The Economic Burden of Self-Reported and Undiagnosed Cardiovascular Diseases and Diabetes on Indonesian Households

OBJECTIVES 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. METHODS This study relies on econometric analyses based on four waves of the Indonesian Family Life Survey (IFLS). RESULTS 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. CONCLUSION 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.