Tingkat mortalitas COVID-19 di Indonesia sebesar 2,7%, angka ini merupakan yang tertinggi di Asia Tenggara. Pasien COVID-19 yang mengalami perburukan di rumah sakit seperti masuk ICU dan kematian sebanyak 15-20%. Perubahan klinis pasien sebelum terjadinya perburukan dan kematian tidak disadari oleh 27,06% tenaga kesehatan. Menurut WHO, EWS dapat digunakan untuk mendeteksi perburukan pasien lebih awal, namun penelitian yang dilakukan untuk melihat hubungan EWS dengan kematian COVID-19 masih terbatas. Tujuan penelitian ini adalah untuk mengetahui besar risiko highrisk EWS dengan kejadian kematian serta probabilitas kesintasan pada pasien COVID-19 yang dirawat di RS UI. Penelitian ini menggunakan desain studi kohort retrospektif.  Populasi pada penelitian ini adalah seluruh pasien COVID-19 yang dirawat inap di RS UI pada periode Maret – Desember 2020. Penelitian ini menggunakan total sampling. Jumlah sampel pada penelitian ini adalah 740 orang yang terdiri dari 137 orang pada kelompok terpapar dan 603 kelompok tidak terpapar. Analisis kesintasan dilakukan dengan menggunakan Kaplan Meier sedangkan analisis multivariat dilakukan dengan cox regresi. Probabilitas kesintasan pasien COVID-19 yang di rawat di RS UI sampai dengan 72 hari pengamatan sebesar 47,4%. Besar risiko pasien COVID-19 yang memiliki highrisk EWS untuk terjadi kematian sebesar 5,32 (95% CI= 3,26-8,69). Tenaga kesehatan diharapkan dapat mendeteksi perburukan pasien sedini mungkin agar bisa dilakukan intervensi lebih awal untuk mencegah kematian pada pasien COVID-19. Kata kunci:  COVID-19, EWS, Mortalitas, Kesintasan

In Indonesia, the COVID-19 mortality level is 2.7%, which renders it the highest in Southeast Asia. The number of patients with COVID-19 that experienced an exacerbation in hospitals that needed ICU support and resulted in death accounts for 15 to 20%. The clinical progression of patients before exacerbation and subsequent death happened was not recognized by 27.06% of health workers. According to the WHO, EWS can be used to detect exacerbation early. However, studies examining the link between EWS and COVID-19 related death are still limited. The purpose of this study is to determine the association between high-risk EWS with the incidence of death and the probability of survival in COVID-19 patients treated at Universitas Indonesia (UI) Hospital. This study uses a retrospective cohort study design. The population included are all COVID-19 patients hospitalized at UI Hospital in the period of March – December 2020. This study uses total sampling with 740 people consisting of 137 people in the exposed group and 603 people in the unexposed group. Survival analysis was performed using Kaplan Meier. Multivariate analysis was done using Cox regression. The probability of survival of COVID-19 patients treated at UI Hospital with up to 72 days of observation is 47.4%. The risk of death of COVID-19 patients with high-risk EWS is 5.32 (95% CI = 3.268.69). Health workers are expected to be able to detect patient deterioration as early as possible so that earlier intervention can be carried out to prevent death in COVID-19 patients. Keywords:  COVID-19, EWS, Mortality, Survival

Along with the worldwide demographic change in the increased number of population aged over 65, Indonesia was no exception. Consequences of the prolonged lifeexpectancy and changes in disease pattern, the care recipients suffering from the chronic diseases have increased. However, the sufficient health care system in the long-term care settings, the home-health care in particular, was not yet established in Indonesia.   The first objective of this research was to observe the current home-based care services in Indonesia, and then determine quality of services, care recipients satisfaction, care recipients’ preference. The main objective was to develop a home-health care model with the concept of Coordination Unit.   The study design was the qualitative research with the mix-method approach consisting of interviews. More specifically, the mixture of the exploratory research approach and applied policy research approach was used with the exploratory approach were applied. The purposive sampling technic was applied, and data are collected through interviews, and analyzed by the framework and thematic analysis.   The result of the research was that no sufficient home-health care services were observed and some of care services were not accordance with the laws and regulations concerning “health care” that might lead to some in miss-treatment. Furthermore, no integrative network was found within the current home-health care. The most importantly, the care recipients’ satisfaction levels were not considered as high, due to the quality of care and care providers. The result of care recipients’ experiences, preferences and satisfaction levels as well as expatriates indicated the necessity of establishment of the care coordination units that possibly increase efficiency, sufficiency in the home-health care, and also improve the care recipients’ satisfaction level as the coordination units undergo to function as a bridge among care recipients, healthcare sectors and non-healthcare sectors. Furthermore, the coordination units establish cooperation and partnerships with appropriate health professionals and healthcare facilities to get the community integrated home-health care, and functions as the center of healthcare information and data of care recipients. Despite of some difficulties such as the health human resources and the competency level of care providers, the community health centers (Puskesmas) have great potentials to play roles as the coordination unit with a new position of “Care Manager.”  This study concluded that the home-health care model developed in this study that was the community-integrated care system with the coordination unit was applicable with high potential. Especially, the home-health care model working together with the Indonesian Health asset such as “Puskesmas,” and or “programs of public health efforts in non-communicable diseases” seems the most practical for Indonesia. Key Words: Care-Recipients-Satisfaction, Home-Health-Care, Care-Coordination-Unit