Assessing Cost Drivers and a Preliminary Costing Model for Low Birth Weight Neonates in The Neonatal Intensive Care Unit at Rumah Sakit Universitas Airlangga

Khairunisa Windia Ningsih, Mahendra Tri Arif^*, Adikara Pagan Pratama^*

Abstract

Low birth weight neonates receiving neonatal intensive care require substantial resources, but the relationship between hospital costs and reimbursement remains important to clarify. This retrospective cohort study identified cost drivers and compared actual costs with BPJS claims among 19 low birth weight neonates with medical complications admitted to the neonatal intensive care unit of Universitas Airlangga General Academic Hospital in 2025. Medical records and financial data were analyzed using descriptive statistics, Spearman correlation, Mann–Whitney U tests, multiple linear regression, and a Wilcoxon signed-rank test. Mean actual cost was IDR19,378,544.74 ± 13,137,212.47, with pharmacy, room, and medical devices representing the largest recorded components. Length of stay showed the strongest correlation with actual cost (ρ = 0.869, p < 0.001) and remained independently associated with log-transformed cost (B = 0.069, β = 0.809, p < 0.001). Each additional hospitalization day was associated with an estimated 7.1% higher cost after adjustment for diagnosis count. The model explained 68.5% of variation in ln (actual cost). Transfusion was associated with higher costs (exact p = 0.033), although only three neonates received transfusion. Mean BPJS reimbursement was IDR15,695,789.47, yielding a mean claim-minus-cost gap of −IDR3,682,755.26; the paired difference was not statistically significant (p = 0.334). Length of stay was the strongest independent cost correlate in this sample. These findings support further development of a costing model, but do not establish predictive validity or an effect of reimbursement discrepancies on clinical decisions.

Keywords

low birth weight; neonatal intensive care unit; cost drivers; hospital costs; BPJS reimbursement; length of stay; costing model

Cite This Article

Ningsih, K. W., Arif, M. T., Pratama, A. P. (2026). Assessing Cost Drivers and a Preliminary Costing Model for Low Birth Weight Neonates in The Neonatal Intensive Care Unit at Rumah Sakit Universitas Airlangga. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 6: Nov – Dec 2026, Pages 931-935. URL: https://www.ijscia.com/wp-content/uploads/2026/11/Volume7-Issue6-Nov-Dec-No.1114-931-935.pdf

Volume 7 | Issue 6: Nov – Dec 2026