ArticleBMJ open2021
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.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 5 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Indirect Costs of Non-Communicable Diseases within the Top Ten Causes of Mortality Worldwide: A Systematic Literature Review.Iranian journal of medical sciences · 2026Pooled it
- Equitable utilization of non-communicable disease services in low- and middle-income countries; associated factors and intervention effects: a systematic review and meta-analysis.BMC health services research · 2026Pooled it
- Variations in multimorbidity measurement in studies evaluating hospitalisation in older adults: a systematic review.BMC geriatrics · 2025Pooled it
- Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.Age and ageing · 2022Pooled it
- The association between educational level and multimorbidity among adults in Southeast Asia: A systematic review.PloS one · 2021Pooled it
- Trial
- Article
- Financial burden of noncommunicable diseases on households in Bangladesh: a quasi-experimental analysis using national survey data.Health economics review · 2026Article
- Burden and temporal trends of non-communicable diseases from 1990 to 2021 and prediction to 2035 in the group of twenty countries: a systematic analysis of the Global Burden of Disease Study 2021.Frontiers in microbiology · 2026Article
- Multimorbidity and the indirect cost of productivity loss from health-related work absenteeism in Belgium.European journal of public health · 2025Observational
- Setting priorities for healthcare interventions in Indonesia: a comprehensive conceptual framework.International journal for equity in health · 2025Review
- Opportunities for improvement of community-based non-communicable disease screening practices in Indonesia: a participant satisfaction survey.BMC health services research · 2025Article
- Article
- How Does Indonesian Chronic Disease Patient Adhere to Their Treatment? A Cross-Sectional Analysis of 11,408 Subjects.Patient preference and adherence · 2025Article
- Clustering the Economic Status via Partitioning around Medoid and Its Association with Common Non-communicable Diseases.Iranian journal of medical sciences · 2024Article
- Treatment Nonadherence among Multimorbid Chronic Disease Patients: Evidence from 3515 Subjects in Indonesia.Medicina (Kaunas, Lithuania) · 2024Article
- The impact of multimorbidity among adults with cardiovascular diseases on healthcare costs in Indonesia: a multilevel analysis.BMC public health · 2024Article
- Development and validation of the adolescent behavioural change Counselling Assessment Tool in Indonesia.BMC health services research · 2024Article
- Living with Multimorbidity through Time: A Meta-Synthesis of Qualitative Longitudinal Evidence.Healthcare (Basel, Switzerland) · 2024Review
- NHS Health Check attendance is associated with reduced multiorgan disease risk: a matched cohort study in the UK Biobank.BMC medicine · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine non-communicable diseases (NCDs) multimorbidity level and its relation to households' socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.
designThis study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).
settingThe original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.
participantsWe 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,
resultsWomen 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.
conclusionsNCD 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.
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