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Mortality Risk Factors Among Indonesians with Tuberculosis: An Analysis of a National Health Insurance Data

Unnes Journal of Public Health · Vol. 15 No. 1 (2026) · hlm. 52–63

DOI
10.15294/ujph.v15i1.32826
ISSN
2548-7604, 2252-6781
Terbit
2026-05-09
Penerbit
Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))
Bahasa
eng

Abstrak

Tuberculosis (TB) significantly contributes to global mortality; thus, identifying mortality risks is crucial for effective disease management. This study aims to explore the risks of mortality among Indonesians with TB. This case-control study analyzed Indonesian health insurance data (2015-2022), employing propensity score matching (1:4 ratio) and Cox modeling to assess the relationship between mortality and demographics/comorbidities. Mortality was treated as a binary (death or survived) and a multistate outcome (including death within two months, death afterward, and survived). The analysis included 60,472 subjects and 1,777 deaths, revealing that most demographics had no correlation with mortality, except for marital status. Being married was protective against mortality after two months (Hazard Ratio [HR] 0.65, 95% Confidence Interval [CI]: 0.45-0.93). Anemia increased mortality risk over time (HR 3.62 within the first two months; 9.19 thereafter). Cancer and heart failure heightened mortality risk early on, while HIV affected later stages. Interestingly, some chronic conditions may provide protective effects. Access to healthcare through universal health coverage (UHC) may help reduce mortality risks. The study emphasizes critical management periods for TB in patients with specific conditions and highlights the importance of UHC in mitigating sociodemographic disparities to improve health outcomes.

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  • National Research and Innovation Agency
  • University of Indonesia
  • Bandung Institute of Technology
  • Yogyakarta State University
  • International Islamic University Malaysia
  • Universitas Halu Oleo
  • Institut Teknologi Sepuluh Nopember
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Rekan penulisOrganisasiArtikel bersama
Devi MunandarNational Research and Innovation Agency5
Muh. Hafizh IzzaturrahimAfiliasi tidak diketahui3
Muhammad Yusuf Al HabsyAfiliasi tidak diketahui3
Ro'fah Nur RachmawatiAfiliasi tidak diketahui3
Ayu PurwariantiBandung Institute of Technology2
Andria ArisalNational Research and Innovation Agency2
Andri Fachrur RozieNational Research and Innovation Agency2
Ekasari NugraheniNational Research and Innovation Agency2
Wiwin SuwarningsihNational Research and Innovation Agency2
Mazaya Nur LabibaUniversity of Indonesia1
Dhina Rotua MutiaraUniversity of Indonesia1
Refiany ShadrinaUniversity of Indonesia1
Nabila Clydea HarahapUniversity of Indonesia1
Anisa Septianing PratiwiAfiliasi tidak diketahui1
Ika Rizqi MeilyaAfiliasi tidak diketahui1
Amri AmirAfiliasi tidak diketahui1
Rafiqi RafiqiAfiliasi tidak diketahui1
Heri RetnawatiYogyakarta State University1
Zhafira Dwika AnandaAfiliasi tidak diketahui1
Abdul MutholibInternational Islamic University Malaysia1
Muhammad YusufUniversitas Halu Oleo1
Anni AnggraeniAfiliasi tidak diketahui1
Hesein H. BahtiAfiliasi tidak diketahui1
Ari HardiantoAfiliasi tidak diketahui1
Dwipuspa Ramadhanti SantosoAfiliasi tidak diketahui1
Fatimah AzzahroAfiliasi tidak diketahui1
Natasya Elora CarissaAfiliasi tidak diketahui1
Muhammad ErlanggaAfiliasi tidak diketahui1
Cindy Sonesha EvikAfiliasi tidak diketahui1
Anang Widhi NirwansyahAfiliasi tidak diketahui1
Hercules Pungky Naga DewaAfiliasi tidak diketahui1
Ismail DemirdagAfiliasi tidak diketahui1
Adithya SudiarnoInstitut Teknologi Sepuluh Nopember1

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Sumber metadata: OAI-PMH (metadata jurnal) https://journal.unnes.ac.id/journals/ujph/oai, pertama di-harvest 6 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en">Mortality Risk Factors Among Indonesians with Tuberculosis: An Analysis of a National Health Insurance Data</dc:title>
	<dc:creator xml:lang="en">Ratna Sari Dewi</dc:creator>
	<dc:creator xml:lang="en">Sutrisno, Deny </dc:creator>
	<dc:creator xml:lang="en">Riswantini, Dianadewi </dc:creator>
	<dc:creator xml:lang="en">Khotimah, Purnomo Husnul </dc:creator>
	<dc:creator xml:lang="en">Handayani, Putu Wuri </dc:creator>
	<dc:creator xml:lang="en">Sadita, Lia </dc:creator>
	<dc:creator xml:lang="en">Natari, Rifani Bhakti </dc:creator>
	<dc:subject xml:lang="en">risk factors; mortality; tuberculosis; health policy </dc:subject>
	<dc:description xml:lang="en">Tuberculosis (TB) significantly contributes to global mortality; thus, identifying mortality risks is crucial for effective disease management. This study aims to explore the risks of mortality among Indonesians with TB. This case-control study analyzed Indonesian health insurance data (2015-2022), employing propensity score matching (1:4 ratio) and Cox modeling to assess the relationship between mortality and demographics/comorbidities. Mortality was treated as a binary (death or survived) and a multistate outcome (including death within two months, death afterward, and survived). The analysis included 60,472 subjects and 1,777 deaths, revealing that most demographics had no correlation with mortality, except for marital status. Being married was protective against mortality after two months (Hazard Ratio [HR] 0.65, 95% Confidence Interval [CI]: 0.45-0.93). Anemia increased mortality risk over time (HR 3.62 within the first two months; 9.19 thereafter). Cancer and heart failure heightened mortality risk early on, while HIV affected later stages. Interestingly, some chronic conditions may provide protective effects. Access to healthcare through universal health coverage (UHC) may help reduce mortality risks. The study emphasizes critical management periods for TB in patients with specific conditions and highlights the importance of UHC in mitigating sociodemographic disparities to improve health outcomes.</dc:description>
	<dc:publisher xml:lang="en">Universitas Negeri Semarang (UNNES) in cooperation with the Association of Indonesian Public Health Experts (Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI))</dc:publisher>
	<dc:date>2026-05-09</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en">Peer-reviewed Article</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://journal.unnes.ac.id/journals/ujph/article/view/32826</dc:identifier>
	<dc:identifier>10.15294/ujph.v15i1.32826</dc:identifier>
	<dc:source xml:lang="en">Unnes Journal of Public Health; Vol. 15 No. 1 (2026); 52-63</dc:source>
	<dc:source>2548-7604</dc:source>
	<dc:source>2252-6781</dc:source>
	<dc:source>10.15294/ujph.v15i1</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://journal.unnes.ac.id/journals/ujph/article/view/32826/9594</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2026 Unnes Journal of Public Health</dc:rights>
</oai_dc:dc>