Marthias, Tiara and Anindya, Kanya and Ng, Nawi and McPake, Barbara and Atun, Rifat and Arfyanto, Hafiz and Hulse, Emily Sg and Zhao, Yang and Jusril, Hafizah and Pan, Tianxin and Ishida, Marie and Lee, John Tayu (2021) Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: A population-based panel data analysis study. BMJ Open, 11 (2). ISSN 20446055
Full text not available from this repository. (Request a copy)Abstract
Objectives To examine non-communicable diseases (NCDs) multimorbidity level and its relation to households' socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss. Design This study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5). Setting The original sampling frame was based on 13 out of 27 provinces in 1993, representing 83 of the Indonesian population. Participants We included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents. Primary outcome measures We examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables, Results Women were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95 CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95 CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95 CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95 CI 0.16 to 0.33) compared with no NCD. Conclusions NCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Item Type: | Article |
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Additional Information: | Cited by: 32; All Open Access, Gold Open Access, Green Open Access |
Uncontrolled Keywords: | Cross-Sectional Studies; Data Analysis; Female; Health Expenditures; Health Services; Humans; Indonesia; Male; Middle Aged; Multimorbidity; Noncommunicable Diseases; adult; aged; Article; asthma; cerebrovascular accident; controlled study; diabetes mellitus; disease association; disease burden; employment status; female; gastrointestinal disease; groups by age; health care cost; health care utilization; health insurance; health survey; heart infarction; human; hypercholesterolemia; hypertension; incidence; Indonesia; laboratory test; liver disease; major clinical study; male; middle aged; multiple chronic conditions; non communicable disease; outpatient; outpatient care; physical examination; prevalence; social status; sustainable development; workforce; cross-sectional study; data analysis; health service; non communicable disease |
Subjects: | R Medicine > RB Biomedical Sciences |
Divisions: | Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition |
Depositing User: | Sri JUNANDI |
Date Deposited: | 24 Sep 2024 08:53 |
Last Modified: | 24 Sep 2024 08:53 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/4720 |