| Summary: | Background : Suitability in enforcement and determination of the primary diagnosis affects the size of the replacement costs (claims) of the administering body to the hospital as a health care provider. Unsuitability in enforcement and determination of the primary diagnosis may result in the loss of the hospital and the insurance carrier body (UPT Managed Care). To determine the cost of care in patients Jamkesda determination and writing Jamkesda primary diagnosis in patients using ICD-10. Based on a preliminary study conducted by researchers at UGM Academic Hospital, researchers found some determination of the primary diagnosis in patients Jamkesda hospitalizations in the disease that does not comply with the rules or the rules contained in the ICD-10.
Goals : Reveal the suitability determination Jamkesda patients with a primary diagnosis o fdisease cases in UGM Academic Hospital and the factors affecting in compatibility.
Methode : Type a descriptive study with a qualitative approach. Cross-sectional study design.
Results : Results from this study is that there is a discrepancy rate determination of the primary diagnosis were 29 cases of patients Jamkesda of 107 cases of medicine and the factors that cause such a discrepancy is the lack of human resources(personnel verifier), lack of knowledge of human resources in the use of ICD-10 ,there are no related SOPs governing the implementation of the determination of the patient's diagnosis based on ICD-10 and no training related to the use of ICD-10.
Keywords : Suitability, Unsuitability, Determination, PrimaryDiagnosis, Jamkesda, Internal Disease, ICD-10
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