Indraswari, Braghmandita Widya and Kelling, Emil and Vassileva, Sofi M. and Sitaresmi, Mei Neni and Danardono, Danardono and Mulatsih, Sri and Supriyadi, Eddy and Widjajanto, Pudjo Hagung and Sutaryo, Sutaryo and Kaspers, Gertjan L. and Mostert, Saskia (2021) Impact of universal health coverage on childhood cancer outcomes in Indonesia. Pediatric Blood and Cancer, 68 (9). ISSN 15455009
Full text not available from this repository. (Request a copy)Abstract
Background: Starting from 2014, the Indonesian government has implemented Universal Health Coverage (UHC) with the aim to make healthcare services accessible and affordable to all Indonesian citizens. A major reason for childhood cancer treatment failure in low- and middle-income countries, particularly among families with low socioeconomic status (SES), is abandonment of expensive cancer treatment. Our study compared childhood cancer treatment outcomes of the overall, low, and high SES population before and after introduction of UHC at a large Indonesian academic hospital. Methods: Medical records of 1040 patients diagnosed with childhood cancer before (2011-2013, n = 506) and after (2014-2016, n = 534) introduction of UHC were abstracted retrospectively. Data on treatment outcome, SES, and health-insurance status at diagnosis were obtained. Findings: After introduction of UHC, the number of insured patients increased from 38 to 82 (P < 0.001). Among low SES population, insurance coverage increased from 40 to 85 (P < 0.001), and among high SES population from 33 to 77 (P < 0.001). In the overall population, treatment abandonment decreased from 36 to 22 (P < 0.001). Event-free survival estimates at four years after diagnosis of overall population improved from 16 to 22 (P < 0.001). Hazard ratio for treatment failure was 1.26 (CI: 1.07-1.48, P = 0.006) for uninsured versus insured patients. In the low SES population, treatment abandonment decreased from 36 to 19 (P < 0.001). Event-free survival estimates at four years after diagnosis of low SES population improved from 14 to 22 (P < 0.001). Interpretation: Introduction of UHC in Indonesia contributed significantly to better treatment outcome and event-free survival of children with cancer from low SES families. © 2021 Wiley Periodicals LLC
Item Type: | Article |
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Additional Information: | Cited by: 5 |
Uncontrolled Keywords: | Child; Humans; Indonesia; Insurance Coverage; Neoplasms; Retrospective Studies; Social Class; Survival Rate; Universal Health Insurance; adolescent; adult; Article; child; childhood cancer; controlled study; data analysis software; event free survival; female; government; hazard ratio; health care access; health insurance; human; Indonesia; major clinical study; male; medical record review; medically uninsured; overall survival; retrospective study; school child; social status; treatment failure; treatment outcome; treatment withdrawal; university hospital; Indonesia; insurance; neoplasm; social class; survival rate |
Subjects: | R Medicine > RJ Pediatrics |
Divisions: | Faculty of Medicine, Public Health and Nursing > Biomedical Sciences |
Depositing User: | Sri JUNANDI |
Date Deposited: | 27 Sep 2024 00:57 |
Last Modified: | 27 Sep 2024 00:57 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/4592 |