ANALISIS UNIT COST OPERASI SECTIO CAESAREA DENGAN METODE TIME DRIVEN ACTIVITY BASED COSTING (STUDI KASUS DI RSKIA UMMI KHASANAH)

Background: The proportion of Sectio caesarea Operations increased from 7% in 2007 to 17% in 2017. BPJS claims for cesarean sections reached IDR 3 trillion in 2017. INA CBGs rates for services with procedures are usually lower than the actual hospital rates. Cost analysis with Time-Driven Activity Based Costing (TDABC) is a cost calculation model that is simpler and more accurate than traditional ABC costing analysis. Therefore, a cost analysis based on the TDABC model for elective cesarean section class III is needed at RSKIA Ummi Khasanah to find out more detailed costs. In addition, these costs can be used as a comparison of applicable hospital rates and hospital claims based on INA-CBGs. Research Methods: This study used a qualitative research design with a case study method at the Ummi Khasanah Mother and Child Special Hospital in Bantul, Yogyakarta, Indonesia. Primary data were obtained from direct observation of class III elective sectio caesarea operation process and interviews with hospital staff. Secondary data were obtained from 2019 annual hospital reports, 2019 hospital reports, and patient medical records. The cost of a cesarean section was calculated and analyzed using the seven-step TDABC model with hospital data in 2019. Research Results and Discussion: The cost of an elective cesarean section with the TDABC method is Rp. 4,576,182.72. Human Resources is the biggest expense (54%) of the total cost of sectio caesarea, which is Rp. 2,478,132.96, cost of medicine, nutrition, and consumables is Rp. 1,137,815.00, Cost of Infrastructure is Rp. 604,232.61, The laboratory examination cost is Rp. 260,000.00, and the indirect cost is Rp. 96.02.15. The intraoperative process is the core process with a cost allocation of Rp 2,535,542.54 or 55% of the total cost of the SC operation process. Conclusion: Based on the research results, TDABC can analyze the cost of sectio cesarea services in detail and identify inefficient processes.