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"Drug users in Indonesia are threatened by many health and social challenges of which HIV, HBV and HCV are dominant and hence the utilization of health services is vital for them. This study was aimed to determine the individual factors that influence the health service utilization among drug users in west Java (Bandung), Indonesia. We used secondary data from the National Drug Survey Indonesia 2008, with a sample size of 130 drug users. The individual determinant of health service utilization were studied in three categories, predisposing, enabling and need factors we found that living with parents, drug overdose, respiratory and miscellaneous symptoms were significantly associated with health service utilization. Those living with parents were more likely to use health services than those living with others. Those who had Digestive and Miscellaneous symptoms and did not experience drug overdose were also more likely to use health service utilization. We did not find any association among the predisposing factors and health service utilization among drug users."

"Prevalensi Diabetes melitus meningkat pesat dalam satu decade terakhir, pekerja kebersihan menjadi salah satu agregat yang berisiko diabetes melitus karena kondisi pekerjaan, kehidupan, sosial ekonomi, dan gaya hidup. penelitian ini bertujuan mengetahui hubungan faktor determinan kesehatan pekerja kebersihan dengan risiko diabetes melitus. Penelitian ini merupakan penelitian kuantitatif non eksperimental cross sectional melalui pendekatan deskriptif korelatif dengan sampel sebanyak 291 orang. Hasil penelitian menunjukan responden Rata-rata berusia 33 tahun (95% CI), laki-laki (76.6%), suku Betawi (49.5%), menikah (72.5%), lulus SMA ( 95%), ≥UMR (100%), memiliki rumah sendiri ( 50.9 %) dan tidak memiliki pekerjaan sampingan (94%), memiliki kebiasaan merokok ( 55%), dan tidak mengonsumsi alkohol ( 98.3 %). lama kerja 7 tahun (95% CI) , waktu jam kerja 11 jam (95% Cl), tingkat stres sedang, dan dukungan sosial baik. Rata-rata aktivitas fisik 3840 METs/minggu (95%CI), pola diet baik, lama waktu tidur 7 jam (95%CI), risiko diabetes melitus sangat rendah (3) (95% CI). Terdapat hubungan usia (p=0.003), jenis kelamin (p=0.000), dan kebiasaan merokok (p=0.000) dengan risiko diabetes melitus pada pekerja kebersihan. Pekerja kebersihan hendaknya mempertahankan dan meningkatkan pola hidup sehat untuk mencegah risiko diabetes melitus.

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The prevalence of diabetes mellitus has increased rapidly in the past decade. Sanitation workers are considered a high-risk group for diabetes mellitus due to their occupational conditions, lifestyle, socioeconomic factors, and living conditions. This study aims to investigate the relationship between determinants of health among sanitation workers and the risk of diabetes mellitus. A cross-sectional method was employed, with a sample size of 291 individuals. The research findings indicate that the average age of respondents was 33 years (95% CI), predominantly male (76.6%), of Betawi ethnicity (49.5%), married (72.5%), high school graduates (95%), earning at least the minimum wage (100%), owning their own homes (50.9%), having no secondary jobs (94%), being smokers (55%), and abstaining from alcohol consumption (98.3%). The average duration of work was 7 years (95% CI), with an average working time of 11 hours (95% CI). Moderate levels of stress and good social support were reported. The average physical activity level was 3840 METs/week (95% CI), with a healthy dietary pattern and 7 hours of sleep per night (95% CI). The risk of diabetes mellitus was found to be very low (3) (95% CI). There was a significant association between age (p=0.003), gender (p=0.000), smoking habits (p=0.000), and the risk of diabetes mellitus among sanitation workers. It is recommended that sanitation workers maintain and improve their healthy lifestyle practices to prevent the risk of diabetes mellitus."

"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."