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( Rosinta Hotmaida Pebrianti Purba ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-
Aims Indonesia is entering an aging society with an older people population reaching 26.82 million people or 9.92% of the total population in 2020. It is predicted that the proportion will be elevated to 25% or being the second largest of aging market in 2045. The senior citizen is the COVID-19 most at risk due to comorbidities and low digital literacy. Lung cancer is one of the highest comorbid factors in increasing the risk of death by 13.5 times and increasing to 16.8 times in the elderly due to COVID-19 (Indonesian COVID-19 Task Force, 2020). This condition increases the aging market in Indonesia but low digital literacy will affect the lower quality of life and increase the burden for next generation rapidly. Methods Using data from the 2014 Indonesia Family Life Survey (IFLS), this study aims to analyze mental health problems and mobile phone ownership in older adults (60+) with lung cancer disease. IFLS is a multi-level (individual, household, community, and facility levels), multi-topic, large-scale, and longitudinal survey that has been conducted in five waves since 1993. IFLS 2014 covers 24 of all 34 Indonesian provinces. However, the covered provinces are also the most populated ones, so the survey is representative of 83% of the Indonesian population. Results The analysis shows that the proportion of older people with lung cancer disease reaches 2,57% and 66,4% are men. 26,47% of them experienced mental health problems. They report sleeping restless, bothered by things, hopeless, unable to concentrate, and feeling unhappy. As much as 51,53% of the elderly with lung cancer disease have mobile phones. However, the percentage of elderly with lung cancer disease experiencing mental health problems will decrease by 6,78% when they have a cellphone. The SES of the elderly in Indonesia has a fairly diverse distribution between provinces. Nearly half of older people’s educational attainment is in elementary school (46.05%) and 73% of Indonesian elderly with lung cancer disease are still working. In general, the elderly with higher digital literacy prefer to seek treatment at a formal health facility than traditional practitioners such as shamans. They tend to seek outpatient care treatment at a community health center or Puskesmas (44,11%) and specialists (29,41%). Conclusions Mental health problems increase the risk of fatalities due to COVID-19, although the older adults in Indonesia seniors have become vaccine recipient’s priority. Strategies are needed to mitigate mental health problems and as early detection in the elderly by utilizing the existing community-based integrated service system such as Puskesmas or Posyandu Lansia to encourage the Aging in Place/Community campaign. Mainstreaming the issue of digital aging can help various information and services needed by the elderly to be healthier, independent, and with dignity especially in the new normal era.
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( Lintong Hottua Simbolon ),( Aprilia G. A. Maay ),( Rosinta Hotmaida Pebrianti Purba ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: In Indonesia, Cirrhosis Hepatitis is the 5th disease with the most social insurance claims after heart disease, stroke, kidney failure, and cancer. Hepatitis Cirrhosis case-control program is focused on preventing Mother to Child Transmission (PPIA) because 95% of hepatitis B transmission is vertical, ie from mothers who are positive for hepatitis B to the fetus. Thus, every baby (0-11 months old) is required to get a complete basic immunization consisting of 1 dose of Hepatitis B, 1 dose of BCG, 3 doses of DPT-HB-HiB, 4 doses of polio drops, and 1 dose of measles / MR. Program coverage reaches 90.61% in 2018 nationally. Nevertheless, the prevalence of hepatitis sufferers increased from 0.2% in 2013 to 0.4% in 2018, equivalent to 13.5 million sufferers dominated from remote provinces such as Papua Island and the Nusa Tenggara Islands. This number makes Indonesia the 3rd country in Asia with the most cases of chronic hepatitis B sufferers after China and India. This study aims to analyze and evaluate risk factors of national policy objectives implementation. Methods: Using the juridical-empirical approach, this study analyzes whether Indonesia’s health service practices conformity is in line with national policy objectives. In accordance with National Social Security and Law Number 11 of 2009 concerning Article 19 of Law concerning Social Welfare, the government is obliged to ensure equal health services access and facilities due to Universal Health Coverage including promotive, preventive, curative, and rehabilitative services by adhering to the cooperation principle (gotong royong). Results: JKN aims to protect the citizens from financial risks through the Social Security Organizing Agency (BPJS) that will cover all types of diseases (Minister of Health Regulation 28/2014). Thus, the cost burden is allocated by the BPJS for curative Cirrhosis Hepatitis absorbs U $ 21.17 million in 2017 and U $ 14 million in 2018. Meanwhile, almost 784.3 thousand individuals each year fall into poverty as a result of hepatic health costs. However, the provisions on the National Formulary 2017 on drugs to reduce symptoms such as pegylated injection, adefovir dipropyl, entecavir, lamivudine, ribavirin, tenofovir, and telbivudine are limited in number and can only be accessed at level 1 facilities at hospitals that are difficult to access community in remote areas. Further, when performing surgery, it turns out there are costs that are not covered and eventually patients become difficult to pay for health care costs. Meanwhile, patients fall into poverty as a result of Cirrhosis Hepatitis health costs. The patient has to spend the cost of illness that is borne for life by 2.7 percent of total household consumption expenditure. This has an impact on reducing the quality of life of patients. Conclusions: The government has not achieved the goal of eliminating Cirrhosis Hepatitis patients from “out of pocket” yet. The government needs to overcome the health policies overlapping and develop hospital formularies due to prevention and health promotion programs. Further, the national health insurance program needs to be allocated more effectively for the construction of the health infrastructure in remote areas to improve the patient’s QoL.
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