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Table 3 Association of individual, household, and district level characteristics with outpatient healthcare costs related to the presence of CVDs with or without other chronic disease comorbidities

From: The impact of multimorbidity among adults with cardiovascular diseases on healthcare costs in Indonesia: a multilevel analysis

Variable

Outpatient costs

Model 1 a coefficient (n = 215,660)

(95% CI)

Model 2 b coefficient (n = 215,660)

(95% CI)

Model 3 c coefficient (n = 215,660)

(95% CI)

Individual level

 Group

  (1) No CVDs, but with single chronic morbidity

REF

REF

REF

REF

REF

REF

  (2) No CVDs, but with multimorbidity

0.55***

(0.54, 0.56)

0.49***

(0.47, 0.51)

0.49***

(0.48,0.51)

  (3) CVDs, but no comorbidity

0.21***

(0.18, 0.23)

0.17***

(0.14, 0.19)

0.17***

(0.14,0.19)

  (4) CVDs and one comorbidity

0.56***

(0.53, 0.58)

0.49***

(0.47, 0.51)

0.49***

(0.47,0.51)

  (5) CVDs and multimorbidity

1.07***

(1.05, 1.09)

1.00***

(0.98, 1.02)

1.00***

(0.99,1.02)

Household type

 Non-subsidized

REF

REF

REF

REF

REF

REF

 Subsidized

-0.08***

(-0.11, -0.06)

-0.08***

(-0.11, -0.06)

-0.08***

(-0.11,-0.06)

Group*Household type

 (1)*Subsidized

      

 (2)*Subsidized

-0.16***

(-0.19, -0.13)

-0.16***

(-0.19, -0.13)

-0.16***

(-0.19,-0.13)

 (3)*Subsidized

-0.14***

(-0.19, -0.09)

-0.14***

(-0.18, -0.09)

-0.14***

(-0.18,-0.09)

 (4)*Subsidized

-0.17***

(-0.22, -0.12)

-0.16***

(-0.21, -0.12)

-0.16***

(-0.21,-0.12)

 (5)*Subsidized

-0.24***

(-0.29, -0.19)

-0.24***

(-0.29, -0.19)

-0.24***

(-0.29,-0.19)

Household level

 Proportions of household members with multimorbidity

-

-

0.16***

(0.14, 0.18)

0.16***

(0.15, 0.19)

 The mean number of household members

-

-

0.01***

(0.01, 0.02)

0.02***

(0.01, 0.03)

District level

 Proportion of primary care per 10,000

-

-

-

-

0.02**

(0.00, 0.03)

 Proportion of hospitals per 10,000

-

-

-

-

0.06***

(0.02, 0.11)

 % of NHI members who utilized healthcare

-

-

-

-

-0.01

(-0.15, 0.12)

 Fiscal category

      

 Low

    

0.01

(-0.01, 0.02)

 Middle

-

-

-

-

-0.01

(-0.02, 0.01)

 High

-

-

-

-

-0.03

(-0.05, -0.01)

 Very high

-

-

-

-

  

 Intercept

4.51

(4.47, 4.55)

4.45

(4.40, 4.49)

4.41

(4.34, 4.49)

 District level’s variance

0.16

(0.15, 0.17)

0.16

(0.15, 0.17)

0.16

(0.15, 0.18)

 Household level’s variance

0.69

(0.68, 0.69)

0.68

(0.68, 0.69)

0.69

(0.68, 0.69)

 ICC (district level)

0.02

(0.01, 0.02)

0.02

(0.01, 0.02)

0.02

(0.01, 0.02)

 ICC (household level)

0.35

(0.34, 0.35)

0.35

(0.34, 0.35)

0.35

(0.34, 0.35)

 Likelihood ratio test (LR)

18,666.79

 

18,441.15

 

17,485.34

 
  1. All models were also adjusted for sex, age, marital status, type of primary health care centres registered, and regions
  2. a Model 1: Multilevel linear regression with transformed outcome, cross-level between individual and controlled for individual-level covariates
  3. b Model 2: Multilevel linear regression with transformed outcome and controlled for individual and household-level covariates
  4. c Model 3: Multilevel linear regression with transformed outcome and controlled for individual, household, and district-level covariates
  5. Coefficient is transformed using an inversed hyperbolic sine transformation (sinh −1, IHS). We retransformed β coefficients to U.S. dollar (USD) using cost value (x) = (exp2x−1)/(2expx). P-values were statistically significant at 1 percent (***), 5 percent (**) or 10 percent (*)
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BMC Public Health

ISSN: 1471-2458

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