Cost consequences analysis of hypertensive outpatients: a study in a private hospital in Yogyakarta special province

Background: Hypertension is a chronic disease that requires long-term treatment and has an impact on the cost of treatment. The costs will be greater given the loss of productivity, family burden, and social life impacted by hypertension based on patient’s perspective. Objective: The purpose of the study was to determine the costs and clinical outcome of antihypertensive therapy from the patient's perspective and to identify the discrepancies between the costs and the INA-CBGs (Indonesia Case Based Groups) tariff. Methods: The research was an observational study with a cross-sectional design. The targeted population was outpatients who had received antihypertensive therapy for at least 1 month at a private hospital in Yogyakarta. The costs included direct medical costs, direct non-medical costs, and indirect costs, while the clinical outcomes were patient’s blood pressure. The descriptive analysis was carried out to describe the characteristics of the research subjects, the clinical outcome, and the cost. Analysis of the discrepancies between the costs and the INA-CBGs tariff used the Mann-Whitney test and One-Sample t-test. Results: The results showed that the average direct medical costs, direct non-medical costs, and indirect costs from the patient’s perspective were IDR359,408.00, IDR24,617.00, and IDR 40,583.00, respectively. There was a significant difference between the real costs and the rate of INA-CBGs based on the results of statistical tests, while the cost discrepancy was IDR5,287,045.00. Conclusion: The direct non-medical costs and indirect costs of hypertensive outpatients were less than the direct medical costs. A significant difference occurred between the real costs and INA CBG’s tariff. Keywords: hypertension, cost consequences, pharmacoeconomics, patient’s perspective

ANALISIS PERBEDAAN BIAYA RIIL DENGAN TARIF INA-CBG’s DAN FAKTOR YANG MEMPENGARUHINYA UNTUK CHRONIC KIDNEY DISEASE PADA ERA JAMINAN KESEHATAN NASIONAL

Background: The National Social Security System (SJSN) is a system in the health sector that aims to provide comprehensive social security in order to create a just, prosperous and prosperous society. According to WHO growth in the number of Chronic Kidney Disease in 2013 increased by 50% from 2012 even in Southeast Asia to the number of sufferers of Chronic Kidney Disease> 380 million people. While in Indonesia, it has increased by 10% every year. This study aims to determine the differences between INA-CBG rates and the real costs of JKN-era Chronic Kidney Disease patients in RSISA Semarang. Method: This research is an observational study with a retrospective analytic descriptive design with quantitative data. The method used is the Cross Sectional method that makes observations, and can describe the factors that influence the real cost of hospitals. The population was 589 patients with Chronic Kidney Disease and 238 patients and analyzed using the chi-square statistical test with p-value <0.05. Results: The results of the study that as many as 14 patients (5.9%) aged 18-28 years, as many as 50 patients (21.0%) aged 29-39 years, as many as 82 patients (34.5%) aged 40-50 years , as many as 68 patients (28.6%) aged 51-60 years, as many as 21 patients (8.8%) aged 61-70 years as many as 3 patients (1.3%) aged 71-80 years. The research results obtained a p-value of 0,000. Conclusion: There is a Difference between Hospital Real Costs and INA-CBG's Rates for Chronic Kidney Disease in JKN Era in Semarang Hospital in 2018. There are no factors that affect the real costs in chronic kidney disease patients JKN participants in 2018 both class of care, length of treatment (LOS), and disease severity.

Costing, Adobe Technique as a Sustainable Construction System in the City of Cuenca

Adobe is an old material used in construction but over time, this construction system has lost space and preference among population. Hence, the need to seek alternatives as professionals in the construction area to encourage the use of the Adobe technique has raised. Thus, the present study made a cost of the items involved in the construction of houses from the adobe based on the theoretical references. In addition, it established a unit price analysis that identifies the particularities of this system focusing on an analytical, descriptive-conclusive methodology whose data are analysed from the results of applying a survey (n = 96) to the inhabitants of the rural sector of Cuenca and construction experts (n = 11). The average price of the construction of houses with Adobe is $ 38,357.23 dollars for a house of 150 m2 taking into account that the real costs and the construction activity are sensitive to changes in the population and market prices.

Accounting of real costs for the production of organic food: world experience and practice of Ukraine

The purpose of the publication is to study the current state of the organization and methods of accounting for the costs of organic production from the point of view of environmental and economic accounting in Ukraine and recommendations for adapting accounting support for managing the costs of production of organic products to the requirements of the formation of integrated information of environmental and economic accounting. To determine the general trends in the development of accounting support for managing the costs of the production of organic products, the methods of induction and deduction were used. The economic and statistical method was used to analyse the state of production of organic products, and the observation method was used to study the state of accounting for the real costs of producing organic food. The state of development of organic production for the period from 2000 to 2019 in the world, Europe and Ukraine has been analysed. It has been determined that at the micro level, in the conditions of organic production, environmental and economic accounting is an information system that allows you to monitor compliance with the requirements of domestic and international legislation regarding the implementation of this type of activity, and, at the next stages, to form consistent and comparable statistical indicators to account for the relationship " links between the environment and the economy. In the absence of regulatory accounting in Ukraine in the conditions of organic production, the formation of internal regulatory accounting regulations is a prerequisite for the effective management of such production. The formed system of cost accounting objects, considering the specifics of technological processes of operators of organic production, will allow organizing a separate accounting of costs for the production of organic products, inorganic products, and products of the transition period. A nomenclature of cost accounting items in terms of production of organic production is proposed, the use of which will make it possible to distinguish in accounting the expenses allowed by legislation in terms of production of organic production from expenses for which there are certain restrictions. The features of the functions of primary documents reflecting the costs of organic production are determined and ways to improve the documentation of production processes are proposed. This will improve the information support for product quality control and will allow adapting the accounting support for managing the production costs of organic products to the requirements of the formation of integrated information on environmental and economic accounting.

The impact of tax policy uncertainty on forecasting

This study examines the impact of tax policy uncertainty (TPU) on analysts' forecasts and managers' interim estimates of effective tax rates (ETRs). We adopt a broad definition of TPU that encompasses both the legislative and regulatory processes and perform tests to validate a news-based measure of TPU consistent with our definition. We document that 1) analysts' implied ETR forecasts are less accurate and more disperse during periods of high TPU, 2) managers' ETR estimates are less accurate during periods of high TPU, and 3) the presence of relatively inaccurate management ETR estimates strengthens the effects of TPU on analysts' ETR forecasts. We further find that firm-level tax-related complexity exacerbates the effects of TPU on analysts' and managers' ETR predictions. Overall, our results are consistent with uncertainty surrounding tax policy impairing analysts' and managers' ability to assess and predict future tax-related fundamentals, thus imposing real costs on managers and market participants.

Costeo basado en actividades (ABC) en las PYMES e iniciativas innovadoras: ¿opción posible o caduca?

The quantification of production/service costs to determine the market price is fundamental in offering the maximum value of satisfaction. Therefore, management accounting is essential. One of the alternative tools is activity-based costing, known as ABC system, an alternative method to overcome the limitations of traditional indirect cost systems, which somehow distort the actual accounting of costs. Will exploring its development, applicability, challenges and benefits still be a possible option? This study aimed at reviewing the scientific literature produced on the activity-based costing system in recent years, identifying trends of adoption and challegnes of implementation in various manufacturing and service firms. High impact journals indexed in PubMed, Web of Science (WoS), Scopus, among others, were analyzed. The results show an increase of publications on the implementation of the ABC system in PubMed (855 publications), WoS (1131) and Scopus (2535). The results show that its applicability remains a possible option as an alternative costing tool for SME managers or owners. This study concludes that the application of the ABC system is adequate to determine real costs and could guarantee more reasonable and competitive prices in the market. However, there is still resistance to its implementation due to human and technological ignorance.

Comparison Of Real Costs In Type 2 Diabetes Mellitus Patients With INA-CBG'S Prices In Ina-Cbg's Regional General Hospital

The mismatch between real costs and the INA-package CBG's pricing is a common difficulty in the implementation of Jamkesmas. The goal of this study is to see how much of a discrepancy there is between real costs and INA-package CBG's rates for type 2 diabetes mellitus inpatients at the Bima District Hospital, as well as to look at the factors that affect real costs. Analytic observation is a sort of study. Jamkesmas claim files and patient medical records were analyzed retrospectively. Claim files and medical records of Jamkesmas diabetes mellitus patients at the Bima District Hospital for the 2020 period with the diagnostic code INA-E-4-10-I, CBG's E-4-10-II, and E-4-10-III were the research subjects, while the study's object was claim files and medical records of Jamkesmas diabetes mellitus patients at the Bima District Hospital for the 2020 period. The data was analyzed descriptively. In addition, a one-sample test statistical analysis was performed to determine the difference between real costs and INA rates, CBG's and a bivariate correlation test to find the factors that affect real costs. The study's study showed it for severity levels I, II, and III, there is a significant cost disparity between real costs and INA-CBG rates. Severity and leght of stay are 2 parameters that influence the real cost of patient treatment. ABSTRAK Selisih antara harga sebenarnya dan harga paket INA CBG merupakan hambatan umum dalam pemasangan Jamkesmas. Tujuan dari penelitian ini adalah untuk mengetahui besarnya gap antara biaya riil dengan tarif CBG paket INA untuk pasien rawat inap diabetes tipe 2 di RSUD Bima, serta faktor-faktor yang mempengaruhi biaya riil. Observasi analitik dapat dianggap sebagai jenis penelitian. Analisis retrospektif terhadap berkas klaim Jamkesmas dan informasi medis pasien dilakukan. Berkas klaim dan rekam medis pasien diabetes mellitus Jamkesmas di RSUD Kabupaten Bima Periode 2020 dengan kode diagnostik INA-E-4-10-I, CBG's E-4-10-II, dan E-4-10-III adalah subjek penelitian, sedangkan objek penelitian adalah berkas klaim dan rekam medis pasien diabetes melitus Jamkesmas di RSUD Kabupaten Bima periode 2020. Data dianalisis secara deskriptif. Selain itu, statistik uji satu sampel analisis dilakukan untuk menentukan perbedaan biaya riil dengan tarif INA, CBG's, dan uji korelasi bivariat untuk menemukan faktor-faktor yang mempengaruhi biaya riil. Hasil kajian menunjukkan bahwa untuk tingkat keparahan I, II, dan III terdapat disparitas biaya yang signifikan antara biaya riil dengan tarif INA-CBG. Tingkat keparahan dan lama rawat inap adalah dua kriteria yang membuat biaya perawatan pasien yang sebenarnya.

Brand essense: elements and added value

The emergence of branding as one of the areas of business has helped to draw the attention of management to the need to give a product or service an emotional reinforcement, a certain factor, working with the subconscious of the consumer. Scientists have experimentally found out that a person’s connection with a product is much stronger if it is based not only on conditionally rational judgments about it, but also on the sensory perception of the brand, the emotional attitude to the company that offers this product.This article is devoted to the study of the brand as the basis for the existence of the added value of the product, which brings the buyer additional satisfaction of certain needs, which may not even be directly related to the tasks potentially solved by the purchased product. In the course of writing the article, the author collected and structured the theorists ‘ ideas about the essence of the brand and its elements, which can be managed by a brand manager within the framework of working with the product. The paper considers the brand as one of the key factors influencing the final price of the product on the shelf, from the aspect of the real costs accompanying its construction, development and maintenance, as well as from the subjective benefits received by the consumer from contact with it. The author of the article provides examples of cases of real companies related to building a brand and its strong influence on the value that the final product carries.