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Abstract

Type 2 diabetes mellitus (T2DM) is a chronic disease with high prevalence and contributes significantly to the burden of inpatient care in Indonesia. The severity of T2DM-related hospitalization as classified under the INA-CBGs system, is an important indicator for assessing disparities in access to care and the health system’s response to vulnerable populations. This study aims to analyze the relationship between socio-demographic characteristics and the severity of T2DM-related hospitalization visits based on 2023 Social Security Administering Body for Health (BPJS Health) data. This study employed a cross-sectional design using secondary data from the 2023 BPJS Health Sample Data. The unit of analysis was hospitalization visits. The study included inpatient hospitalization visits with a diagnosis of T2DM (ICD-10: E11). Univariate and bivariate methods were conducted, including chi-square tests and ordinal logistic regression was estimated using cluster-robust standard errors. Hospitalization severity was categorized based on the INACBGs classification (mild, moderate, severe). Among 431 T2DM-related hospitalization visits, age >45 years (OR = 2.17; p = 0.035), divorced status (OR = 2.33; p = 0.021), and lower middle socioeconomic status (OR = 1.54; p = 0.046) were significantly associated with higher INA-CBGs hospitalization severity. Gender, inpatient care class, and type of healthcare facility ownership were not statistically significantly associated with hospitalization severity. These findings highlight the importance of the health system's response to the social determinants reflected in INA-CBGs–based hospitalization severity among T2DM-related visits. Targeted and multisectoral interventions are needed to reduce disparities and improve service quality for socially vulnerable groups.

Keywords: Type 2 diabetes mellitus, hospitalization severity, socio-demographics, BPJS Health

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Bahasa Abstract

Diabetes Melitus Tipe 2 (DMT2) merupakan penyakit kronis dengan prevalensi tinggi dan berkontribusi besar terhadap beban layanan rawat inap di Indonesia. Tingkat keparahan rawat inap terkait DMT2, sebagaimana diklasifikasikan dalam sistem INA-CBGs merupakan indikator penting dalam menilai ketimpangan akses dan respons sistem kesehatan terhadap kelompok rentan. Studi ini bertujuan untuk menganalisis hubungan antara karakteristik sosio-demografi dengan tingkat keparahan kunjungan rawat inap DMT2 berdasarkan data BPJS Kesehatan tahun 2023. Penelitian ini menggunakan desain cross sectional berbasis data sekunder dari Data Sampel BPJS Kesehatan tahun 2023. Unit analisis adalah kunjungan rawat inap. Subjek penelitian adalah kunjungan rawat inap dengan diagnosis DMT2 (ICD-10: E11). Analisis dilakukan secara univariat dan bivariat dengan uji chi-square dan regresi logistik ordinal dengan cluster-robust standard errors. Tingkat keparahan rawat inap dikategorikan berdasarkan klasifikasi INACBGs (ringan, sedang, berat). Dari 431 kunjungan rawat inap terkait DMT2, usia >45 tahun (OR = 2,17; p = 0,035), status cerai (OR = 2,33; p = 0,021), dan status sosial ekonomi menengah ke bawah (OR = 1,54; p = 0,046) berhubungan signifikan dengan tingkat keparahan rawat inap yang lebih tinggi berdasarkan INA-CBGs. Jenis kelamin, kelas rawat, dan kepemilikan fasilitas kesehatan tidak memiliki hubungan yang signifikan secara statistik. Temuan ini menegaskan pentingnya respons sistem kesehatan terhadap determinan sosial yang tercermin dalam tingkat keparahan rawat inap berbasis INA-CBGs pada kunjungan rawat inap DMT2. Intervensi multisektor yang terarah diperlukan untuk mengurangi ketimpangan perawatan serta meningkatkan kualitas pelayanan bagi kelompok rentan.

Kata Kunci: Diabetes Melitus Tipe 2, keparahan rawat inap, sosio-demografi, BPJS Kesehatan

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