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Latar Belakang: Pertumbuhan populasi lansia di Indonesia diiringi oleh peningkatan prevalensi penyakit tidak menular (PTM) seperti jantung, kanker, dan stroke, yang dapat memengaruhi kemampuan lansia dalam menjalankan Activities of Daily Living (ADL). Status ADL yang rendah berdampak pada kualitas hidup individu dan meningkatkan beban kesehatan nasional. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara PTM (jantung, kanker, stroke) dan status ADL pada lansia di Indonesia, serta mengevaluasi pengaruh faktor sosiodemografi (umur, jenis kelamin, pendidikan, status ekonomi, lokasi tempat tinggal) terhadap hubungan tersebut. Metode: Penelitian ini menggunakan desain analisis data sekunder dengan pendekatan cross-sectional, berdasarkan data Survei Kesehatan Indonesia (SKI) 2023. Analisis data dilakukan menggunakan regresi logistik multinomial untuk mengeksplorasi hubungan antara PTM dan status ADL, dengan mempertimbangkan variabel sosiodemografi. Hasil: Analisis menunjukkan hubungan signifikan antara PTM dengan ketergantungan ADL pada lansia. Stroke memiliki pengaruh terbesar terhadap ketergantungan ADL (OR = 35,9; CI 35,520–36,199; p < 0,000), diikuti oleh kanker dan penyakit jantung. Faktor sosiodemografi seperti usia lanjut, pendidikan rendah, dan status ekonomi rendah juga meningkatkan risiko ketergantungan ADL secara signifikan. Kesimpulan: PTM, terutama stroke, merupakan faktor risiko utama ketergantungan ADL pada lansia di Indonesia. Diperlukan intervensi kesehatan yang terfokus pada pencegahan dan pengelolaan PTM, serta kebijakan yang memperhatikan faktor sosiodemografi untuk meningkatkan kualitas hidup lansia.
Kata kunci: Penyakit Tidak Menular, Activities of Daily Living, Lansia.
Background: The growing elderly population in Indonesia is accompanied by an increasing prevalence of non-communicable diseases (NCDs) such as heart disease, cancer, and stroke, which can impact the ability of older adults to perform Activities of Daily Living (ADL). Low ADL status adversely affects individuals' quality of life and places a significant burden on the national healthcare system. Objective: This study aims to analyze the relationship between NCDs (heart disease, cancer, stroke) and ADL status among the elderly in Indonesia, while also evaluating the influence of sociodemographic factors (age, gender, education, economic status, and place of residence) on this relationship. Methods: This study employs a secondary data analysis design with a cross-sectional approach, utilizing data from the 2023 Indonesian Health Survey (SKI). Logistic regression analysis was conducted to explore the relationship between NCDs and ADL status, considering sociodemographic variables. Results: The analysis revealed a significant relationship between NCDs and ADL dependence among the elderly. Stroke was identified as having the strongest impact on ADL dependence (OR = 35.9; CI 35.520–36.199; p < 0.000), followed by cancer and heart disease. Sociodemographic factors, such as advanced age, low educational attainment, and low economic status, were also significantly associated with higher risks of ADL dependence. Conclusion: NCDs, particularly stroke, are major risk factors for ADL dependence among the elderly in Indonesia. Focused health interventions targeting the prevention and management of NCDs, along with policies that address sociodemographic disparities, are essential to improving the quality of life for the elderly. Keywords: Non-communicable diseases, Activities of Daily Living, Elderly.
Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyebab kematian keempat tertinggi di dunia, dengan total sekitar 3,5 juta kematian pada tahun 2021 menurut data WHO. Jumlah ini setara dengan 5% dari seluruh kematian global. Di Indonesia, PPOK termasuk dalam 20 besar penyakit dengan kunjungan rawat jalan tingkat lanjut (RJTL) terbanyak berdasarkan ICD selama delapan tahun terakhir, dari 2017 hingga 2024. Mengingat PPOK adalah penyakit kronis yang membutuhkan penanganan jangka panjang dan stabil, integrasi layanan primer dan lanjutan menjadi kunci keberhasilan pengelolaannya. Penelitian ini bertujuan untuk mengetahui pola pemanfaatan layanan kesehatan tingkat primer dan lanjutan oleh peserta Jaminan Kesehatan Nasional (JKN) yang menderita PPOK di Indonesia, serta faktor-faktor yang memengaruhinya berdasarkan karakteristik predisposisi, kemampuan, dan sistem pelayanan kesehatan. Desain penelitian ini adalah kuantitatif dengan pendekatan cross-sectional menggunakan Data Sampel BPJS Kesehatan tahun 2024. Total sampel yang dianalisis adalah 5.281 sebelum pembobotan. Analisis data dilakukan menggunakan tabulasi silang, uji chi-square, dan regresi logistik multinomial. Hasil penelitian menunjukkan bahwa pemanfaatan layanan kesehatan oleh penderita PPOK didominasi oleh layanan tingkat primer (73,3%). Pemanfaatan layanan tingkat lanjut saja lebih tinggi (16%) dibandingkan dengan integrasi layanan primer dan lanjutan (10,6%). Ditemukan bahwa karakteristik predisposisi, kemampuan, dan sistem pelayanan kesehatan berhubungan secara signifikan dengan pola pemanfaatan layanan kesehatan tingkat primer dan lanjutan pada penderita PPOK di Indonesia. Temuan ini menekankan pentingnya penguatan pelayanan penapisan dan program rujuk balik (PRB), penerapan pendekatan pelayanan yang holistik, serta integrasi yang lebih kuat antara layanan primer dan lanjutan untuk meningkatkan efektivitas penatalaksanaan PPOK.
Kata kunci: Penyakit paru obstruktif kronik (PPOK), Utilisasi Pelayanan Kesehatan, Jaminan Kesehatan Nasional (JKN), Data Sampel BPJS Kesehatan
Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death globally, with approximately 3.5 million deaths reported in 2021, according to WHO data. This figure accounts for around 5% of all global deaths. In Indonesia, COPD has consistently ranked among the top 20 diseases with the highest number of advanced outpatient visits (RJTL) based on ICD data from 2017 to 2024. Given that COPD is a chronic condition requiring long-term and stable management, integration between primary care services and advanced care services is essential to ensure comprehensive disease management. This study aims to examine the pattern of primary and advanced healthcare service utilization among participants of the National Health Insurance (JKN) who suffer from COPD in Indonesia, and to identify influencing factors based on predisposing characteristics, enabling resources, and the healthcare system. The research used a quantitative cross-sectional design, utilizing the 2024 Sample Data from BPJS Kesehatan. A total of 5,281 samples were analyzed prior to weighting. Data analysis was conducted using cross-tabulation, chi-square tests, and multinomial logistic regression. The findings reveal that healthcare service utilization by COPD patients is predominantly at the primary care level (73.3%). The utilization of advanced care services alone (16%) was higher than the integrated healthcare services (10.6%). It was also found that predisposing characteristics, enabling factors, and the healthcare system were significantly associated with the pattern of healthcare utilization among COPD patients in Indonesia. These findings highlight the importance of strengthening early diagnostic capacity for COPD at primary healthcare facilities, implementing a holistic service approach, and enhancing integration between primary and advanced care to improve the effectiveness of COPD management. These findings highlight the importance of strengthening screening services and the Back Referral Program (PRB), implementing a holistic approach to care, and fostering stronger integration between primary and secondary care services to enhance the effectiveness of COPD management.
Despite improvements in healthcare access through the National Health Insurance (JKN) program, Indonesia continues to face challenges such as uneven distribution of facilities, limited healthcare professionals, and low public trust in domestic services. These conditions have led many Indonesians to seek medical care abroad, resulting in an estimated foreign exchange loss of up to IDR 165 trillion per year. This study aims to analyze factors associated with the types of overseas health services chosen by Indonesians using data from the 2023 Indonesian Health Survey (SKI). A quantitative cross-sectional design was applied, covering 38 provinces. Over the past three years, medical check-ups were the most frequently selected service, followed by surgical procedures and other treatments. Predisposing factors, including age, gender, marital status, education level, and employment status, showed no significant relationship. In contrast, enabling factors such as health insurance ownership, availability of complete facilities, and destination country were significantly associated with service type. Need factors, particularly medical history, were not significantly related. These findings highlight the need to develop nationally prioritized services, improve preventive care quality, strengthen health service integration, and expand wellness-based services.
