Tesis

Analisis Beban Finansial terhadap Kualitas Hidup pada Pasien Kanker yang Menjalani Terapi Radiasi di Rumah Sakit Pusat Rujukan Nasional Indonesia. = Financial Burden Analysis on the Health-Related Quality of Life in Cancer Patients Undergoing Radiation Therapy at the National Referral Hospital in Indonesia.

Tujuan: Mengetahui hubungan beban finansial terhadap kualitas hidup pasien kanker yang menjalani terapi radiasi di instalasi radioterapi rumah sakit pusat rujukan nasional Indonesia yang menggunakan JKN. Metode: Desain penelitian deskriptif analitik dengan metode cross sectional. Data diambil dari rekam medis dan kuesioner yang didalamnya terdapat formulir EORTC QLQ-C30 untuk menilai HRQoL, yang diisi melalui wawancara via telepon pada pasien kanker yang telah menjalani radioterapi di IPTOR RSUPN Dr. Cipto Mangunkusumo periode Januari 2022 - Maret 2023. Dilakukan analisis untuk mengidentifikasi dan mengetahui hubungan antara karakteristik sosiodemografi, klinis, dan ekonomi/beban ekonomi, terhadap HRQoL pasien kanker. Hasil: Dari analisis bivariat masing-masing variabel independen, didapatkan untuk global health yang secara statistik memiliki hubungan (p > 0,25) antara lain usia (p=0,166), jenis kelamin (p=0,090), stadium (p=0,111), pendapatan bulanan (p=0,114), dan skor COST FACIT (p < 0,001). Untuk fungsi fisik, yang berhubungan yaitu KPS (p=0,089), OTT (p=0,048), pendapatan (p=0,146), dan skor COST FACIT (p < 0,001). Sedangkan fungsi emosional, berhubungan dengan usia (p=0,081), jenis kelamin (p=0,113), KPS (p=0,119), indikasi radiaisi (p=0,188), OTT (p=0,053), OOP (p=0,021), financial catastrophe (p=0,135), dan skor COST FACIT (p < 0,001). Hasil analisis multivariat dengan regresi linier didapatkan hanya skor COST FACIT yang memiliki nilai p < 0,05 dari analisisi regresi liniernya untuk global health (p < 0,001 b=0.443 R2=18,8%), fungsi fisik (p < 0,001 b=0,456 R2=20,1%), dan fungsi emosional (p < 0,001 b=0,523 R2=34,6%). Kesimpulan: Toksisitas finansial memilki hubungan yang bermakna dalam menilai HRQoL pasien kanker yang menjalani radioterapi. Pendapatan, OOP, dan financial catastrophe juga dapat dipertimbangkan dan menjadi perhatian dalam mengevaluasi HRQoL dari pasien kanker.
Kata Kunci: Radioterapi, beban kanker, financial catastrophe, toksisitas finansial, HRQoL.



Objective: To determine the relationship between financial burden and the quality of life of cancer patients undergoing radiation therapy at the radiotherapy installation of the national referral hospital in Indonesia that utilizes the National Health Insurance (JKN). Methods: A descriptive-analytical research design with a cross-sectional method was employed. Data were obtained from medical records and questionnaires containing the EORTC QLQ-C30 form to assess HRQoL, filled out through telephone interviews with cancer patients who had undergone radiotherapy at IPTOR RSUPN Dr. Cipto Mangunkusumo from January 2022 to March 2023. An analysis was conducted to identify and understand the relationship between sociodemographic, clinical, and economic/economic burden characteristics with the HRQoL of cancer patients. Results: From the analysis of each independent variable, it was found that for global health, there is a statistically significant relationship (p > 0.25) with age (p=0.166), gender (p=0.090), stage (p=0.111), monthly income (p=0.114), and COST FACIT score (p < 0.001). For physical function, the relationship variables are KPS (p=0.089), OTT (p=0.048), income (p=0.146), and COST FACIT score (p < 0.001). Meanwhile, emotional function related to age (p=0.081), gender (p=0.113), KPS (p=0.119), radiation indication (p=0.188), OTT (p=0.053), OOP (p=0.021), financial catastrophe (p=0.135), and COST FACIT score (p < 0.001). The results of multivariate analysis with linear regression show that only the COST FACIT score has a p-value < 0.05 from its linear regression analysis for global health (p < 0.001 b=0.443 R2=18.8%), physical function (p < 0.001 b=0.456 R2=20.1%), and emotional function (p < 0.001 b=0.523 R2=34.6%). Conclusion: Financial toxicity is significantly related to assessing the HRQoL of cancer patients undergoing radiotherapy. Income, OOP, and financial catastrophe should also be considered and given attention when evaluating the HRQoL of cancer patients.
Keywords: Radiotherapy, cancer burden, financial catastrophe, financial toxicity, HRQoL.