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"Tujuan: Mengetahui hubungan beban finansial terhadap kualitas hidup pasien kanker yang menjalani terapi radiasi di instalasi radioterapi rumah sakit pusat rujukan nasional Indonesia yang menggunakan JKN.Metode: Desain penelitian deskriptif analitik dengan metode cross sectional. Data diambil dari rekam medis dan kuesioner yang didalamnya terdapat formulir EORTC QLQ-C30 untuk menilai HRQoL, yang diisi melalui wawancara via telepon pada pasien kanker yang telah menjalani radioterapi di IPTOR RSUPN Dr. Cipto Mangunkusumo periode Januari 2022 - Maret 2023. Dilakukan analisis untuk mengidentifikasi dan mengetahui hubungan antara karakteristik sosiodemografi, klinis, dan ekonomi/beban ekonomi, terhadap HRQoL pasien kanker.Hasil: Dari analisis bivariat masing-masing variabel independen, didapatkan untuk global health yang secara statistik memiliki hubungan (p>0,25) antara lain usia (p=0,166), jenis kelamin (p=0,090), stadium (p=0,111), pendapatan bulanan (p=0,114), dan skor COST FACIT (p<0,001). Untuk fungsi fisik, yang berhubungan yaitu KPS (p=0,089), OTT (p=0,048), pendapatan (p=0,146), dan skor COST FACIT (p<0,001). Sedangkan fungsi emosional, berhubungan dengan usia (p=0,081), jenis kelamin (p=0,113), KPS (p=0,119), indikasi radiaisi (p=0,188), OTT (p=0,053), OOP (p=0,021), financial catastrophe (p=0,135), dan skor COST FACIT (p<0,001). Hasil analisis multivariat dengan regresi linier didapatkan hanya skor COST FACIT yang memiliki nilai p<0,05 dari analisisi regresi liniernya untuk global health (p<0,001 b=0.443 R2=18,8%), fungsi fisik (p<0,001 b=0,456 R2=20,1%), dan fungsi emosional (p<0,001 b=0,523 R2=34,6%).Kesimpulan: Toksisitas finansial memilki hubungan yang bermakna dalam menilai HRQoL pasien kanker yang menjalani radioterapi. Pendapatan, OOP, dan financial catastrophe juga dapat dipertimbangkan dan menjadi perhatian dalam mengevaluasi HRQoL dari pasien kanker.

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Objective: To determine the relationship between financial burden and the quality of life of cancer patients undergoing radiation therapy at the radiotherapy installation of the national referral hospital in Indonesia that utilizes the National Health Insurance (JKN).

Methods: A descriptive-analytical research design with a cross-sectional method was employed. Data were obtained from medical records and questionnaires containing the EORTC QLQ-C30 form to assess HRQoL, filled out through telephone interviews with cancer patients who had undergone radiotherapy at IPTOR RSUPN Dr. Cipto Mangunkusumo from January 2022 to March 2023. An analysis was conducted to identify and understand the relationship between sociodemographic, clinical, and economic/economic burden characteristics with the HRQoL of cancer patients.

Results: From the analysis of each independent variable, it was found that for global health, there is a statistically significant relationship (p>0.25) with age (p=0.166), gender (p=0.090), stage (p=0.111), monthly income (p=0.114), and COST FACIT score (p<0.001). For physical function, the relationship variables are KPS (p=0.089), OTT (p=0.048), income (p=0.146), and COST FACIT score (p<0.001). Meanwhile, emotional function related to age (p=0.081), gender (p=0.113), KPS (p=0.119), radiation indication (p=0.188), OTT (p=0.053), OOP (p=0.021), financial catastrophe (p=0.135), and COST FACIT score (p<0.001). The results of multivariate analysis with linear regression show that only the COST FACIT score has a p-value <0.05 from its linear regression analysis for global health (p<0.001 b=0.443 R2=18.8%), physical function (p<0.001 b=0.456 R2=20.1%), and emotional function (p<0.001 b=0.523 R2=34.6%).

Conclusion: Financial toxicity is significantly related to assessing the HRQoL of cancer patients undergoing radiotherapy. Income, OOP, and financial catastrophe should also be considered and given attention when evaluating the HRQoL of cancer patients."

"Tujuan: Untuk mengetahui gambaran tingkat Toksisitas Finansial dan kemampuan pemenuhan kebutuhan dasar rumah tangga pada pasein kanker yang berobat menggunakan asuransi Jaminan Kesehatan Nasional (JKN) di Instalasi Radioterapi pada Rumah Sakit pusat rujukan nasional di Indonesia.Metode: Penelitian deskriptif analitik dengan metode potong lintang, dilakukan wawancara pada pasien kanker yang telah selesai menjalani terapi radiasi dengan menggunakan kuesioner COST-FACIT untuk menilai Toksisitas Finansial, serta pengambilan data demografi, sosial ekonomi, status penyakit, serta pengaruh Toksisitas Finansial terhadap kebutuhan dasar rumah tangga dengan menggunakan formulir dan data sekunder rekam medis.Hasil: Totat terdapat 105 pasien yang menyelesaikan pengisian kuesioner COST- FACIT. Delapan puluh tiga pasien (79%) mengalami Toksisitas Finansial, dimana 40 pasien (38,1%) mengalami Toksisitas Finansial Grade 1, 41 pasien (39%) Grade 2, dan 2 pasien (1,9%) pasien dengan Grade 3. Pada analisa univariat didapatkan jenis kelamin, tingkat pendidikan, tingkat pendapatan, moda transportasi, indikasi radiasi, status covid, dan overall treatment times menjadi tujuh kategori yang secara signifikan berhubungan dengan Toksisitas Finansial, namun hanya jenis kelamin dan tingkat pendidikan yang berhubungan signifikan pada analisa Multivariat. Pasien yang mengalami Toksisitas Finansial secara signifikan berhubungan dengan kesulitan dalam pembayaran energi, pembayaran perumahan, dan pembiayaan transportasi.Kesimpulan: Pasien laki-laki memiliki resiko lebih tinggi untuk mengalami Toksisitas Finansial dibandingkan dengan perempuan, dimana faktor pendidikan yang lebih rendah menjadi faktor yang bersama-sama dengan jenis kelamin menjadi prediktor terhadap nilai COST FACIT dalam menilai Toksisitas Finansial. Pasien- pasien yang mengalami Toksisitas Finansial juga akan mengalami kesulitan dalam mencukupi kebutuhan dasar rumah tangga.

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Purpose: To determine the level of Financial Toxicity and the ability to fulfill basic household needs in cancer patients seeking treatment using National Health Insurance (JKN) in Radiotherapy Installations at National Referral Center Hospitals in Indonesia.

Method: Descriptive analytical research using a cross-sectional method, interviews were conducted with cancer patients who had completed radiation therapy using the COST-FACIT questionnaire to assess Financial Toxicity, as well as collecting demographic, socio-economic data, disease status, and the influence of Financial Toxicity on basic needs household using forms and medical records.

Results: A total of 105 patients completed the COST-FACIT questionnaire. Eighty- three patients (79%) experienced Financial Toxicity, of which 40 patients (38.1%) experienced Grade 1 Financial Toxicity, 41 patients (39%) Grade 2, and 2 patients (1.9%) had Grade 3. In the univariate analysis, it was found that gender, education level, income level, mode of transportation, radiation indication, covid status, and overall treatment times were seven categories that were significantly related to Financial Toxicity, but only gender and education level were significantly related in the Multivariate analysis. . Patients experiencing Financial Toxicity were significantly associated with difficulties with energy payments, housing payments, and transportation financing.

Conclusion: Male patients have a higher risk of experiencing Financial Toxicity compared to women, where lower education is a factor that together with gender is a predictor of the COST FACIT value in assessing Financial Toxicity. Patients who experience Financial Toxicity will also experience difficulty in meeting basic household needs."

"Berdasarkan data Global Cancer Observatory (GLOBOCAN) 2022, jumlah kasus kanker baru di Indonesia diperkirakan 408.661 kasus dan jumlah kematian akibat kanker di Indonesia diperkirakan 242.988 kematian. Penatalaksanaan penyakit kanker tidak terbatas pada penanganan penyakit secara klinis, tetapi juga harus melibatkan rencana penatalaksanaan yang dapat memberikan kualitas hidup terbaik secara keseluruhan. Health-Related Quality of Life (HRQoL) pasien kanker merupakan persepsi pasien terhadap efek penyakit dan/atau pengobatan dan dianggap sebagai hasil terapi yang penting pada pasien kanker. Perlu diketahui faktor-faktor yang berhubungan dengan HRQoL pasien kanker agar pemangku kebijakan dapat menyusun kebijakan yang sesuai. Metode penelitian yang digunakan adalah metode cross-sectional dengan pendekatan kuantitatif menggunakan kuesioner EQ-5D-5L. Hasil analisis menunjukkan bahwa dari 14 variabel yang diteliti terdapat 4 variabel yang terbukti signifikan berhubungan, yaitu tingkat pendidikan (p = <0,001), pendapatan (p = 0,043), operasi (p = 0,022) dan komorbid (p = 0,007). Faktor dominan yang berhubungan signifikan dengan HRQoL pasien kanker adalah tingkat pendidikan (p = 0,000 dan B -0,430). Faktor-faktor yang berhubungan dengan HRQoL pasien kanker perlu menjadi target intervensi para pemangku kebijakan. Pendidikan mampu meningkatkan pemberdayaan pasien kanker. Edukasi untuk pasien kanker menjadi hal yang penting sehingga pemahaman yang baik dari pasien kanker terhadap penyakit yang diderita dapat memengaruhi HRQoL agar menjadi lebih baik.

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Based on data from the Global Cancer Observatory (GLOBOCAN) 2022, the number of new cancer cases in Indonesia is estimated at 408,661 cases and the number of cancer deaths in Indonesia is estimated at 242,988 deaths. Cancer management is not limited to clinical disease management, but must also involve a management plan that can provide the best overall quality of life. Health-Related Quality of Life (HRQoL) of cancer patients is the patient's perception of the effects of disease and/or treatment and is considered an important therapeutic outcome in cancer patients. It is necessary to know the factors associated with HRQoL of cancer patients so that policy makers can develop appropriate policies. The research method used was a cross-sectional method with a quantitative approach using the EQ-5D-5L questionnaire. The results of the analysis showed that of the 14 variables studied there were 4 variables that proved to be significantly related, namely education level (p = <0.001), income (p = 0.043), surgery (p = 0.022) and comorbidities (p = 0.007). The dominant factor significantly associated with HRQoL of cancer patients was education level (p = 0.000 and B -0.430). Factors associated with HRQoL of cancer patients need to be targeted for intervention by policy makers. Education can increase the empowerment of cancer patients. Education for cancer patients is important so that cancer patients' good understanding of their disease can affect their HRQoL for the better."

"Penyakit jantung koroner menyebabkan penurunan fungsi fisik dan psikologis yang berdampak pada kualitas hidup. Penelitian ini bertujuan untuk mengtahui faktor yang mempengaruhi kualitas hidup pasien penyakit jantung koroner. Adapun variabel independen dalam penelitian ini adalah usia, jenis kelamin, pendidikan, pekerjaan, penghasilan, status perkawinan, ansietas, depresi, koping dan dukungan sosial. Penelitian ini menggunakan analitik korelasi dengan desain cross sectional. Jumlah sampel dalam penelitian ini ada 100 responden. Pada analisi regresi linier ganda didapat 3 variabel yang berpengaruh terhadap kualitas hidup yaitu usia, penghasilan dan depresi. Hasil penelitian lebih lanjut didapatkan depresi sebagai faktor yang paling berhubungan dengan kualitas hidup (p=0.0005). Berdasarkan hal tersebut perawat perlu mendeteksi secara dini depresi yang dialami oleh pasien dan memberikan pendidikan kesehatan.

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Coronary heart disease caused decrease in physical function and psychological impact on quality of life. The aims of this study was to quality of life of patients with coronary heart disease. The independent variables in this study were age, gender, education, occupation, income, marital status, anxiety, depression, coping and social support. This study used the analytic correlation with cross-sectional design. The number of samples in this study there were 100 respondents. In multiple linear regression analysis found three variables that affect the quality of life: age, income and depression. The study further found that depression as the factors most associated with quality of life (p = 0.0005). Based on this study nurses need to be early detect patients depression and provided health education."

"Pendahuluan: Pada tahun 2021, penyakit kanker menggantikan stroke dan penyakit ginjal sebagai penyakit kedua penyebab klaim jaminan kesehatan nasional terbesar di Indonesia. Penelitian sebelumnya telah meneliti dampak determinan sosial kesehatan terhadap beban finansial kanker, namun tidak pada pasien kanker yang menjalani radioterapi.Tujuan: Mengetahui insidensi dan prediktor kebangkrutan finansial pasien kanker yang menjalani radioterapi dalam jaminan kesehatan nasional di pusat rujukan bervolume tinggi di Jakarta.Metode: Studi kohort campuran ini merekrut pasien pertama radioterapi pada Januari 2022-Maret 2023. Pasien diikuti sampai enam bulan setelah radioterapi. Analisis data dilakukan untuk mengidentifikasi kejadian dan prediktor kebangkrutan finansial, dengan kematian sebagai luaran kompetitor.Hasil: Total 115 pasien berhasil direkrut. Rerata usia peserta adalah 50 tahun dan 67% adalah perempuan. Enam bulan setelah radioterapi, 11,3% meninggal dan 36,5% mengalami kebangkrutan finansial. Prediktor kebangkrutan finansial yang teridentifikasi adalah pendidikan, pekerjaan, asal tempat tinggal, lokasi keganasan, dan indikasi radioterapi. Setelah menganggap variabel lain konstan, sektor informal dan tidak bekerja memiliki kemungkinan kebangkrutan finansial 99,45 kali (95% CI, 51,75–191,14) dan 36,93 kali (95% CI, 12,42–109,77) dari sektor formal. Indikasi adjuvan/neoadjuvan dan paliatif meningkatkan kemungkinan kebangkrutan finansial 17,65 kali (95% CI, 4,614–67,476) dan 22,54 kali (95% CI, 11,934–42,589). Setelah mempertimbangkan efek perancu usia dan transportasi, pengeluaran out of pocket tidak memprediksi kebangkrutan finansial dan kematian. Kesimpulan: Prediktor kebangkrutan finansial dalam penelitian ini berguna untuk pembuat kebijakan dalam intervensi beban keuangan pasien kanker di Indonesia. Rekomendasi pendekatan terbaik adalah intervensi populasi pasien sektor informal dan tidak bekerja, serta dengan indikasi radiasi adjuvan/neoadjuvan dan paliatif.

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Introduction: In 2021, cancer replaced stroke and kidney disease as the second largest cause of national health insurance claim in Indonesia. Previous research has examined the impact of social determinants of health on the financial burden of cancer, but not in cancer patients undergoing radiotherapy.

Objectives: To determine the incidence and predictors of financial catastrophe in cancer patients undergoing radiotherapy within the setting of national health insurance at our high-volume cancer referral center in Jakarta.

Methods: This mixed cohort study recruited patients first receiving radiotherapy within January 2022 to March 2023. Patients were followed up to six months after radiotherapy. Data analysis was conducted to identify incidence and predictors of financial catastrophe, considering death as a competing outcome.

Results: A total of 115 patients were successfully recruited. The mean age of participants was 50 years and 67% were women. Six months after radiotherapy, 11.3% died and 36.5% experienced financial catastrophe. The identified predictors of financial catastrophe were education, employment, place of residence, cancer site, and radiotherapy indication. After holding other variables constant, the informal and unemployed sectors have 99.45 times (95% CI, 51.75–191.14) and 36.93 times (95% CI, 12.42–109.77) odds of financial catastrophe than the formal sector. Adjuvant/neoadjuvant and palliative indications increased the odds of financial bankruptcy by 17.65 times (95% CI, 4.614–67.476) and 22.54 times (95% CI, 11.934–42.589), respectively. After adjusting for confounders, out-of-pocket spending did not significantly predict financial catastrophe or mortality. Conclusions: The predictors of financial catastrophe identified in this study will be useful in informing policymakers to give an impactful intervention to reduce the overlooked financial burden for cancer patients in Indonesia. The recommended approach is intervention in the informal sector and non-working population, as well as those with adjuvant/neoadjuvant and palliative radiation."

"Penyakit kusta merupakan salah satu dari delapan penyakit terabaikan atau Neglected Tropical Disease (NTD) yang masih ada di Indonesia Beban akibat penyakit kusta bukan hanya karena masih tingginya jumlah kasus yang ditemukan tetapi juga kecacatan dan kualitas hidup yang diakibatkannya. Bertujuan untuk mengidentifikasi tentang faktorfaktor yang berhubungan dengan kualitas hidup pada pasien kusta yang mengalami kecacatan di Rumah Sakit Kusta Dr. Sitanala Kota Tangerang. Penelitian kuantitatif non eksperimen menggunakan desain crossectional. Dengan besar sampel yang digunakan adalah 96 responden. Hasil penelitian menunjukan tidak ada hubungan secara signifikan antara umur (p 0,253), jenis kelamin (p 1,000), pendidikan (1,000), penghasilan (p 1,000), tingkat kecacatan (p 0,397), proses penyakit (1,000), Pengetahuan (0,626), stigma (p 0,955) dengan kualitas hidup. Ada hubungan yang signifikan antara keterbatasan aktivitas fungsional (p 0,002), koping (p 0,006) dan dukungan sosial (0,002) terhadap kualitas hidup. Faktor yang paling dominan berhubungan dengan kualitas hidup adalah keterbatasan aktivitas fungsional. Penyusunan standar asuhan keperawatan pasien kusta yang mengalami kecacatan diharapkan mempertimbangkan keterbatasan fungsional, koping individu dan dukungan sosial.

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Leprosy is one of the eight neglected tropical diseases (NTD) that still exist in Indonesia. Although the disability rate declines but the impact on quality of life remains. The purpose of this study was to explain the factors related to quality of life in leprosy patients with disabilities in Leprosy Hospital Dr Sitanala Kota Tangerang. The method of this research is non-experimental quantitative method and crossectional study design. The sample was 96 respondents of leprosy patients with disability.

The results showed no significant relation age (p 0.253), sex (p 1,000), education (1,000), income (p 1,000), disability rate (p 0.397), disease process (1,000), knowledge (p 0.626) , stigma (p 0.955) on quality of life. There are significant relationship among functional activity limitations (p 0.002), coping (p 0.006) and social support (0.002) on quality of life. Conclusion: There are relationship between the limitations of functional activity, individual coping and social support with quality of life. Implication standard care should involved disability, limited functional, coping and social support."

"ABSTRAKPasien Penyakit Ginjal Kronik (PGK) memerlukan hemodialisis akibat mengalami gangguan fungsi endokrin, metabolic, cairan elektrolit serta asam basa. Tindakan hemodialisis tersebut dapat berdampak terhadap kualitas hidup responden. Berbagai faktor yang diduga berhubungan dengan kualitas hidup pada responden hemodialisis diantaranya faktor demografi, lama menjalani hemodialisis, kadar hemoglobin, tekanan darah, adekuasi hemodialisis dan akses vaskuler.Tujuan penelitian untuk mengidentifikasi dan menjelaskan faktor yang berhubungan dengan kualitas hidup pada responden yang menjalani hemodialisis.Desain penelitian cross sectional deskriptif korelasi dengan jumlah sampel 95 orang yang menjalani hemodialisis di RSI Fatimah Cilacap dan RSUD Banyumas. Hasil penelitian menunjukkan bahwa responden yang berkualitas hidup baik (52.6%) dengan rata-rata usia 44.82±11.57 tahun. Tidak ditemukan hubungan antara kualitas hidup dengan faktor demografi, kadar hemoglobin, akses vaskuler, dan adekuasi hemodialisis. Kualitas hidup memiliki hubungan dengan tekanan darah (hipertensi) dengan p value 0.02 ; OR: 4.5 , dan lama waktu menjalani hemodialisis (≥11 bulan) dengan p value 0.035; OR:2.6. Penelitian ini menyimpulkan bahwa tekanan darah dan lama menjalani hemodialisis merupakan faktor independen yang berhubungan dengan kualitas hidup. Pada penelitian selanjutnya diharapkan meneliti tentang adekuasi nutrisi, kontrol Calcium & Phospat. Diperlukan konseling tentang nutrisi, farmakologi dan exercise untuk responden hemodialisis.

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ABSTRACT

Patients with Chronic Kidney Disease (CKD) requiring hemodialysis due to malfunctioning endocrine, metabolic, electrolyte and acid-base fluids. Hemodialysis may have an impact on respondents quality of life. Various factors are thought to relate to quality of life in hemodialysis respondents include demographic factors, duration undergoing hemodialysis, hemoglobin, blood pressure, adequacy hemodialysis and vascular access.

The aim is to identify and explain factors related to quality of life in respondents who underwent hemodialisis.Desain cross sectional descriptive correlation study with a sample of 95 people who underwent hemodialysis in RSI Fatimah Cilacap and Banyumas Hospital. Results showed that respondents who live good quality (52.6%) with an average age of 44.82 years ± 11:57. No relationship was found between quality of life by demographic factors, levels of hemoglobin, vascular access and hemodialysis adequacy. Quality of life has a relationship with blood pressure (hypertension) with p value 0:02; OR: 4.5, and the length of time undergoing hemodialysis (≥11 months) with a p value of 0035; OR: 2.6. This study concluded that blood pressure and duration of hemodialysis undergo an independent factor associated with quality of life. In further studies are expected to examine the adequacy of nutrition, calcium and phosphate control. Required counseling about nutrition, pharmacology and exercise for the respondent hemodialysis."

"ABSTRAKTuberkulosis (TB) masih menjadi masalah kesehatan di Indonesia dan diKabupaten Pesawaran. Pelaksanaan tugas kesehatan keluarga dapatmempengaruhi kualitas hidup pasien TB di Kabupaten Pesawaran. Penelitian inibertujuan untuk mengetahui hubungan karakteristik klien dan pelaksanaan tugaskesehatan keluarga dengan kualitas hidup klien TB paru. Desain deskriptifkorelatif dengan pendekatan cross-sectional digunakan dalam penelitian pada 41pasien TB berumur 18-59 tahun pada fase intensif pengobatan dari bulan Aprilsampai Mei 2014. Hasil penelitian menunjukkan kualitas hidup klien TBterganggu. Ada hubungan yang signifikan antara pekerjaan (p = 0,034), tugaskesehatan keluarga (p = 0,005), pendapatan (p = 0,030) dan dukungan keluarga (p= 0,012) dengan kualitas hidup klien TB. Pengembangan program yangterintegrasi antara program TB dan perawatan kesehatan masyarakat dan programlainya untuk meningkatkan kemampuan keluarga melaksanakan tugas kesehatankeluarga.

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ABSTRACTTuberculosis (TB) is a major public health problem in Indonesia as well as inPasawaran. The family health tasks implementation may affect Health RelatedQuality Of Life (HRQOL) among TB patients in Pesawaran. This study aims todetermine the corelation of characteristics of patients and family health tasks toHRQOL TB patients. The descriptive correlative design with cross-sectionalapproach was applied to this study to 41 patients. The inclusion criteria for therespondents are aged range at18-59 years old and under the initial phase of TBtreatment from April to May 2014. The results showed that HRQOL among TBpatients generally were impaired. The characteristics associated to HRQOLamong TB patients were occupation (p = 0.034), family health tasks (p = 0.002),income (p = 0.034) and family support (p = 0.012) . An integrated program needto be developed to increase family’s ability to improve family health tasks."

"[Latar belakang : Kelompok geriatri memiliki karakteristik khusus yang berpotensi meningkatkan lama masa rawat dan menurunkan kualitas hidup dan terbukti dapat diperbaiki dengan Pendekatan Paripurna Pasien Geriatri (P3G). Terdapat kemungkinan adanya perbedaan antara lama masa rawat dan kualitas hidup pasien geriatri dengan P3G sebelum dengan sesudah adanya sistem pembiayaan JKN (Jaminan Kesehatan Nasional)Tujuan: melakukan evaluasi pelaksanaan sistem JKN terhadap lama rawat, quality adjusted life days (QALD) dan efektivitas biaya pasien geriatri yang dirawat di ruang rawat geriatri akut RSCM.Metode: Penelitian kohort retrospektif dengan kontrol historis dilakukan pada pasien geriatri ≥ 60 tahun dengan ≥ 1 sindrom geriatri yang dirawat di ruang rawat geriatri akut RSCM periode Juli-Desember 2013 (era non JKN) dan Januari-Juni 2014 (era JKN). Perbedaan dua rerata lama rawat dan QALD era non JKN dengan JKN dianalisis dengan uji-T tidak berpasangan. Dilakukan juga penghitungan incremental cost effectivity ratio (ICER) program JKN dengan outcome lama rawat dan QALD yang akan dipresentasikan dalam skema ICER.Hasil: Dari total 225 subjek, 100 subjek berada di era non JKN dan 125 subjek di era JKN dengan karakteristik relatif sama. Rerata usia adalah 70 [60-86] tahun dan 68 [60-85] tahun secara berurutan. Tidak ada perbedaan lama rawat antara era non JKN dan JKN dengan median 12 [2-76] dan 12 [2-59] hari, p= 0,974. Begitu juga tak ada perbedan QALD antara kelompok non JKN dan JKN dengan median 0,812[-3,1 – 24,37] dan 0,000 [-7,37 – 22,43], p= 0,256. Biaya per satu kali rawat pada era non JKN adalah Rp. 19.961,000 [Rp.2.57 juta –Rp. 100 juta] dan JKN Rp. 20.832.000,- [Rp.3.067 juta - Rp.100 juta]. Skema ICER memperlihatkan biaya rawat lebih mahal Rp. 1.500.000,- untuk mendapatkan lama rawat lebih pendek 0,91 hari. Berdasarkan QALD, biaya rawat lebih murah Rp.3.484.887,- dengan 0,25 QALD lebih rendah dibanding era non JKN.Simpulan: Tidak ada perbedaan lama rawat dan kualitas hidup pasien yang dirawat pada era non JKN dengan era JKN.;Background: Geriatric population with special characteristics tend to have longer average length of stay and lower quality of life. CGA (comprehensive Geriatric Assesment) was proven to improve the outcomes and has already be the standard procedure in RSCM. There were concerns on the difference between length of stay and quality of life before and after NHIP (National Health Insurance program) applied.Objectives: To evaluate the implementation of NHIP system according to length of stay, quality adjusted life days and cost effectiveness of care in geriatric patients in acute care for elderly Cipto Mangunkusumo HospitalMethod : This is a retrospective cohort study with historical control. The subjects were geriatric patients ≥60 years old with one or more geriatrics giants between Juli to Desember 2013 (Non NHIP) and Januari to Juni 2014 (NHIP). We used independent T test to compare between two mean of length of stay and QALD.Results : The characteristics were relatively similar between 100 subject in non NHIP group and 125 subject in NHIP group. the median of age were 70 [60- 86] dan 68 [60- 85] years old respectively. There was no significant difference between length of stay in non NHIP, median 12[2-76] days and NHIP group, median 12[2-59] days, p= 0,974. Quality of life which described as QALD proved that there was also no significant difference between non NHIP, median 0,812[-3,1 – 24,37] and NHIP group, median 0,000 [-7,37 –22,43], p= 0,256. The cost spent for one admission was Rp. 19.961,000 [Rp.2.57–Rp. 100 millions] in non NHIP and Rp. 20.832.000,- [Rp.3.067-Rp.100 millions] in NHIP group. Incremental cost effectiveness ratio (ICER) scheme showed NHIP is more expensive Rp.1.500.000,- to have 0,91 shorter days than non NHIP system. For QALD, the cost was cheaper Rp.3.484.887,- to have 0,25 QALD lower than non NHIP.Conclusion: There were no difference in length of stay and quality of life of patients who admitted in acute geriatric Cipto Mangunkusumo hospital with CGA approach before and after National Health Insurance program implementation., Background: Geriatric population with special characteristics tend to have longer average length of stay and lower quality of life. CGA (comprehensive Geriatric Assesment) was proven to improve the outcomes and has already be the standard procedure in RSCM. There were concerns on the difference between length of stay and quality of life before and after NHIP (National Health Insurance program) applied.Objectives: To evaluate the implementation of NHIP system according to length of stay, quality adjusted life days and cost effectiveness of care in geriatric patients in acute care for elderly Cipto Mangunkusumo HospitalMethod : This is a retrospective cohort study with historical control. The subjects were geriatric patients ≥60 years old with one or more geriatrics giants between Juli to Desember 2013 (Non NHIP) and Januari to Juni 2014 (NHIP). We used independent T test to compare between two mean of length of stay and QALD.Results : The characteristics were relatively similar between 100 subject in non NHIP group and 125 subject in NHIP group. the median of age were 70 [60- 86] dan 68 [60- 85] years old respectively. There was no significant difference between length of stay in non NHIP, median 12[2-76] days and NHIP group, median 12[2-59] days, p= 0,974. Quality of life which described as QALD proved that there was also no significant difference between non NHIP, median 0,812[-3,1 – 24,37] and NHIP group, median 0,000 [-7,37 –22,43], p= 0,256. The cost spent for one admission was Rp. 19.961,000 [Rp.2.57–Rp. 100 millions] in non NHIP and Rp. 20.832.000,- [Rp.3.067-Rp.100 millions] in NHIP group. Incremental cost effectiveness ratio (ICER) scheme showed NHIP is more expensive Rp.1.500.000,- to have 0,91 shorter days than non NHIP system. For QALD, the cost was cheaper Rp.3.484.887,- to have 0,25 QALD lower than non NHIP.Conclusion: There were no difference in length of stay and quality of life of patients who admitted in acute geriatric Cipto Mangunkusumo hospital with CGA approach before and after National Health Insurance program implementation.]"

"Pendahuluan: Luka bakar adalah cedera berat akibat kerusakan atau kehilangan jaringan yang disebabkan oleh kontak dengan sumber panas serta berpengaruh pada seluruh fungsi sistem tubuh. Pada luka bakar, cedera mengakibatkan kerusakan pada penampilan seseorang dan citra tubuhnya sehingga perasaan negatif yang dialami juga dapat diikuti masalah lainnya yang menyebabkan psikopatologi atau gejala masalah kejiwaan. Metode: Studi potong lintang dengan metode pengambilan sampel secara konsekutif yang melibatkan pasien luka bakar di poliklinik Bedah Plastik serta Unit Luka Bakar RSCM, Jakarta dilakukan antara April-Mei 2017. Responden mengisi kuesioner self-report berupa Kuesioner Biodata untuk mendapat profil demografi, SRQ-20 titik potong ge;6 untuk melihat gejala psikopatologi, Kuesioner WHOQoL-BREF untuk melihat skor kualitas yang meliputi domain fisik, psikologis, sosial, dan lingkungan. Data yang didapat diolah menggunakan analisis korelasi Spearman. Hasil: 56 pasien luka bakar berpartisipasi dalam penelitian ini. 30.4 pasien tidak bekerja serta 48.2 memiliki penghasilan sangat rendah per bulannya. 67.9 pasien mengalami luka bakar akibat api dengan 44.6 mengalami luas luka bakar 10-30 TBSA dan mayoritas individu 80.4 mengalami luka bakar kombinasi derajat 2 3. Berdasarkan analisis yang dilakukan, 57.1 pasien mengalami psikopatologi dan rerata penilaian kualitas hidup yang rendah domain fisik 48.1, domain psikologis 51.5 . Didapatkan korelasi negatif yang bermakna p le; 0.05 antara domain psikologis dengan gejala depresi, cemas, dan penurunan energi; domain fisik dengan gejala penurunan energi, serta domain sosial dengan gejala cemas. Pembahasan: Penelitian yang dilakukan mendapatkan berbagai hasil yang bermakna untuk membuktikan adanya korelasi antara psikopatologi dengan berbagai domain kualitas hidup yang terpengaruh.

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Introduction: Burns result in severe injuries that cause damage or loss of tissue due to contact with sources of heat resulting in injuries to all body systems. Injuries of the skin, which functions as a barrier to protect internal organs, may cause patients to experience damage to one's physical appearance and body image causing negative feelings that may lead to other problems such as psychopathology and symptoms of mental illness.

Method: A cross sectional study with consecutive sampling method of burn patients who were treated at the Plastic Surgery Outpatient Clinic and Burn Unit of RSCM was conducted between April May 2017. Subjects were asked to fill in self report questionnaires including patient identity form, SRQ 20 cutoff point ge 6 for presence of psychopathology, and WHOQoL BREF to obtain mean scores of quality of life that include four domains of physical, psychological, social, and environment assessment. Data collected was analyzed using correlation analysis.

Result: 56 burn patients were included in the study. 30.4 did not work and 48.2 had very low income per month. 67.9 patients experienced burns due to fire and 44,6 had burns 10 30 of the TBSA with a majority of patients 80.4 experiencing a combination of second third degree burns. Based on the analysis, 57.1 of patients had a form of psychopathology and low mean scores of quality life physical domain 48.1, psychological domain 51.5. Significant negative correlations p le 0.05 were obtained between the psychological domain and symptoms of depression, anxiety, low energy physical domain and low energy and social domain with anxiety.

Discussion: This study obtained significant results to identify the correlation between psychopathology and various domains of quality of life affected."