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Non-communicable comorbidities in pulmonary tuberculosis and healthcare utilization: a cross-sectional study of 2021 Indonesian national health insurance data

Authors
 Danik Iga Prasiska  ;  Durga Datta Chapagain  ;  Kennedy Mensah Osei  ;  Vasuki Rajaguru  ;  Sun Joo Kang  ;  Tae Hyun Kim  ;  Sang Gyu Lee  ;  Whiejong Han 
Citation
 ARCHIVES OF PUBLIC HEALTH, Vol.82(1) : 127, 2024-08 
Journal Title
ARCHIVES OF PUBLIC HEALTH
ISSN
 0778-7367 
Issue Date
2024-08
Keywords
Comorbidity ; Health ; Insurance ; Non-communicable ; Service ; Tuberculosis
Abstract
Background
Limited research exists on the comorbidity of pulmonary tuberculosis with non-communicable diseases (NCDs) and its implications for healthcare utilization in Indonesia. The lack of investigation into NCD comorbidity among pulmonary tuberculosis patients could adversely affect both the healthcare system and the national health insurance scheme. Understanding the NCD comorbidity among pulmonary tuberculosis patients, associated factors, and healthcare utilization is crucial for ensuring the effective and efficient delivery of health services.

Method
This study utilized an observational cross-sectional design based on anonymized sample data from tuberculosis cases covered by Indonesia's National Health Insurance in 2021. Chi-square tests were employed to analyze dependent and independent variables, while unadjusted and adjusted logistic regressions were used to explore further associations.

Results
The prevalence of NCD comorbidity in tuberculosis patients was 11.81%. Aged over 60 (aOR 5.16; [CI] 4.23—6.3), married (aOR 1.19; [CI] 1.05—1.34), and unemployed (aOR 1.27; [CI] 1.08—1.49) were associated with the NCD comorbidity in pulmonary tuberculosis patients. Factors associated with increased inpatient service utilization among pulmonary tuberculosis patients included aged over 60 (aOR 5.69; [CI] 4.81—6.74), male (aOR 1.32; [CI] 1.23—1.40), self-employment (aOR 1.42; [CI] 1.29—1.56), having insurance subsidized by central government (aOR 1.89; [CI] 1.73—2.08) or local government funds (aOR 1.75; [CI] 1.58—1.93), and having comorbidity non-communicable diseases (aOR 1.80; [CI] 1.66—1.96).

Conclusion
Pulmonary tuberculosis patients exhibit a significant prevalence of NCD comorbidity, which substantially impacts healthcare utilization. Early detection and management of these conditions are critical to mitigate burdens on both the healthcare system and the financial sustainability of the national health insurance scheme. Integrating health services for tuberculosis and NCDs through bidirectional screening is essential for comprehensive patient care.
Files in This Item:
T202405511.pdf Download
DOI
39160626
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kang, Sunjoo(강선주) ORCID logo https://orcid.org/0000-0002-1633-2558
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Rajaguru, Vasuki(바수키) ORCID logo https://orcid.org/0000-0003-2519-2814
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
Han, Whiejong(한휘종)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200556
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