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Abstrak :
Tujuan : Pembangunan pusat pelayanan radioterapi sampai saat ini belum menjadi prioritas utama khususnya di negara berkembang. Tingginya biaya yang dihabiskan untuk pusat pelayanan merupakan salah satu alasannya. Biaya terkait sumber daya manusia (SDM) berhubungan erat dengan biaya operasional yang dikeluarkan. Pengetahuan terkait produktivitas yang mencakup beban SDM dan penggunaan pesawat radiasi merupakan dasar untuk terciptanya pelayanan radioterapi dengan biaya efektif. Oleh karena itu, digagaslah penelitian tentang produktivitas SDM dan penggunaan pesawat radiasi di pusat pelayanan Onkologi Radiasi di Indonesia sebagai bagian dari penelitian terkait biaya radioterapi. Metode : studi deskriptif cross sectional. Subjek penelitian merupakan seluruh pusat pelayanan Onkologi Radiasi di Indonesia yang telah melakukan pelayanan selama setahun. Subjek diberikan kuesioner secara digital yang berisikan pertanyaan terkait ketersediaan SDM dan pesawat radiasi. Data yang didapat kemudian dimasukkan ke dalam Radiotherapy Resources and Cost Calculator (RRCC) v.20 serta dilakukan penghitungan dengan asumsi aktual sesuai kondisi di Indonesia. Hasil : beban kerja Dokter Spesialis, Fisika Medis, dan RTT di Indonesia bervariasi dengan rerata beban kerja secara berurutan sebesar 92,5% (asumsi aktual), 97,7%, 107,6%, dan 80,8%. Beban kerja SDM secara statistik lebih tinggi pada pusat pelayanan dengan brakhiterapi dan pusat pelayanan dengan jumlah pasien yang tinggi. Rerata penggunaan pesawat radiasi sebesar 104,1% dan 138% secara statistik signifikan lebih tinggi pada rumah sakit pemerintah dan jumlah pasien tinggi. Jumlah pasien memiliki korelasi kuat dengan jumlah kebutuhan dokter spesialis (r=0,927), fisika medis (r=0,838) dan RTT (r=0,886). Jumlah pasien dapat menjadi prediktor untuk menentukan kebutuhan Dokter Spesialis dengan adjusted R2 = 72,1% dan 80%, kebutuhan fisika medis adjusted R2 = 69,3%, dan kebutuhan RTT dengan adjusted R2 = 83,3%.Kesimpulan : produktivitas SDM dan penggunaan pesawat radiasi pada pusat pelayanan Onkologi Radiasi di Indonesia bervariasi. Penghitungan produktivitas dengan RRCC v.20 dapat diaplikasikan pada pusat pelayanan Onkologi Radiasi di Indonesia. ......Objective: The development of a radiotherapy center has not been a top priority, especially in developing countries. The high cost spent on service centers is one of the reasons. Human resource costs are inextricably linked to operational expenses. Knowledge related to productivity, which includes the workload of human resources and the use of radiation equipment, is the basis for creating cost-effective services. Therefore, research was initiated on human resource productivity and the use of radiation equipment at radiotherapy centers in Indonesia as part of research related to radiotherapy costs. Method: descriptive cross-sectional study. The research subjects were all radiotherapy centers in Indonesia that had been running for a year. Subjects were given a digital questionnaire containing questions related to the availability of human resources and radiation equipment. The data obtained is then entered into the Radiotherapy Resources and Cost Calculator (RRCC) v.20, and calculations are carried out with actual assumptions according to conditions in Indonesia. Results: The workload of specialists, medical physicists, and RTTs in Indonesia varies, with an average workload of 92.5% (actual assumption), 97.7%, 107.6%, and 80.8%, respectively. HR workload is statistically higher in centers with brachytherapy and in centers with a high number of patients. The mean use of radiation equipment was 104.1% and 138%, respectively, statistically significantly higher in government hospitals, and centers with a high number of patients. The number of patients has a strong correlation with the number of specialists (r = 0.927), medical physics (r = 0.838), and RTT (r = 0.886). The number of patients can be a predictor for determining the need for specialist doctors with adjusted R2 values of 72.1% and 80%, medical physics needs with adjusted R2 values of 69.3%, and RTT needs with adjusted R2 values of 83.3%. Conclusion: HR productivity and the use of radiation equipment at radiation oncology service centers in Indonesia vary. The calculation of productivity with RRCC v.20 can be applied to radiotherapy centers in Indonesia.

Abstrak :
Latar Belakang: Postoperative gastrointestinal tract dysfunction (POGD) merupakan komplikasi yang sering terjadi pada pasien pascaoperasi yang menyebabkan peningkatan morbiditas dan lama rawat inap. Malnutrisi sering terjadi pada periode perioperasi. Indeks massa bebas lemak menjadi salah satu penilaian untuk identifikasi pasien dengan malnutrisi. Penelitian ini bertujuan untuk mengetahui hubungan indeks massa bebas lemak praoperasi dengan POGD menggunakan skor Intake-Feeling Nauseated, Emesis, Exam, Duration (I-FEED) dan lama rawat inap pasien pascalaparotomi elektif. Metode: Studi potong lintang dilakukan pada 92 subjek berusia 18-64 tahun yang menjalani laparotomi elektif di RSUPN Dr. Cipto Mangunkusumo selama bulan Maret-Mei 2023. Pengukuran indeks massa bebas lemak praoperasi menggunakan bioelectrical impedance analysis (BIA) SECA mBCA-525. Penilaian POGD berdasarkan American Society for Enchanced Recovery and Perioperative Quality Initiative Joint Consensus Statement menggunakan skor I-FEED. Penilaian rawat inap dengan data rekam medis dan perhitungan lama rawat pascaoperasi. Dilakukan analisis univariat, bivariat dan analisis multivariat pada studi ini. Hasil: Rerata indeks massa bebas lemak pasien 16,5  2,3 kg/m2 dengan kategori rendah sebanyak 29,3%. POGD terjadi pada 41,3% subjek dan median lama rawat pascaoperasi 4 (2-17) hari. Tidak ditemukan korelasi yang bermakna secara statistik pada indeks massa bebas lemak praoperasi dengan POGD menggunakan skor I-FEED dan lama rawat inap pascaoperasi. Analisis klasifikasi indeks massa bebas lemak praoperasi yang rendah meningkatkan risiko kejadian POGD (OR 2,84; 95% CI 1,13-7,16). Analisis lanjutan dengan regresi linier menunjukkan serum albumin praoperasi dan durasi operasi menjadi faktor yang paling berkorelasi dengan skor I-FEED serta asupan protein dan karbohidrat berkorelasi dengan lama rawat pascaoperasi. Kesimpulan: Tidak ditemukan korelasi bermakna antara indeks massa bebas lemak praoperasi dengan POGD menggunakan skor I-FEED dan lama rawat inap pasien pascalaparotomi elektif. ......Background: Postoperative gastrointestinal tract dysfunction (POGD) is a complication that increases morbidity and length of stay. Malnutrition often occurs in the perioperative period. Fat-free mass index is one of the assessments for identifying patients with malnutrition that caused complication. This study aims to assess the association between preoperative fat-free mass index and POGD using the Intake-Feeling Nauseated, Emesis, Exam, Duration (I-FEED) score and postoperative length of stay in elective laparotomy patients. Methods: This cross-sectional study was conducted on 92 subjects aged 18-64 years at Dr. Cipto Mangunkusumo Hospital who underwent elective laparotomy from March to May 2023. The fat-free mass index was measured using a multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. The POGD assessment was based on the American Society for Enchanced Recovery and Perioperative Quality Initiative Joint Consensus Statement using the I-FEED score. The length of stay assessment calculated with postoperative length of hospitalization and medical record. Univariate, bivariate, and multivariate analyses were performed in this study. Results: The average of patient’s fat-free mass index was 16.5  2,3 kg/m2 and found 29.3% of subjects in low category. 41.3% of subjects developed POGD, and median length of postoperative hospital stay was 4 (2-17) days. There was no statistically significant correlation between preoperative fat-free mass index and POGD using I-FEED score and postoperative length of hospital stay. Classification analysis of low preoperative fat-free mass index increased the risk of POGD (OR 2.84; 95% CI 1.13-7.16). Further analysis using linear logistic for other confounding factors revealed that preoperative serum albumin and duration of surgery were the most correlated factors in I-FEED score. Protein and carbohydrate intake were correlated with postoperative length of hospital stay. Conclusion: There is no correlation between preoperative fat-free mass index and POGD using I-FFEED score and length of stay after elective laparotomy.