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    Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling

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    Author
    Uli, RE; Satyana, RPU; Zomer, E; Magliano, D; Liew, D; Ademi, Z
    Date
    2020-01-01
    Source Title
    BMJ Open
    Publisher
    BMJ PUBLISHING GROUP
    University of Melbourne Author/s
    Magliano, Dianna; Liew, Danny
    Affiliation
    Medicine and Radiology
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Uli, R. E., Satyana, R. P. U., Zomer, E., Magliano, D., Liew, D. & Ademi, Z. (2020). Health and productivity burden of coronary heart disease in the working Indonesian population using life-table modelling. BMJ OPEN, 10 (9), https://doi.org/10.1136/bmjopen-2020-039221.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/251631
    DOI
    10.1136/bmjopen-2020-039221
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482464
    Abstract
    OBJECTIVES: The impact of coronary heart disease (CHD) and its effect on work productivity at a population level remains unknown in Indonesia. This study estimates the health and productivity lost to CHD in terms of years of life, quality-adjusted life years (QALYs) and productivity-adjusted life years (PALYs). SETTING AND PARTICIPANTS: A life-table model was constructed to simulate the experiences of Indonesians currently aged 15-54 years (working age) with CHD, followed-up to 55 years (retirement age). The life-table analysis was then repeated assuming that the cohort did not have CHD. Differences in the results reflected the impact of CHD. Demographical, prevalence and mortality data were based on the 2017 Global Burden of Disease study and 2018 Indonesian National Health Survey. Costs, productivity indices and utilities were derived from published sources. The cost of each PALY was assumed to be equivalent to gross domestic product per equivalent full-time worker (US$11 765). Future costs and outcomes were discounted by 3% annually. PRIMARY AND SECONDARY OUTCOME MEASURES: Differences in total deaths, years of life and PALYs represented the impact of CHD. RESULTS: At present, 1 954 543 (1.45%) Indonesians of working-age have CHD. By retirement age, it was estimated that CHD resulted in 32 492 (36.6%) excess deaths, 128 132 (0.5%) years of life lost, 2 331 495 (10.5%) QALYs lost and 1 589 490 (6.9%) PALYs lost. The economic impact of lost productivity amounted to US$33.3 billion, and healthcare costs to US$139 billion. CONCLUSION: The health and economic burden of CHD in Indonesia looms large. This highlights the importance of its prevention and control, strategies for which, if effective, will deliver financial return.

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