Finkelstein Eric A, Chay Junxing, Bajpai Shailendra
Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore, Singapore; Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore, Singapore.
PLoS One. 2014 Jun 10;9(6):e99572. doi: 10.1371/journal.pone.0099572. eCollection 2014.
The goal of this study is: (1) to estimate the current direct out-of-pocket (OOP) and indirect non-communicable diseases (NCD) burden on Indonesian households and (2) to project NCD prevalence and burden in 2020 focusing specifically on hypertension, diabetes, heart problems and stroke.
This study relies on econometric analyses based on four waves of the Indonesian Family Life Survey (IFLS).
In aggregate, of the NCDs studied, heart problems exert the greatest economic burden on households, costing Int$1.56 billion in OOP and indirect burden in 2010. This was followed by hypertension (Int$1.36 billion), diabetes (Int$0.81 billion) and stroke (Int$0.29 billion). The OOP and indirect burden of these conditions is estimated to be Int$4.02 billion. Diabetes and stroke are expected to have the largest proportional increases in burden by 2020; 56.0% for diabetes and 56.9% for stroke to total Int$1.27 billion and Int$0.45 billion respectively. The burden of heart problems in 2020 is expected to increase by 34.4% to total Int$2.09 billion and hypertension burden will increase by 46.1% to Int$1.99 billion. In 2020, these conditions are expected to impose an economic burden of Int$5.80 billion.
In conclusion, this study demonstrates the significant burden of 4 primary NCDs on Indonesian households. In addition to the indirect burden, hypertension, diabetes, heart problems and stroke account for 8% of the nation's OOP healthcare expenditure, and due to rising disease prevalence and an aging population, this figure is expected to increase to 12% by 2020 without a significant health intervention.
本研究的目的是:(1)估算印度尼西亚家庭目前因非传染性疾病产生的直接自付费用(OOP)和间接负担;(2)预测2020年非传染性疾病的患病率和负担,特别关注高血压、糖尿病、心脏问题和中风。
本研究依赖于基于印度尼西亚家庭生活调查(IFLS)四轮数据的计量经济学分析。
总体而言,在所研究的非传染性疾病中,心脏问题给家庭带来的经济负担最大,2010年的自付费用和间接负担达15.6亿印尼盾。其次是高血压(13.6亿印尼盾)、糖尿病(8.1亿印尼盾)和中风(2.9亿印尼盾)。这些疾病的自付费用和间接负担估计为40.2亿印尼盾。预计到2020年,糖尿病和中风的负担将有最大比例的增长;糖尿病增长56.0%,中风增长56.9%,分别达到12.7亿印尼盾和4.5亿印尼盾。预计2020年心脏问题的负担将增长34.4%,达到20.9亿印尼盾,高血压负担将增长46.1%,达到19.9亿印尼盾。2020年,这些疾病预计将带来58.0亿印尼盾的经济负担。
总之,本研究表明4种主要非传染性疾病给印度尼西亚家庭带来了沉重负担。除间接负担外,高血压、糖尿病、心脏问题和中风占该国医疗保健自付费用的8%,由于疾病患病率上升和人口老龄化,如果没有重大的健康干预措施,预计到2020年这一数字将增至12%。