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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) · pp. 52–63

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

Abstract

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.

Keywords

Collaboration network of the authors

40 authors · 114 co-authorship links · 10 across different organisations · showing the 40 most connected

Hover or tap a name to highlight its co-authors. Double-click to open the author's page.

  • 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
  • Affiliation unknown
  • Different organisations
  • Same organisation
  • Affiliation unknown
  • Thicker line = more joint articles · bigger circle = more articles
Show as table
Co-authorOrganisationJoint articles
Devi MunandarNational Research and Innovation Agency5
Muh. Hafizh IzzaturrahimAffiliation unknown3
Muhammad Yusuf Al HabsyAffiliation unknown3
Ro'fah Nur RachmawatiAffiliation unknown3
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 PratiwiAffiliation unknown1
Ika Rizqi MeilyaAffiliation unknown1
Amri AmirAffiliation unknown1
Rafiqi RafiqiAffiliation unknown1
Heri RetnawatiYogyakarta State University1
Zhafira Dwika AnandaAffiliation unknown1
Abdul MutholibInternational Islamic University Malaysia1
Muhammad YusufUniversitas Halu Oleo1
Anni AnggraeniAffiliation unknown1
Hesein H. BahtiAffiliation unknown1
Ari HardiantoAffiliation unknown1
Dwipuspa Ramadhanti SantosoAffiliation unknown1
Fatimah AzzahroAffiliation unknown1
Natasya Elora CarissaAffiliation unknown1
Muhammad ErlanggaAffiliation unknown1
Cindy Sonesha EvikAffiliation unknown1
Anang Widhi NirwansyahAffiliation unknown1
Hercules Pungky Naga DewaAffiliation unknown1
Ismail DemirdagAffiliation unknown1
Adithya SudiarnoInstitut Teknologi Sepuluh Nopember1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://journal.unnes.ac.id/journals/ujph/oai, first harvested 6 Nov 2026, last seen 8 Nov 2026.
Original metadata (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>
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