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Tujuan: untuk mengetahui karakteristik pasienDM tipe 2 di RSUP NTB tahun 2012-2013, serta mengukur asosiasi sederhana DSME terhadap lama hari rawat pasien di RSUP NTB. Desain dan
Metode: Tinjauan secara retrospektif terhadap 199 rekam medis pasien DM tipe 2.
Hasil: DSME disampaikan oleh perawat dan ahli gizi. Akan tetapi, tidak seluruh pasien mendapat edukasi. Di RSUP NTB, yang tercatat edukasi tentang: diet (53%),aktivitas fisik (33%), tentang obat (8%), komplikasi (1%), edukasi lainnya (6%),dan 27% pasien yang tidak mendapat edukasi apapun oleh perawat. Sebanyak 43.7% pasien yang mendapat konseling gizi oleh ahli gizi. Pasien yang mendapatDSME memiliki lama hari rawat yang lebih singkat dibandingkan dengan yang tidak mendapat edukasi.
Kesimpulan: berdasarkan catatan rekam medis DSMEdi RSUP NTB belum optimal dan DSME berperan mempersingkat lama harirawat pasien.
Kata kunci: Diabetes Self Management Education, DM tipe 2, lama hari rawat,rawat inap, RSUP NTB.
Background: Type 2 Diabetes Mellitus (type 2 DM) is a disease that can not becured. An adequate education is one of way management of type 2 DM. DiabetesSelf Management Education (DSME) in hospitals not adequate and impact onlength of stay.
Purpose: this study to describe characteristics of patients withtype 2 DM at General Hospital West Nusa Tenggara 2012-2013, and measuredassociation of DSME to length of stay.
Design and Method: Descriptiveresearch method with retrospective design. Number of samples involved in thisstudy is 199 medical records of patients with type 2 DM.
Result: DSMEdelivered by nurses and nutritionists. But, not all patients get DSME. DSMErecorded was about: diet (53%), exercises (33%), medicines (8%),complications of type 2 DM (1%), other education (6%), and 27% of patients donot get any DSME. Patients with DSME has shorter length of stay than patientwithout DSME.
Conclusion: according to medical records, DSME at GeneralHospital West Nusa Tenggara 2012-2013 is not optimal and DSME role inlength of stay of patients with type 2 Diabetes Mellitus.
Keywords: Diabetes Self Management Education; type 2 DM; length of stay,inpatient, RSUP NTB.
Type 2 diabetes mellitus is a non-communicable disease that can be treated, and its consequences can be prevented or delayed through proper diet, physical activity, medication, as well as regular screening and treatment of complications. However, this disease is often diagnosed several years after onset, by which time complications and comorbidities may have developed, making it one of the top 10 causes of hospitalizations. This study aims to determine the effect of severity and comorbidity on the length of hospital stay among patients with type 2 diabetes mellitus in advanced referral health facilities (FKRTL) among BPJS Kesehatan participants in 2023, controlled for variables such as FKRTL type, FKRTL ownership, segmentation, care class, age, and gender. This research used 2023 BPJS Kesehatan sample data with a cross-sectional study design. The analysis included univariate, bivariate, and multivariate methods. Bivariate analysis showed a significant relationship between severity and length of stay (p-value = 0.001), while comorbidities were not significantly associated with length of stay (p-value = 0.285). Moderate to severe severity and comorbidities with a CCI score of ≥1 were associated with a higher risk of prolonged hospitalization and a lower risk of short hospitalization compared to the ideal length of stay (RRR = 4.95; 95% CI = 0.82–29.85; RRR = 0.46; 95% CI = 0.29–0.72 | RRR = 1.11; 95% CI = 0.25–4.92; RRR = 0.67; 95% CI = 0.41–1.10). Multivariate analysis controlling for FKRTL type, FKRTL ownership, segmentation, care class, age, and gender showed that the association between severity and length of stay remained significant after controlling for FKRTL type and FKRTL ownership, while the association between comorbidity and length of stay remained insignificant even after adjusting for control variables. Efforts to enhance clinical early detection programs for the severity level and comorbidities of type 2 diabetes mellitus are necessary to prevent prolonged hospital stays due to complications and disease severity, which contribute to a significant healthcare burden.
ABSTRAK Penelitian ini bertujuan untuk mengetahui estimasi lama hari rawat dan total tagihan rawat inap pasien stroke hemoragik di Unit Stroke Rumah Sakit “X” Yogyakarta tahun 2011-2012. Desain penelitian yang digunakan yaitu cross sectional. Sampel dalam penelitian ini yaitu seluruh pasien di unit stroke dengan diagnosis utama stroke hemoragik yang memenuhi kriteria inklusi. Hasil penelitian mendapatkan persamaan regresi untuk estimasi lama hari rawat pada pasien keluar hidup yaitu; Lama Hari Rawat = 7,046 + 0,023 (umur) + 0,935 (jenis kelamin) + 0,118 (diagnosis sekunder) + 8,024 (riwayat ICU) + 1,744 (hari keluar). Persamaan regresi untuk mengestimasi total tagihan rawat inap yaitu; Total Tagihan Rawat Inap = Rp 2.854.882 + Rp 7.810 (umur) + Rp 162.803 (diagnosis sekunder) + Rp 3.738.001 (ICU) + Rp 364.164 (lama hari rawat) – Rp 384.543 (hari masuk) + Rp 854.197 (kelas I) Rp 1.971.282 (VIP). Diharapkan hasil penelitian ini berguna bagi penderita stroke dan keluarga, manajemen rumah sakit, pihak pembayar dan para pembuat kebijakan dalam mengantisipasi dampak ekonomi dari meningkatnya kasus stroke.Beban ekonomi akibat stroke terutama karena biaya perawatan di rumah sakit semakin meningkat seiring meningkatnya kejadian stroke. Penelitian ini bertujuan untuk mengetahui estimasi lama hari rawat dan total tagihan rawat inap pasien stroke hemoragik di Unit Stroke Rumah Sakit “X” Yogyakarta tahun 2011-2012. Desain penelitian yang digunakan yaitu cross sectional. Sampel dalam penelitian ini yaitu seluruh pasien di unit stroke dengan diagnosis utama stroke hemoragik yang memenuhi kriteria inklusi. Hasil penelitian mendapatkan persamaan regresi untuk estimasi lama hari rawat pada pasien keluar hidup yaitu; Lama Hari Rawat = 7,046 + 0,023 (umur) + 0,935 (jenis kelamin) + 0,118 (diagnosis sekunder) + 8,024 (riwayat ICU) + 1,744 (hari keluar). Persamaan regresi untuk mengestimasi total tagihan rawat inap yaitu; Total Tagihan Rawat Inap = Rp 2.854.882 + Rp 7.810 (umur) + Rp 162.803 (diagnosis sekunder) + Rp 3.738.001 (ICU) + Rp 364.164 (lama hari rawat) – Rp 384.543 (hari masuk) + Rp 854.197 (kelas I) Rp 1.971.282 (VIP). Diharapkan hasil penelitian ini berguna bagi penderita stroke dan keluarga, manajemen rumah sakit, pihak pembayar dan para pembuat kebijakan dalam mengantisipasi dampak ekonomi dari meningkatnya kasus stroke.
ABSTRACT The economic burden of stroke due primarily because of the cost of hospital care are increasing with the increasing incidence of stroke. This study aims to determine the estimated length of stay of hospitalization and the total hospitalization billings of hemorrhagic stroke patients in Stroke Unit "X" Hospital, Yogyakarta, 2011-2012. The research design used was cross-sectional. The sample in this study were all patients at the Stroke Unit with a primary diagnosis of hemorrhagic stroke who meet the inclusion criteria. The results got the regression equation for estimating length of stay is; Length of Stay = 7,046 + 0,023 (age) + 0,935 (sex) + 0,118 (secondary diagnose) + 8,024 (history in ICU) + 1,744 (day of discharge). The regression equation for estimating Inpatient Total Billings = Rp 2.854.882 + Rp 7.810 (age) + Rp 162.803 (secondary diagnose) + Rp 3.738.001 (history in ICU) + Rp 364.164 (length of stay) – Rp 384.543 (day of admission) + Rp 854.197 (class I) Rp 1.971.282 (VIP).
Penyakit Ginjal Kronik merupakan salah satu penyakit tidak menular yang prevalensinya terus meningkat dari tahun ke tahun. Penurunan fungsi ginjal menjadi penyakit ginjal kronik tahap akhir mengakibatkan pasien harus menjalani terapi penganti ginjal semur hidup. Terapi yang paling banyak digunakan saat ini adalah hemodialisis. Meskipun alat hemodialisis telah banyak dan canggih, namun ketahanan hidup pasien PGK masih rendah. Salah satu penyebab rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis adalah komorbiditas atau penyakit penyerta. Komorbiditas yang saat ini paling umum pada pasien PGK yang menjalani hemodialisis adalah diabetes mellitus. Desain penelitian ini menggunakan desain kohort restrospektif. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan dan 1 tahun pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus lebih rendah dibandingkan pasien dengan komorbiditas bukan diabetes mellitus. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan, 1 tahun dan pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus adalah dalah 69%, 55% 34%, dan 34% sedangkan komorbiditas bukan diabetes mellitus adalah 76%, 61%, 53% dan 51%. Secara bivariat, pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus memiliki risiko untuk meninggal 1.75 kali lebih cepat dibandingkan dengan pasien komorbiditas bukan diabetes mellitus. Sementara itu dari analisis multivariat didapatkan variabel konfonder yang mempengaruhi rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis pada pasien dengan komorbiditas diabetes mellitus adalah akses vaskular.
Chronic kidney disease (CKD) is one of the no-communicable diseases which increase every years. The decline of kidney function will progress to End Stage Renal Disease (ESRD). The ESRD patients has to undurgo dialysis therapy during their lives. the most dialysis therapy is hemodialysis. Although the machine of hemodialysis are quiet a a lot and sophisticate, the survival of CKD patients is still low. One of the causes of low survival PGK patient on maintenance hemodialysis is the comorbid or present disease. Nowadays the most common comorbid for CKD patient with hemodialysis is diabetes mellitus. Research design is using Kohort Retrospective. The probability of survival of 3 months,6 months, 9 months and 1 year CKD patients on maintenance hemodialysis with comorbid diabetes mellitus is lower than patients without comorbidities of diabetes mellitus. The probability ofsurvival of 3 months, 6 months, 9 months, 1 year and CKD patients on maintenance with comorbid diabetes mellitus are 69%, 55% 34%, and 34% while one not comorbid diabetes mellitus are 76%, 61%, 53 % and 51%. In bivariate analysis,CKD patients on maintenance hemodialis with comorbid diabetes mellitus have a risk of dying 1.75 times faster than patients without comorbiddiabetes mellitus. Meanwhile obtained from multivariate analysis confonder variables that affect the low survival of CKD patients on maintenance in patients with comorbid diabetes mellitus is a vascular access.
Diabetes mellitus type 2 is a serious public health problem in the world. Diabetes mellitus is also the main cause of morbidity, mortality, disability, and economic loss all over the world include development countries. The research objective is to estimate the diabetes mellitus prevalence, risk factors, and prediction model in urban areas of Indonesia. By analyzed The Indonesia Basic Health Research Survey 2007 that consist of 19,960 respondents aged above 15 years old who had Oral Glucose Tolerance Test (OGTT). Only 18,746 respondents had been analyzed. Logistic regression with two stage design sampling was used to analyze the data.
