Background: Valvular heart disease (VHD) represents a major cardiovascular burden that requires efficient management in tertiary healthcare facilities. Length of stay (LOS) is a key indicator for assessing bed utilization and operational efficiency. This study aimed to describe the distribution and variation in LOS according to the characteristics of patients with valvular heart disease at the University of Indonesia Hospital (RSUI). Methods: This quantitative cross-sectional study employed a census (total sampling) approach using secondary medical record data from 227 patients treated at the University of Indonesia Hospital (RSUI) between January 2021 and December 2024. The independent variables included clinical characteristics (number of affected valves, disease severity, LVEF, TAPSE, and heart failure status) and comorbidities (hypertension, coronary artery disease, and the number of other comorbidities). Pattern analysis was conducted using descriptive-comparative methods by examining the distribution and variation of length of stay in the overall study population, followed by stratification according to sex and age. Results: The majority of patients were aged ≥50 years (79.7%), male (53.3%), and had heart failure (74.4%). Most patients had reduced left ventricular ejection fraction (LVEF ≤50%; 60.8%), right ventricular dysfunction (TAPSE ≤16 mm; 27.8%), and comorbidities such as chronic kidney disease (36.1%) and diabetes mellitus (26.9%). The median length of stay (LOS) was 5 days (IQR: 2 days; range: 2–18 days). Overall, LOS was relatively homogeneous across the study population. However, stratified analysis showed that coronary artery disease (CAD) was associated with a shorter LOS among male patients, whereas in the 60–69-year age group, severe valvular disease, right ventricular dysfunction, and heart failure were associated with a longer LOS. Patients aged >69 years had a shorter LOS, reflecting a more conservative therapeutic approach. Conclusion: The LOS of patients with VHD at RSUI was relatively homogeneous, with a median of 5 days, suggesting that standardized clinical pathways effectively reduced variations in healthcare delivery. RSUI is recommended to implement risk stratification upon admission by considering right ventricular function (TAPSE) and major comorbidities, particularly among pre-elderly and early elderly patients.

Background: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with one of the highest health burdens in Indonesia, with prevalence nearly doubling over a decade, from 6.9% (2013) to 11.7% (2023), placing Indonesia as the country with the fifth-highest number of diabetes patients in the world (20.4 million in 2024). T2DM patients face a threefold higher risk of cardiovascular disease and a tenfold higher risk of kidney disease, with complication-related costs accounting for approximately 74% of total direct medical costs covered by BPJS Kesehatan. The effectiveness of prevention programs such as Prolanis depends heavily on understanding the factors that accelerate complication onset. Therefore, this study aimed to determine the survival of T2DM patients enrolled in the National Health Insurance (JKN) program with respect to complication onset, along with its associated determinants. Methods: This study used BPJS Kesehatan Sample Data from 2020, employing a retrospective closed-cohort design with an observation period of 2020–2025. Analyses were conducted using the Kaplan-Meier method and Cox Proportional Hazard regression. Results: Of 2,704 T2DM patients included in the study, 54.1% experienced complications, with a 4-year survival rate of 0.473 (95% CI: 0.45–0.49) and a median time-to-event of 3.639 years. The Kaplan-Meier and log rank analysis found out that age at diagnosis (p = 0,041), hypertension (p < 0,0001), and dyslipidemia (p < 0,0001) variables significantly differs the time of complication onset among T2DM patients. Based on the Cox Proportional Hazard analysis, factors that significantly accelerated complication onset were having hypertension (aHR=1,370; 95% CI: 1,231–1,525) and having dyslipidemia (aHR=1,522; 95% CI: 1,363–1,647), while being ≥65 of age when first diagnosed is a protective factor (aHR=0,868; CI: 0,771 – 0,978). Conclusion: Survival from complications among JKN-enrolled T2DM patients in Indonesia remains relatively low, with hypertension and dyslipidemia as the main determinants. Comprehensive efforts to prevent and manage these comorbidities are therefore needed, including through optimized risk stratification within the Prolanis program. Keywords: Type 2 Diabetes Mellitus, Survival Analysis, Complications, National Health Insurance, BPJS Sample Data

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Latar belakang: Diabetes melitus (DM) tipe 2 merupakan penyakit tidak menular dengan beban kesehatan tertinggi di Indonesia, dengan prevalensi yang meningkat hampir dua kali lipat dalam satu dekade, dari 6,9% (2013) menjadi 11,7% (2023), serta menempatkan Indonesia sebagai negara dengan jumlah penderita diabetes tertinggi kelima di dunia (20,4 juta jiwa pada 2024). Penderita DM tipe 2 menghadapi risiko tiga kali lebih tinggi mengalami penyakit kardiovaskular dan sepuluh kali lebih tinggi mengalami penyakit ginjal, dengan beban biaya komplikasi yang mencakup sekitar 74% dari total biaya medis langsung yang ditanggung BPJS Kesehatan. Efektivitas program pencegahan seperti Prolanis sangat bergantung pada pemahaman mengenai faktor-faktor yang mempercepat terjadinya komplikasi. Oleh karena itu, penelitian ini dilakukan untuk mengetahui kesintasan komplikasi pasien DM tipe 2 peserta Jaminan Kesehatan Nasional (JKN) beserta faktor-faktor yang memengaruhinya. Metode: Penelitian ini menggunakan Data Sampel BPJS Kesehatan tahun 2020 dengan desain studi kohort tertutup retrospektif dan masa pengamatan pada 2020—2025. Analisis dilakukan menggunakan metode Kaplan-Meier dan uji Cox Proportional Hazard. Hasil: Dari 2.704 pasien DM tipe 2 yang diikutsertakan, terdapat 54,1% kejadian komplikasi, dengan 4-year survival rate sebesar 0,473 (95% CI: 0,45–0,49) dan median time-to-event 3,639 tahun. Pada faktor sosiodemografi, faktor usia saat diagnosis secara signifikan memengaruhi survival rate (p = 0,041) walau perlu diinterpretasikan dengan kehati-hatian. Pada faktor klinis, pasien DM tipe 2 dengan hipertensi (p < 0,0001) dan dislipidemia (p < 0,0001) secara signifikan memiliki 4-year survival rate lebih rendah. Berdasarkan analisis multivariat, faktor yang secara signifikan mempercepat kejadian komplikasi hipertensi (aHR=1,370; 95% CI: 1,231–1,525), dislipidemia (aHR=1,522; 95% CI: 1,363–1,647), sedangkan berumur ≥65 saat diagnosis (aHR=0,868; CI: 0,771 – 0,978) merupakan faktor protektif. Kesimpulan: Kesintasan komplikasi pasien DM tipe 2 peserta JKN di Indonesia masih tergolong rendah, dengan hipertensi dan dislipidemia sebagai determinan utama. Oleh karena itu, diperlukan penguatan upaya pencegahan dan pengendalian komorbiditas secara komprehensif, salah satunya melalui optimalisasi stratifikasi risiko dalam program Prolanis. Kata kunci: Diabetes Melitus Tipe 2, Analisis Kesintasan, Komplikasi, Jaminan Kesehatan Nasional (JKN), Data Sampel BPJS Kesehatan

Latar Belakang: Perawatan gigi dan mulut memiliki risiko tinggi untuk terjadi penularan COVID-19, maka sangatlah penting untuk dokter gigi melaksanakan perawatan dengan protokol pencegahan transmisi COVID-19 yang ketat. Pada penelitian ini dilakukan analisis kesiapan dokter-dokter gigi di Indonesia terhadap upaya pencegahan transmisi COVID-19, yang belum banyak diteliti di Indonesia. Dilakukan juga analisis kesiapan dengan faktorfaktor yang dapat memiliki asosiasi dengan kesiapan. Metode: Penelitian ini menggunakan desain potong lintang (cross- sectional). Pengambilan data dilakukan dengan kuesioner secara daring. Total diperoleh 520 sampel, dengan sampel berupa dokter gigi yang masih aktif berpraktik dengan minimal gelar dokter gigi. Pada awal kuesioner, ditanyakan pertanyaan awal mengenai karakteristik responden. Selanjutnya, responden diberikan 21 pertanyaan mengenai persepsi mereka terhadap upaya pencegahan transmisi COVID-19, dan 18 pertanyaan mengenai kesiapan/ rutinitas melaksanakan tindakan-tindakan pencegahan transmisi COVID-19 pada tempat praktik mereka. Hasil: Analisis multivariat dengan regresi logistik menunjukkan bahwa variabel yang memiliki asosiasi signifikan dengan kesiapan setelah dikontrol variabel lain adalah persepsi (adjusted odds ratio: 22,1, 95% CI: 2,9- 171,8), usia (adjusted odds ratio 0,3, 95% CI: 0,1-0,8), dan lokasi praktik (adjusted odds ratio 2,9, 95% CI: 1,5-5,6). Kesimpulan: Pelatihan dan edukasi dari organisasi profesi dokter gigi untuk meningkatkan kesiapan dokter gigi terhadap berbagai upaya pencegahan transmisi COVID-19 perlu diberikan. Selain pelatihan, berbagai stakeholder juga perlu bekerjasama untuk menangani segala keterbatasan sumber daya yang diperlukan untuk pencegahan COVID-19.  Kata kunci: Pencegahan Transmisi COVID-19, Dokter Gigi, Perawatan Gigi dan Mulut

Background: Dental treatments have a very high risk of COVID-19 transmission, therefore, it is very important for dentists to implement strict infection control measures during treatment. In this research, an analysis of dentists’ preparedness towards COVID-19 prevention measures was done. An analysis of the dentists’ preparedness with factors that can have an effect on preparedness was also done. Method: This research used a cross sectional design, and data was taken using an online questionnaire. The inclusion criteria of the samples were dentists that were still actively performing treatment. A total of 520 samples were obtained. In the beginning of the questionnaire, questions regarding the characteristics of the respondents were given. Afterwards, 21 questions regarding the respondents’ perception towards various COVID-19 prevention measures and 18 questions regarding the respondents’ preparedness/ routine in performing the various COVID-19 prevention measures were given. Results: Multivariate analysis with logistic regression showed variables that had a significant association with total preparedness were perception (adjusted odds ratio: 22,1, 95% CI: 2,9- 171,8), age (adjusted odds ratio 0,3, 95% CI: 0,1-0,8), and type of treatment facility (adjusted odds ratio 2,9, 95% CI: 1,5-5,6). Conclusion: Training and education by dentists’ professional organizations to improve the preparedness of dentists towards various COVID19 preventive measures needs to be given. Besides training, stakeholders need to work together to provide various resources needed for COVID-19 prevention if the resources are limited. Keywords: COVID-19 Prevention Measures, Dentists, Dental Settings