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"Latar belakang: COVID-19 menginfeksi semua kelompok umur, namun beban infeksi lebih tinggi dan lebih berbahaya pada kelompok usia lanjut. Pasien yang mengalami infeksi akut COVID-19 juga bisa mengalami gejala menetap yang disebut dengan Sindrom Pasca COVID-19, khususnya pada lansia. Belum ada data yang menunjukkan prevalensi Sindrom Pasca COVID-19 pada lansia di Indonesia dan juga faktor-faktor risiko yang berhubungan dengan kejadian Sindrom Pasca COVID-19 pada lansia.Tujuan: Penelitian ini bertujuan untuk mengetahui seberapa besar prevalensi Sindrom Pasca COVID-19 pada lansia di Indonesia serta meneliti hubungan antara faktor-faktor risiko dengan kejadian Sindrom Pasca COVID-19 dengan menggunakan definisi waktu >4 minggu, >8 minggu, dan >12 minggu.Metode: Penelitian ini merupakan penelitian kohort retrospektif yang menggunakan rekam medis dan wawancara untuk mendapatkan data terkait keberadaan faktor-faktor risiko dan gejala menetap pasca perawatan infeksi akut COVID-19.Hasil: Penelitian ini diikuti oleh 329 pasien lansia (≥60 tahun) yang sempat dirawat akibat COVID-19 di RSCM dan RS Mitra Keluarga Kalideres pada 1 Januari-31 Desember 2021. Prevalensi Sindrom Pasca COVID-19 pada lansia adalah sebesar 31%, 18,24%, dan 10,64% dengan menggunakan definisi waktu >4 minggu, >8 minggu, dan >12 minggu, secara berurutan. Clinical Frailty Scale rawat inap (OR 2,814 [IK 95% 1,172-6,758) dan imobilitas rawat inap (OR 4,767 [IK95% 2,117-10,734]) berhubungan dengan Sindrom Pasca COVID-19 >4 minggu. Selanjutnya, jumlah gejala awal (OR 2,043 [IK95% 1,005-4,153]), konstipasi rawat inap (OR 2,832 [IK95% 1,209-6,633]), imobilitas rawat inap (OR 2,515 [IK95% 1,049-6,026]), dan instabilitas rawat inap (OR 2,291 [IK95% 1,094-4,800) berhubungan dengan Sindrom Pasca COVID-19 >8 minggu. Gangguan pendengaran dan penglihatan follow-up (OR 2,926 [IK95% 1,285-6,665]) dan imobilitas rawat inap (OR 3,684 [IK95% 1,507-9,009]) berhubungan dengan Sindrom Pasca COVID-19 >12 minggu.Kesimpulan: Infeksi akut dengan ≥ 5 gejala, adanya frailty dan sindrom geriatri, khususnya imobilitas saat perawatan, berhubungan dengan Sindrom Pasca COVID-19 pada lansia.

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Background: COVID-19 infects all age groups, but the burden of infection is higher and more dangerous in the elderly. Patients with acute COVID-19 infection can also experience persistent symptoms called Post-Covid-19 Syndrome, especially elderly. No data show the prevalence of Post-Covid-19 Syndrome in the elderly in Indonesia and the risk factors associated with the occurrence of Post-Covid-19 Syndrome in the elderly

Objective: This study aims to determine the prevalence of Post-Covid-19 Syndrome in the elderly in Indonesia and examine the relationship between risk factors and the incidence of Post-Covid-19 Syndrome by using the definition of time > 4 weeks, > 8 weeks. , and >12 weeks.

Methods: This study is a retrospective cohort study that uses medical records and interviews to obtain data regarding risk factors and persistent symptoms after treatment of acute COVID-19 infection.

Results: This study is followed by 329 elderly patients (≥60 years) who had been treated because of COVID-19 at Cipto Mangunkusumo Hospital and Mitra Keluarga Kalideres Hospital from January 1st until December 31st, 2021. the prevalence of Post COVID-19 Syndrome in the elderly was 31%, 18.24%, and 10.64% using the time definition of >4 weeks, >8 weeks, and >12 weeks, respectively. Clinical Frailty Scale during hospitalization scores (OR 2.814 [95% CI 1.172-6.758]) and immobility during hospitalization (OR 4.767 [95% CI 2.117-10.734]) were associated with Post-Covid-19 Syndrome >4 weeks. Furthermore, number of initial symptoms (OR 2,043 [CI95% 1.005-4.153]), constipation during hospitalization (OR 2.832 [CI95% 1.209-6633]), immobility during hospitalization (OR 2,515 [95% CI 1,049-6.026]), and instability during hospitalization (OR 2,291 [CI 95% 1,094-4,800]) was associated with Post-Covid-19 Syndrome >8 weeks. In addition, impairment of visual and hearing during follow-up (OR 2,926 [95% CI 1,285-6,665]) and immobility during hospitalization (OR 3,684 [95% CI 1.507-9,009]) was associated with Post-Covid-19 Syndrome >12 weeks.

Conclusions: Acute infection with ≥ 5 symptoms, frailty, and geriatric syndrome, especially immobility during hospitalization, were associated with Post-Covid-19 Syndrome in the elderly."

"Latar belakang: Pendekatan Paripurna Pasien Geriatri (P3G) telah menjadi standar pelayanan di RSCM karena terbukti menghasilkan luaran perawatan geriatri yang lebih baik. Semenjak awal tahun 2014, di Indonesia diberlakukan sistem pembiayaan Jaminan Kesehatan Nasional. Belum diketahui apa pengaruh penerapan JKN terhadap kesintasan dan efektifitas biaya pasien geriatri yang dirawat di RSCM. Tujuan: Mengetahui perbandingan kesintasan dan efektifitas biaya pasien geriatri pada era JKN dan non JKN yang dirawat di RSCM. Metode: Penelitian menggunakan metode kohort retrospektif dengan kontrol historis. Sampel dikumpulkan dari pasien geriatri yang dirawat di RSCM selama periode Juli 2013-Juni 2014 yang kemudian dibagi menjadi kelompok JKN dan kelompok non JKN sebagai kontrol. Akan dinilai perbedaan kesintasan dengan kurva kesintasan dan efektifitas biaya perawatan dengan menghitung incremental cost effectiveness ratio (ICER). Hasil: Dari total 225 subjek, 100 subjek berada di era non JKN dan 125 subjek di era JKN dengan karakteristik demografis dan klinis yang relatif sama. Tidak ada perbedaan mortalitas selama perawatan dan kesintasan 30 hari antara kelompok JKN dan non JKN (31,2% vs 28%, p=0,602 dan 65,2% vs 66,4%, p = 0,086). Kurva kesintasan 30 hari antara kedua kelompok tidak menunjukkan perbedaan bermakna. ICER memperlihatkan pada era JKN investasi biaya Rp. 1,4 juta,- terkait dengan penurunan kesintasan 1,2% dibandingkan kelompok non JKN, namun perbedaan tersebut tidak bermakna secara klinis dan statistik. Simpulan: Tidak ada perbedaan bermakna angka mortalitas antara pasien geriatri yang dirawat di RSCM pada kelompok JKN dan non JKN. Perhitungan ICER menunjukkan dibutuhkan investasi biaya untuk memperoleh penurunan kesintasan pada penerapan JKN, namun perlu dipertimbangkan implentasi JKN yang masih dalam tahap awal. Diperlukan penelitian lanjutan saat implementasi JKN telah berlangsung dalam kurun waktu lebih panjang.

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Background: Comprehensive Geriatrics Assesment (CGA) has been proven to improve the overall outcome of inpatient geriatric patients, and has been implemented in RSCM as the standard geriatric medical care. Since January 2014, a new insurance system called National Health Insurance Program (NHIP) was implemented in Indonesia. It is unclear how NHI will affect survival and cost effectiveness of geriatric inpatients receiving CGA.

Objectives: To compare the survival and cost effectiveness betewwn NHIP and non NHIP era in geriatric patients admitted in RSCM.

Method: This is a retrospective cohort study with hystorical control. The subject were geriatric inpatients ≥60 years old with one or more geriatrics giants between Juli to Desember 2013 (non NHIP) and Januari to Juni 2014 (NHIP). A survival analysis and determination of incremental cost effectivitveness ratio (ICER) was used to compare the survival and cost effectiveness between the two group.

Result: The clinical and demographics characteristics were relatively similar between the NHIP and non NHIP group. No difference in inhospital mortaliy rate and 30 day survival rate between NHIP and non NHIP group (31,2% vs 28%, p=0,602, 65,2% vs 66,4%, p = 0,086, respectively). No significant difference was found when comparing the survival curve between the two group. Calculation of ICER shows that NHIP is associated with an increased cost of 1,4 million rupiah and 1,2 % higher mortality rate.

Conclusion: NHIP had no impact on survival in geriatric inpatients. ICER calculation shows NHIP implementation is associated with higher investment cost to yield lower survival rate. Further research is needed to evaluate this result when NHIP had been implemented for a longer duration."