Abstract
Given the increasing burden of chronic diseases in Indonesia, characteristics of chronic multimorbidities have not been comprehensively explored. Therefore, this research evaluated chronic multimorbidity patterns among Indonesians using Indonesian National Health Insurance (INHI) sample data. We included 46 chronic diseases and analyzed their distributions using population-weighted variables provided in the datasets. Results showed that chronic disease patients accounted for 39.7% of total patients who attended secondary health care in 2015–2016. In addition, 43.1% of those were identified as having chronic multimorbidities. Findings also showed that multimorbidities were strongly correlated with an advanced age, with large numbers of patients and visits in all provinces, beyond those on Java island. Furthermore, hypertension was the leading disease, and the most common comorbidities were diabetes mellitus, cerebral ischemia/chronic stroke, and chronic ischemic heart disease. In addition, disease proportions for certain disease dyads differed according to age group and gender. Compared to survey methods, claims data are more economically efficient and are not influenced by recall bias. Claims data can be a promising data source in the next few years as increasing percentages of Indonesians utilize health insurance coverage. Nevertheless, some adjustments in the data structure are accordingly needed to utilize claims data for disease control and surveillance purposes.
Highlights
The rise of multimorbidities is commonly associated with large demands for healthcare utilization [1]
Hypertension was the leading disease that was present in 70% of the most common disease dyads in the five regions
Age is the most important variable that corresponds to the risk of having chronic multimorbidities
Summary
The rise of multimorbidities is commonly associated with large demands for healthcare utilization [1]. Most multimorbidity studies revealed that an advanced age is the factor most often correlated with increasing odds of having chronic multimorbidities [2,3,4,5,6,7], which corresponds to a large proportion of multimorbidities in elderly groups [8]. Indonesia is currently entering the early stages of an aging population with more than 25 million citizens currently aged ≥60 years [9] or 9% of the total population. Despite this condition, only limited programs for elderly groups that include health aspects can be provided
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