜在风险进行比较。