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"Pendahuluan: Gagal jantung merupakan tantangan serius dalam dunia kesehatan dengan dampak global yang signifikan, termasuk di Indonesia, menunjukkan prevalensi tinggi yang mendorong perlunya upaya pencegahan dan manajemen yang efektif. Oleh karena itu, kami ingin mengembangkan dan menguji aplikasi berbasis web “jantung sehatq" sebagai solusi inovatif untuk meningkatkan perilaku self-management pada pasien gagal jantung. Tujuan: Mengidentifikasi pengaruh edukasi dan monitoring aplikasi berbasis web jantung sehatq terhadap perilaku self-management pada pasien gagal jantung di RSUD dr.R. Soedjono Selong. Metode: Menggunakan desain quasi eksperimen, pre-post-test dengan kelompok kontrol, dimana pasien (n = 54) yang sesuai kriteria menerima perawatan standar (kelompok kontrol) atau intervensi dengan aplikasi berbasis web jantung sehatq yang dirancang untuk meningkatkan perilaku self-managemnt pada kelompok (intervensi) dan diikuti selama 1 bulan. Instrumen yang digunakan: kuisioner The European Health Failure Self Care Behaviour Scale (EHFScBS-9), Caregiver Contributions to Self-Care of Heart Failure Index-2 (CC-SCHFI-2) 29 item, Dutch Heart Failure Knowledge Scale (DHFKS) 15 item. Penelitian ini dilakukan pada bulan Juni 2023 hingga Juli 2023. Hasil: Pada awalnya, rata-rata perilaku self-management pada skala EHFScB-9 adalah 50,20±11,65 pada kelompok kontrol dan 52,16±11,06 pada kelompok intervensi. Setelah 1 bulan, terdapat perbedaan yang signifikan (secara keseluruhan P <0,001) dalam perilaku self-management antar kelompok penelitian; kelompok kontrol vs kelompok intervensi; rata-rata 51,03±11,53 vs. 77,98±6,35 [interval kepercayaan (CI) 95% -31,58-(-22,32)]. Kesimpulan: Penelitian ini memberikan kontribusi pada pemahaman tentang peran aplikasi berbasis web dalam meningkatkan perilaku self-management pasien gagal jantung. Namun, penelitian lebih lanjut diperlukan untuk memahami secara lebih mendalam dampak intervensi terhadap respon pasien dan bagaimana hal ini dapat mempengaruhi perjalanan penyakit secara keseluruhan.

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Background: Heart failure poses a serious challenge in the field of health with significant global impacts, including in Indonesia, indicating a high prevalence that underscores the need for effective prevention and management efforts. Therefore, we aim to develop and test the web-based application 'jantung sehatq' as an innovative solution to enhance self-management behaviors in heart failure patients. Objective: To identify the effect of education and monitoring of the jantung sehatq web-based application on self-management behavior in heart failure patients at at the regional general hospital dr. R. Soedjono Selong. Method: Utilizing a quasi-experimental design, pre-post-test with a control group, where patients (n = 54) meeting the criteria received standard care (control group) or intervention with the 'jantung sehatqt' web-based application designed to enhance self-management behaviors in the intervention group, and followed for 1 month. Instruments used: The European Health Failure Self Care Behaviour Scale (EHFScBS-9) questionnaire, Caregiver Contributions to Self-Care of Heart Failure Index-2 (CC-SCHFI-2) 29 items, Dutch Heart Failure Knowledge Scale (DHFKS) 15 items. This research was conducted from June 2023 to July 2023. Results: at baseline, the mean self-management behavior on the EHFScB-9 scale was 50.20±11.65 in the control group and 52.16±11.06 in the intervention group. After 1 month, there was a significant difference (overall P <0.001) in self-management behavior between the research groups; control group vs. intervention group; mean 51.03±11.53 vs. 77.98±6.35 [95% Confidence Interval (CI) -31.58-(-22.32)]. Conclutions: This study contributes to the understanding of the role of web-based applications in enhancing self-management behaviors in heart failure patients. However, further research is needed to gain a deeper understanding of the intervention's impact on patient responses and how this may influence the overall course of the disease."

"Self care penderita gagal jantung merupakan penentu keberhasilan perawatan. Self care membutuhkan pengetahuan dan keterampilan yang dapat diberikan melalui discharge planning sejak penderita dirawat. Discharge planning yang tidak maksimal memberikan pengaruh langsung dan menyebabkan rehospitalisasi serta penambahan lama perawatan. Discharge planning membutuhkan kolaborasi multidisiplin, pasien harus terlibat aktif dalam pelaksanaannya. Di Indonesia, rumah sakit mempunyai kewenangan mengatur pelaksanaan discharge planning, namun pada kenyataannya discharge planning disusun hanya dalam bentuk ringkasan yang akan disampaikan seperti jadwal kunjungan dan obat – obatan. Tujuan: mengidentifikasi pengaruh discharge planning terstruktur terhadap self care. Metode: quasy experiment dengan 46 menggunakan 3 kuisioner dan analisis meliputi univariat dan bivariat (beda 2 mean). Hasil: terdapat beda mean yang signifikan sebelum dan sesudah interevensi pada kelompok intervensi. Kesimpulan: terdapat pengaruh pemberian discharge planning terhadap self care. Rekomendasi: dalam perawatan gagal jantung, discharge planning menjadi bagian penting untuk memaksimalkan perawatan dan self care. 

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Self-care of patients with heart failure is a determinant treatment to success. Patient’self-care requires knowledge and skills that can be provided through a program of discharge planning since the patient is admitted to the hospital. The discharge planning program that is not optimally given to the patient will produce direct effect and cause re-hospitalization and possible extended hospital stay. The implementation of the discharge planning requires multidisciplinary collaboration and the patient must be actively involved in the practice. In Indonesia, hospitals have authorities to regulate the implementation of discharge planning program, but in reality, what they said a discharge planning is consists of only a form of medical summary that concluded with a schedule of visits and medicines to be consumed. The objective of the study was to identify the effect of structured discharge planning structured on self-care of patients with heart failure. Method: A quasy experimental study has involved 46 subjects, used 3 different questionnaire and analysis included univariate and bivariate (Two Difference mean). The result showed that there is a significant difference mean before and after intervention in the treatment group. Conclusion: There is a significant effect of structured discharge planning on self-care. Recommendation: A structured discharge planning program becomes an important part of caring for patients with heart failure in order to maximize nursing care and self-care ability of the patients."

"Gagal jantung merupakan salah satu penyakit kronis yang paling sering memerlukan pengobatan ulang di rumah sakit. Tingginya tingkat readmission pada pasien gagal jantung sering terjadi karena keterlambatan dalam mengenal gejala, ketidakpatuhan terhadap diet dan pengobatan, kurangnya keterampilan dan pengetahuan dalam self care. Self care dapat mencegah terjadinya perburukan sehingga readmission tidak terjadi, selain itu self care juga berdampak terhadap kualitas hidup. Individu dalam melakukan self care dipengaruhi beberapa faktor dari dalam maupun luar individu. Tujuan penelitian ini adalah mengetahui hubungan karakteristik responden, status fungsional, komorbiditas, tingkat depresi, dukungan sosial, persepsi penyakit dengan self care pasien gagal jantung yang readmission. Penelitian menggunakan desain cross sectional dengan tehnik purposive sampling pada 93 responden pasien gagal jantung yang readmission di Ruang Rawat Inap dan Poliklinik Jantung RSUP Persahabatan. Hasil penelitian setelah dianalisis dengan Chi-square menunjukkan status perkawinan (p 0,028; α 0,05), pendidikan (p 0,018; α 0,05), komorbiditas (p 0,034; α 0,05), tingkat depresi(p 0,006; α 0,05), dukungan sosial (p 0,000; α 0,05), dan persepsi penyakit (p 0,002; α 0,05) memengaruhi self care responden secara signifikan. Kesimpulan penelitian ini adalah perlunya meningkatkan follow up setelah pasien pulang dan melibatkan keluarga dalam upaya self care.

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Heart failure is the chronic diseases most often requires repeat treatment at the hospital. The high level of readmission patients heart failure often occurs due to delays in recognizing symptoms, noncompliance diet and treatment, lack of skills and knowledge self care. Self care can prevent deterioration so the readmission does not occur, besides it affects the quality of life. Individuals doing self care influenced by several factors from inside and outside. The purpose of this study to know the relationship of respondent characteristics, functional status, comorbidity, depression, social support, illness perception with self care patients heart failure readmission. The study used design cross sectional with purposive sampling technique in 93 patients heart failure readmission at Inpatient and Outpatient Care RSUP Persahabatan. The results this study after being analyzed by Chi square showed marital status (p 0,028; α 0.05), education (p 0,018; α 0,05), comorbidity (p 0,034; α 0,05), depression (p 0,006; α 0,05), social support (p 0,000; α 0,05), and illness perception (p 0,002; α 0,05) significantly influenced self care. The conclusions this study need to improve follow up after the patient returns home and involves the family effort to self care."

"Latar Belakang: Infeksi COVID-19 merupakan penyakit dengan komplikasi multi-organ, salah satunya komplikasi kardiovaskular. Dengan kejadian gagal jantung akut sebagai komplikasi COVID-19 dengan mortalitas dan morbiditas yang tinggi, perlu dilakukan identifikasi faktor-faktor yang berhubungan dengan terjadinya gagal jantung akut pada pasien COVID-19, khususnya pada derajat sedang – berat.Tujuan : Mengetahui prediktor gagal jantung akut pada pasien COVID-19 yang dirawat, khususnya derajat sedang – beratMetode : Metode penelitian bersifat kohort retrospektif. Luaran primer adalah kejadian gagal jantung akut saat perawatan. Terdapat 15 faktor klinis dan laboratoris yang dianalisis secara bivariat dan multivariat.Hasil: Dari total 208 subjek sesuai kriteria inklusi dan eksklusi, sebanyak 73 subjek (35%) mengalami episode gagal jantung akut saat perawatan. Riwayat gagal jantung kronik memiliki risiko 5,39 kali (95% IK: 1,76 – 16,51; p = 0,003) mengalami kejadian gagal jantung akut. Pasien dengan nilai TAPSE < 17 mm memiliki risiko 4,25 kali (95% IK: 1,13 – 16,07; p= 0,033) mengalami gagal jantung akut. Sedangkan pemakaian ACE-i/ARB memiliki risiko 0,16 kali (95% IK: 0,05 – 0,51; p = 0,002) untuk mengalami gagal jantung akut intraperawatan dibandingkan kelompok tanpa pemakaian ACE-i/ARB.Kesimpulan: Riwayat gagal jantung kronik, TAPSE < 17 mm, dan pemakaian ACE-i/ARB diidentifikasi sebagai prediktor kejadian gagal jantung akut pada pasien COVID-19.

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Introduction: COVID-19 infection is a disease with multi-organ complications, including cardiovascular organ. As heart failure is one of COVID – 19 complications that has high morbidity and mortality, we need to identify factors that can predict acute heart failure in COVID – 19, especially in moderate to severe patients.

Objective : to determine predictors of acute heart failure in hospitalized COVID -19 patients

Method : This was a retrospective cohort study. The primary outcome was acute heart failure that happened during hospitalization. There were total of 16 clinical (age, sex, body mass index, hypertension, diabetes, smoking history, coronary artery disease, chronic kidney disease, chronic heart failure, chronic obstructive pulmonary disease, PaO2/FiO2 ratio, non-cardiogenic shock at admission, use of ACE-inhibitors/ARBs during hospitalization, ejection fraction, TAPSE) as well as 6 laboratory parameters (neutrophil - lymphocyte ratio, platelet - lymphocyte ratio, eGFR, D-Dimer, procalcitonin, CRP) that were used in statistical analysis.

Result: From total of 208 subjects with moderate – severe COVID-19, 73 (35%) had acute heart failure. The median time of developing heart failure is 4 ( 1 - 27) days. On multivariate analysis, patients with history of chronic heart failure exhibited a 5.39-fold higher risk of acute heart failure compared with no history of chronic heart failure (95% CI: 1.76 – 16.51; p = 0.003). The risk of acute heart failure was multiplied by 4.25 in patients that was presented with TAPSE <17 mm (95% CI: 1.13 – 16.07; p= 0.033). In contrast, use/continuation of ACE-inhibitors/angiotensin receptor blockers during hospitalization showed reduced risk of acute heart failure (16% of the risk developing acute heart failure compared with patients with no use of ACE-inhibitors/angiotensin receptor blockers). In subjects developing acute heart failure, the mortality rate was 67%, compared with 57% in subjects without acute heart failure (p = 0,028).

Conclusion: History of chronic heart failure, TAPSE <17 mm, and the use of ACE-inhibitors/angiotensin receptor blockers were identified as predictors of acute heart failure in hospitalized COVID-19 patients."

"Penelitian ini bertujuan untuk mengembangkan instrumen penilaian desain antarmuka dalam bentuk aplikasi kuesioner online berbasis web dengan menggunakan Shneiderman’s Eight Golden Rules of Interface Design sebagai landasan teorinya. Perancangan butir pertanyaan kuesioner dilakukan dengan melakukan evaluasi kuesioner yang telah dirancang oleh Irfani (2020) secara kualitatif melalui wawancara content validity kepada praktisi dan expert UI/UX serta face validity kepada target pengguna aplikasi. Pengembangan desain antarmuka aplikasi kuesioner dilakukan dengan metode User-Centered Design dan pengembangan sistem dilakukan dengan metode pendekatan Kanban. Aplikasi hasil pengembangan kemudian diterapkan pada penilaian aplikasi studi kasus e-Learning dan Online Travel Agent, dengan perolehan total sebanyak 339 responden. Hasil penilaian menunjukkan bahwa aplikasi pada kategori Online Travel Agent secara umum memperoleh skor yang lebih tinggi dibandingkan dengan aplikasi e-Learning. Selain itu, diperoleh serangkaian rekomendasi antarmuka untuk beberapa aplikasi pada masing-masing kategori berdasarkan titik kerendahan skor pada butir kuesioner. Oleh karena itu, dapat disimpulkan bahwa implementasi aplikasi kuesioner Rule8 sebagai platform instrumen penilaian desain antarmuka dapat dijadikan tolak ukur performa desain antarmuka serta alat analisis titik kelemahan desain antarmuka suatu aplikasi.

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This research aims to develop an interface design assessment instrument in the form of a web-based online questionnaire application utilizing Shneiderman's Eight Golden Rules of Interface Design principles as its theoretical basis. The development of questionnaire questions were carried out by evaluating the questionnaire that had been designed by Irfani (2020) qualitatively through content validity interviews with UI/UX practitioners or experts as well as face validity interviews with target application users. The User-Centered Design approach is used for the development of said application’s interface design while system development is then carried out using the Kanban approach method. The developed application is then implemented by assessing e-Learning and Online Travel Agent case study applications, resulting in a total of 339 respondents. Assessment results show that applications in the Online Travel Agent category would generally obtain higher scores compared to e-Learning applications. In addition, a series of interface design recommendations for several applications in each category were obtained from score and comparison analysis based on aspects with the lowest scores. Hence, it can be concluded that the implementation of the Rule8 questionnaire application as an interface design assessment instrument platform can be used as a benchmark for interface design performance as well as a tool for analyzing weak points in an application's interface design."

"Penelitian ini bertujuan untuk mengembangkan instrumen penilaian desain antarmuka dalam bentuk aplikasi kuesioner online berbasis web dengan menggunakan Shneiderman’s Eight Golden Rules of Interface Design sebagai landasan teorinya. Perancangan butir pertanyaan kuesioner dilakukan dengan melakukan evaluasi kuesioner yang telah dirancang oleh Irfani (2020) secara kualitatif melalui wawancara content validity kepada praktisi dan expert UI/UX serta face validity kepada target pengguna aplikasi. Pengembangan desain antarmuka aplikasi kuesioner dilakukan dengan metode User-Centered Design dan pengembangan sistem dilakukan dengan metode pendekatan Kanban. Aplikasi hasil pengembangan kemudian diterapkan pada penilaian aplikasi studi kasus e-Learning dan Online Travel Agent, dengan perolehan total sebanyak 339 responden. Hasil penilaian menunjukkan bahwa aplikasi pada kategori Online Travel Agent secara umum memperoleh skor yang lebih tinggi dibandingkan dengan aplikasi e-Learning. Selain itu, diperoleh serangkaian rekomendasi antarmuka untuk beberapa aplikasi pada masing-masing kategori berdasarkan titik kerendahan skor pada butir kuesioner. Oleh karena itu, dapat disimpulkan bahwa implementasi aplikasi kuesioner Rule8 sebagai platform instrumen penilaian desain antarmuka dapat dijadikan tolak ukur performa desain antarmuka serta alat analisis titik kelemahan desain antarmuka suatu aplikasi.

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This research aims to develop an interface design assessment instrument in the form of a web-based online questionnaire application utilizing Shneiderman's Eight Golden Rules of Interface Design principles as its theoretical basis. The development of questionnaire questions were carried out by evaluating the questionnaire that had been designed by Irfani (2020) qualitatively through content validity interviews with UI/UX practitioners or experts as well as face validity interviews with target application users. The User-Centered Design approach is used for the development of said application’s interface design while system development is then carried out using the Kanban approach method. The developed application is then implemented by assessing e-Learning and Online Travel Agent case study applications, resulting in a total of 339 respondents. Assessment results show that applications in the Online Travel Agent category would generally obtain higher scores compared to e-Learning applications. In addition, a series of interface design recommendations for several applications in each category were obtained from score and comparison analysis based on aspects with the lowest scores. Hence, it can be concluded that the implementation of the Rule8 questionnaire application as an interface design assessment instrument platform can be used as a benchmark for interface design performance as well as a tool for analyzing weak points in an application's interface design."

"Penelitian ini bertujuan untuk mengembangkan instrumen penilaian desain antarmuka dalam bentuk aplikasi kuesioner online berbasis web dengan menggunakan Shneiderman’s Eight Golden Rules of Interface Design sebagai landasan teorinya. Perancangan butir pertanyaan kuesioner dilakukan dengan melakukan evaluasi kuesioner yang telah dirancang oleh Irfani (2020) secara kualitatif melalui wawancara content validity kepada praktisi dan expert UI/UX serta face validity kepada target pengguna aplikasi. Pengembangan desain antarmuka aplikasi kuesioner dilakukan dengan metode User-Centered Design dan pengembangan sistem dilakukan dengan metode pendekatan Kanban. Aplikasi hasil pengembangan kemudian diterapkan pada penilaian aplikasi studi kasus e-Learning dan Online Travel Agent, dengan perolehan total sebanyak 339 responden. Hasil penilaian menunjukkan bahwa aplikasi pada kategori Online Travel Agent secara umum memperoleh skor yang lebih tinggi dibandingkan dengan aplikasi e-Learning. Selain itu, diperoleh serangkaian rekomendasi antarmuka untuk beberapa aplikasi pada masing-masing kategori berdasarkan titik kerendahan skor pada butir kuesioner. Oleh karena itu, dapat disimpulkan bahwa implementasi aplikasi kuesioner Rule8 sebagai platform instrumen penilaian desain antarmuka dapat dijadikan tolak ukur performa desain antarmuka serta alat analisis titik kelemahan desain antarmuka suatu aplikasi.

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This research aims to develop an interface design assessment instrument in the form of a web-based online questionnaire application utilizing Shneiderman's Eight Golden Rules of Interface Design principles as its theoretical basis. The development of questionnaire questions were carried out by evaluating the questionnaire that had been designed by Irfani (2020) qualitatively through content validity interviews with UI/UX practitioners or experts as well as face validity interviews with target application users. The User-Centered Design approach is used for the development of said application’s interface design while system development is then carried out using the Kanban approach method. The developed application is then implemented by assessing e-Learning and Online Travel Agent case study applications, resulting in a total of 339 respondents. Assessment results show that applications in the Online Travel Agent category would generally obtain higher scores compared to e-Learning applications. In addition, a series of interface design recommendations for several applications in each category were obtained from score and comparison analysis based on aspects with the lowest scores. Hence, it can be concluded that the implementation of the Rule8 questionnaire application as an interface design assessment instrument platform can be used as a benchmark for interface design performance as well as a tool for analyzing weak points in an application's interface design."

"Prsoses inversi dan forward modeling merupakan proses yang umum dilakukan dalam keilmuan geofisika khususnya pada metode magnetotelurik (MT) untuk memprediksi data dan parameter fisis material batuan di bawah permukaan bumi. Data dalam konteks ini merupakan resistivitas semu dan fase sementara parameter fisis merupakan resistivitas batuan. Proses tersebut biasanya dilakukan dengan menggunakan perangkat lunak tertentu yang perlu di unduh dan di install pada perangkat keras yang memenuhi spesifikasi, hal ini menjadi tidak fleksibel karena perangkat lunak perlu di install ulang jika ingin mengganti perangkat keras dan tidak semua perangkat keras dapat digunakan. Pada penelitian ini penulis mengembangkan platform website berbasis bahasa pemrograman python untuk melakukan proses forward modeling dan inversi data MT 1-D. Forward modeling dilakukan dengan menggunakan persamaan rekursif yang menyatakan hubungan antara impedansi dua lapisan sedangkan inversi dilakukan dengan menggunakan metode Levenberg-Marquardt. Pada inversi dengan stasiun lebih dari 1 maka kurva sounding hasil inversi akan dibentuk menjadi penampang resistivitas bawah permukaan dengan cara Krigging. Secara kuantitatif hasil inversi dengan website memiliki RMS error berkisar 0.08-0.21 % untuk data sintetik dan 0.84-1.84 % untuk data lapangan, secara kualitatif kurva inversi website memiliki trend yang mirip dengan software konvensional sehingga inversi website dinilai cukup valid. Dengan dikembangkannya platform web ini proses inversi dan forward modeling data MT 1-D dapat dilakukan di mana saja melalui perangkat apapun selama terdapat koneksi internet dan browser. Namun karena terdapat perbedan antara penampang hasil inversi website dengan software konvensional yang menyebabkan detil struktur tidak terlihat, maka website ini lebih cocok untuk digunakan pada keperluan akademis untuk melihat pola resistivitas bawah permukan secara umum dan bukan secara detail.

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Invers and forward modeling is a common process or technique done in the field of geophysics, particularly on magnetotelluric method (MT) in order to predict data and physical parameters of rock materials underneath the surface. Data in this context is apparent resistivity and phase, while physical parameters is the conductivity of the rock materials. This process usually conducted using a certain software that has to be installed on a hardware that meets the minimum requirement, this is not flexible in modern age because the software would need to be re-installed if we wish to use other device, moreover not all device is compatible. In this research, writer is developing a web platform based on python programming language for the purpose of forward and invers modeling of 1-D MT data. The forward modeling algorithm is done by utilizing the recursive equation which states the relationship between impedance of two sequential layers while inverse modeling is done using Levenberg-Marquardt method. In a case where the inverted data has more than 1 station, the sounding curve as the output of the inversion will be made into a resistivity crossection using Krigging. Quantitatively the inversion result using this website has an RMS error of 0.08 - 0.21 % for syntethic data and 0.84 – 1.84 % for real data, qualitatively the inversion curve resulting from this website has similar trend to an inversion curve done by a conventional software, thus the inversion using this website is valid. With the development of this web platform the inverse and forward modeling process of 1-D MT data can be conducted anywhere through all kinds of device as long as internet conection and browser is available. However due to the difference between cross section resulting from inversion using website and using conventional software that has lead to certain structure can not be seen, therefore this website is more suitable to be used in an academic purposes to see subsurface resistivity pattern in general and not in detail."

"[ABSTRAKLatar belakang:Hipertensimerupakan salah satu faktor risiko gagal jantung kongestif. Di rawat inap RSUD Pasar Rebo pada tahun 2014, gagal jantung kongestif masuk dalam 10 penyakit terbanyak, dengan biaya total yang cukup besar dan terdapat selisih tarif antara tarif RS dengan tarif JKN, sehingga perlu dilakukan analisis minimalisasi biaya salah satunya pada obat antihipertensi.Tujuan: Penelitian ini bertujuan untuk memilih alternatif yang lebih cost- minimize antara ramipril-spironolakton dengan valsartan pada pengobatan gagal jantung kongestif di RSUD Pasar Rebo tahun 2014.Metode Penelitian: Penelitian ini merupakan penelitian kuantitatifberupa analisis cross-sectional retrospektif. Penelitian dilakukan dengan membandingkan nilai rata-rata biaya total dua alternatif pengobatan gagal jantung kongestif, yaitu ramipril-spironolakton dengan valsartan dengan menggunakan perspektif Rumah Sakit. Komponen biaya langsung medis yang dihitung adalah biaya obat, biaya jasa dokter dan biaya rawat inap. Sedangkan efektivitas dipastikan memiliki efek yang setara.Hasil: Berdasarkan hasil penelitian yang telah dilakukan pada pasien gagal jantung kongestif di RSUD Pasar Rebo tahun 2014 didapatkan bahwa: (1) Nilairata-rata biaya total penggunaan kombinasi obat ramipril-spironolakton sebesar Rp.2.527.743; (2) Rata-rata biaya total penggunaan obat valsartan sebesar Rp.2.430.923; (3) Obat ramipril-spironolakton efektivitasnya tidak berbeda signifikan atau setara dengan obat valsartan; (4) Adanya penghematan pada rata- rata biaya total obat valsartan sebesar Rp.96.820 per pasien; (5) Adanya penghematan pada biaya rawat inap obat valsartan sebesar Rp.299.031 per pasien.Kesimpulan: Obat valsartan memberikan nilai rupiah yang terendah dan menjadi pilihan yang lebih cost-minimize dibandingkan obat ramipril-spironolakton pada pasien gagal jantung kongestif di RSUD Pasar Rebo Tahun 2014.

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ABSTRACTBackground: Hypertension once of risk factor for congestive heart failure. The Pasar Rebo Hospital inpatient care in 2014, congestive heart failure is the top 10 most prevalent diseases, with a large of number total cost and there is a difference between tariff rates RS and JKN rate, so we need a cost-effectiveness analysis one with antihypertensive drug.Objective: This study aimed to choose an alternative that is more cost-minimize between the ramipril-spironolactone with valsartan in the treatment of congestive heart failure at Pasar Rebo Hospital in 2014.Methods: This is a quantitative research in the form of a retrospective cross- sectional analysis. The study was conducted by comparing the average value of total cost of two alternative treatment of congestive heart failure, ramipril- spironolactone with valsartan by using Hospital’s perspective. The direct medical cost component are cost of drugs, cost of physician services and cost of hospitalizations. Whereas effectiveness measuredand firmly to be equivalent.Results: Based on the research that has been conducted in patients with congestive heart failure at Pasar Rebo Hospital in 2014 found that: (1) The average total cost of ramipril-spironolactone’s drugare Rp.2.527.743; (2) The average total cost of valsartan’s drug are Rp.2.430.923; (3) Ramipril- spironolactone’s drug effectiveness does not significantly difference to valsartan’s drug; (4) There is cost saving on the average of total cost using valsartan’s drug Rp.96.820 per patient; (5) There is cost saving on hospitalization cost using valsartan’s drug Rp.299.031 per patient.Conclusions:V alsartan’ s drug give lowest rupiah value and be more cost minimizes option than ramipril-spironolactone’s drug for patient with congestive heart failure at Pasar Rebo Hospital in 2014., Background: Hypertension once of risk factor for congestive heart failure. The Pasar Rebo Hospital inpatient care in 2014, congestive heart failure is the top 10 most prevalent diseases, with a large of number total cost and there is a difference between tariff rates RS and JKN rate, so we need a cost-effectiveness analysis one with antihypertensive drug.Objective: This study aimed to choose an alternative that is more cost-minimize between the ramipril-spironolactone with valsartan in the treatment of congestive heart failure at Pasar Rebo Hospital in 2014.Methods: This is a quantitative research in the form of a retrospective cross- sectional analysis. The study was conducted by comparing the average value of total cost of two alternative treatment of congestive heart failure, ramipril- spironolactone with valsartan by using Hospital’s perspective. The direct medical cost component are cost of drugs, cost of physician services and cost of hospitalizations. Whereas effectiveness measuredand firmly to be equivalent.Results: Based on the research that has been conducted in patients with congestive heart failure at Pasar Rebo Hospital in 2014 found that: (1) The average total cost of ramipril-spironolactone’s drugare Rp.2.527.743; (2) The average total cost of valsartan’s drug are Rp.2.430.923; (3) Ramipril- spironolactone’s drug effectiveness does not significantly difference to valsartan’s drug; (4) There is cost saving on the average of total cost using valsartan’s drug Rp.96.820 per patient; (5) There is cost saving on hospitalization cost using valsartan’s drug Rp.299.031 per patient.Conclusions:V alsartan’ s drug give lowest rupiah value and be more cost minimizes option than ramipril-spironolactone’s drug for patient with congestive heart failure at Pasar Rebo Hospital in 2014.]"

"Latar Belakang: Beberapa penelitian telah menunjukkan bahwa hipokloremia berhubungan dengan peningkatan rehospitalisasi dan mortalitas pada pasien dengan gagal jantung (chloride hypothesis). Akan tetapi, penelitian-penelitian tersebut hanya membandingkan kelompok pasien gagal jantung dengan hipokloremia dengan kelompok normokloremia saat admisi. Tujuan: Mengetahui pengaruh normalisasi kadar klorida terhadap rehospitalisasi dan mortalitas pasien gagal jantung. Metode: Dilakukan penelitian kohort prospektif pasien gagal jantung dekompensasi akut (GJDA) yang dirawat inap dari September 2018 sampai Februari 2019. Pasien dengan hipokloremia dan normonatremia saat admisi dibagi menjadi kelompok hipokloremia persisten hingga saat pemulangan dibanding kelompok normokloremia saat pemulangan. Luaran primer adalah rehospitalisasi karena gagal jantung dalam 180 hari. Luaran sekunder adalah mortalitas dalam 180 hari. Hasil: Terdapat 162 pasien (53,6%) yang termasuk dalam kelompok hipokloremia persisten dan 140 pasien (46,3%) yang termasuk dalam kelompok normokloremia saat pemulangan. Model regresi Cox menunjukkan hipokloremia persisten tidak berkaitan bermakna dengan peningkatan rehospitalisasi karena gagal jantung (hazard ratio 1,21; interval kepercayaan 95% 0,78-1,89; p 0,392) dan mortalitas (hazard ratio 1,39; interval kepercayaan 95% 0,74-2,65; p 0,305) dibandingkan dengan kelompok normokloremia saat pemulangan. Kesimpulan: Hipokloremia persisten pada pasien GJDA bukan merupakan prediktor independen terhadap rehospitalisasi gagal jantung dan mortalitas.

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Background: Recent studies have shown that hypochloremia is associated with increased risk of rehospitalization and death in patients with heart failure (chloride hypothesis). In these studies, however, patients with hypochloremia were compared only with patients with a normal chloride level at hospital admission. Aim: To evaluate the effect of the normalization of serum chloride on the heart failure to rehospitalization and mortality. Method: This was a prospective cohort study of patients hospitalized for acute decompensated heart failure (ADHF) from September 2018 to February 2019. Patients with hypochloremia and normonatremia at admission were divided into patients with persistent hypochloremia at the time of discharge and patients who achieved normalization of their serum chloride levels at discharge. The primary outcome was 180-day rehospitalization. The secondary outcome was 180-day mortality.

Results: There were 162 patients (53,6%) with persistent hypochloremia and 140 patients (46,3%) with normochloremia at discharge. Cox regression model indicated persistent hypochloremia did not significantly predict heart failure rehospitalisation (hazard ratio 1.21; 95% confidence interval 0.78-1.89; p 0.392) and mortality (hazard ratio 1.39; 95% confidence interval 0.74-2.65; p 0.305) compared with group of normochloremia at discharge.

Conclusion: Persistent hypochloremia in ADHF patients is not an independent predictor of heart failure rehospitalisation and mortality."