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Anomaly Detection of Hospital Claim Using Support Vector Regression

IJCCS (Indonesian Journal of Computing and Cybernetics Systems) · Vol. 18 No. 1 (2024) · pp. 1–12

DOI
10.22146/ijccs.91857
ISSN
2460-7258, 1978-1520
Published
2024-01-31
Publisher
IndoCEISS in colaboration with Universitas Gadjah Mada, Indonesia.
Language
eng
License
creativecommons.org/licenses/by-sa/4.0

Abstract

BPJS Kesehatan plays a crucial role in providing affordable access to healthcare services and reducing individual financial burdens. However, deficit issues can disrupt the sustainability of the program, making anomaly detection highly important to conduct. Previous research on unsupervised anomaly detection in BPJS Kesehatan revealed a limitation with Simple Linear Regression (SLR), which only accommodates linear relationships among independent variables and the target variable of BPJS Kesehatan claim values. Minister of Health Regulation No. 52 of 2016 identified eight influential non-linear independent variables, leading to the proposal of Support Vector Regression (SVR) to address SLR's shortcomings.Research findings demonstrate SVR's superior anomaly detection performance over SLR. Interestingly, the SVR model excels in anomaly detection but lacks in prediction. Optimal tuning of SVR hyperparameters (C=9, epsilon=90, gamma=0.009, residual anomaly definition > 0.5*RMSE for both datasets) yields impressive metrics: Accuracy=0.97, Precision=0.84, Recall=0.97, and F1-Score=0.90. The anomaly detection results are expected to greatly support the sustainability of the BPJS Kesehatan program in Indonesia.

Keywords

Collaboration network of the authors

27 authors · 34 co-authorship links · 4 across different organisations

Hover or tap a name to highlight its co-authors. Double-click to open the author's page.

  • Universitas Gadjah Mada
  • Universitas Teknokrat Indonesia
  • Universitas Sulawesi Tenggara
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
Show as table
Co-authorOrganisationJoint articles
Sigit PriyantaUniversitas Gadjah Mada2
Anifudin AzisUniversitas Gadjah Mada1
Praretno WibowoAffiliation unknown1
Juwita MaharantiAffiliation unknown1
Iqnatius Dimas NugrohoUniversitas Gadjah Mada1
Amelia NursantiUniversitas Gadjah Mada1
Tri Kuntoro PriyambodoUniversitas Gadjah Mada1
Zaied ShouranUniversitas Gadjah Mada1
Nur Azizul HaqimiUniversitas Gadjah Mada1
Friska Ayu ListyaUniversitas Gadjah Mada1
Wahyono WahyonoUniversitas Gadjah Mada1
Riska Amalia PraptiwiUniversitas Gadjah Mada1
Dayan Ramly RamadhanUniversitas Gadjah Mada1
Hendri Kurniawan PrakosaUniversitas Gadjah Mada1
Anindhita NisitasariUniversitas Gadjah Mada1
Raymond LuisUniversitas Gadjah Mada1
Sarah Rosdiana TambunanUniversitas Gadjah Mada1
Reka AlamsyahUniversitas Gadjah Mada1
Debby AlitaUniversitas Teknokrat Indonesia1
Muslikhah MuslikhahAffiliation unknown1
Elih SudiapermanaAffiliation unknown1
Moh Edi WibowoUniversitas Gadjah Mada1
Agus SihabudinAffiliation unknown1
Lukman HeryawanUniversitas Gadjah Mada1
Ahmad RiyadiUniversitas Sulawesi Tenggara1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://journal.ugm.ac.id/ijccs/oai, first harvested 26 Oct 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Anomaly Detection of Hospital Claim Using Support Vector Regression</dc:title>
	<dc:creator>Hapsari, Luthfia Nurma</dc:creator>
	<dc:creator>Rokhman, Nur</dc:creator>
	<dc:subject xml:lang="en-US"></dc:subject>
	<dc:subject xml:lang="en-US">Anomaly Detection; BPJS Kesehatan; Support Vector Regression; PCA</dc:subject>
	<dc:description xml:lang="en-US">BPJS Kesehatan plays a crucial role in providing affordable access to healthcare services and reducing individual financial burdens. However, deficit issues can disrupt the sustainability of the program, making anomaly detection highly important to conduct. Previous research on unsupervised anomaly detection in BPJS Kesehatan revealed a limitation with Simple Linear Regression (SLR), which only accommodates linear relationships among independent variables and the target variable of BPJS Kesehatan claim values. Minister of Health Regulation No. 52 of 2016 identified eight influential non-linear independent variables, leading to the proposal of Support Vector Regression (SVR) to address SLR's shortcomings.Research findings demonstrate SVR's superior anomaly detection performance over SLR. Interestingly, the SVR model excels in anomaly detection but lacks in prediction. Optimal tuning of SVR hyperparameters (C=9, epsilon=90, gamma=0.009, residual anomaly definition &gt; 0.5*RMSE for both datasets) yields impressive metrics: Accuracy=0.97, Precision=0.84, Recall=0.97, and F1-Score=0.90. The anomaly detection results are expected to greatly support the sustainability of the BPJS Kesehatan program in Indonesia.</dc:description>
	<dc:publisher xml:lang="en-US">IndoCEISS in colaboration with Universitas Gadjah Mada, Indonesia.</dc:publisher>
	<dc:contributor xml:lang="en-US"></dc:contributor>
	<dc:date>2024-01-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
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	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://journal.ugm.ac.id/ijccs/article/view/91857</dc:identifier>
	<dc:identifier>10.22146/ijccs.91857</dc:identifier>
	<dc:source xml:lang="en-US">IJCCS (Indonesian Journal of Computing and Cybernetics Systems); Vol 18, No 1 (2024): January; 1-12</dc:source>
	<dc:source>2460-7258</dc:source>
	<dc:source>1978-1520</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://journal.ugm.ac.id/ijccs/article/view/91857/38499</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2024 IJCCS (Indonesian Journal of Computing and Cybernetics Systems)</dc:rights>
	<dc:rights xml:lang="en-US">http://creativecommons.org/licenses/by-sa/4.0</dc:rights>
</oai_dc:dc>