Setiawan Ery, Devine Angela, Prameswary Helen Dewi, Baird J Kevin, Price Ric, Thriemer Kamala
Division of Global and Tropical Health, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Health Administration and Policy, Universitas Indonesia, Depok, Indonesia.
BMJ Glob Health. 2025 May 12;10(5):e018255. doi: 10.1136/bmjgh-2024-018255.
Data on morbidity, mortality and cost for malaria-related hospitalisation are important for prioritising resources for malaria control strategies, but these data are often limited. The aim of this study was to understand the current malaria service delivery in Indonesia, including referral rates to hospitals, mortality outcomes and malaria-related costs at hospitals, using data from National Health Insurance claims.
Data were gathered from the recent Indonesian National Health Insurance dataset for claims made between 2015 and 2020. Cases were selected for any diagnosis with the international classification of diseases-10th revision codes for malaria-related diseases. Patients' sociodemographic status, repeated presentations to healthcare facilities, referral patterns and costs of treatment for the hospital settings were assessed by malaria species. Costs were reported in 2020 US$.
Data were available for 12 970 episodes of malaria, which occurred in 8833 patients. accounted for 6019 (46.4%) episodes, and for 4307 (33.2%) episodes. The incidence rates were 0.38 (95% CI 0.29 to 0.47) per person-years for and 0.33 (95% CI 0.19 to 0.52) for . 46% of malaria cases initially presented at the hospital. Among these patients, the mean cost was US$16.2 (SD 4.4) for an outpatient consultation and US$228.7 (SD 122.6) for inpatient care. In total, 4.8% (623) of patients re-presented to the hospital within 30 days of a malaria episode, of whom 1.7% (219) required admission for inpatient care, which was estimated to cost US$230.0 (SD 105.5). The risk of mortality for inpatients with malaria was 2.1% (36/1718) compared with 1.2% (16/1359) for patients with malaria; p=0.069.
The National Health Insurance claim data provide detailed costing estimates. Integrating data from the existing malaria information system with the data from the National Health Insurance claims can provide important insights into the healthcare costs associated with the management of malaria that could help optimise national antimalarial policy.
疟疾相关住院治疗的发病率、死亡率和成本数据对于为疟疾控制策略确定资源优先级很重要，但这些数据往往有限。本研究的目的是利用国民健康保险理赔数据，了解印度尼西亚目前的疟疾服务提供情况，包括转诊至医院的比例、死亡率结果以及医院的疟疾相关成本。
数据收集自印度尼西亚最近的国民健康保险数据集，涵盖2015年至2020年期间的理赔记录。通过国际疾病分类第十次修订版代码选择任何疟疾相关疾病诊断的病例。按疟原虫种类评估患者的社会人口统计学状况、再次前往医疗机构就诊情况、转诊模式和住院治疗费用。费用以2020年美元报告。
有12970例疟疾发作的数据，涉及8833名患者。间日疟占6019例（46.4%），恶性疟占4307例（33.2%）。间日疟的发病率为每人每年0.38（95%可信区间0.29至0.47），恶性疟为0.33（95%可信区间0.19至0.52）。46%的疟疾病例最初在医院就诊。在这些患者中，门诊咨询的平均费用为16.2美元（标准差4.4），住院护理费用为228.7美元（标准差122.6）。总共有4.8%（623例）患者在疟疾发作后30天内再次前往医院，其中1.7%（219例）需要住院治疗，估计费用为230.0美元（标准差105.5）。间日疟住院患者的死亡率为2.1%（36/1718），而恶性疟患者为1.2%（16/1359）；p = 0.069。
国民健康保险理赔数据提供了详细的成本估算。将现有疟疾信息系统的数据与国民健康保险理赔数据相结合，可以深入了解与疟疾管理相关的医疗成本，这有助于优化国家抗疟政策。
