Integrated Healthcare Center in the elderly community in Indonesia: An analysis of Indonesian Family Life Survey Data

Abstract

The percentage of the elderly (60+ years) in Indonesia was 10.82% in 2021 and is projected to increase to 19.9% by 2045. The elderly have the highest risk of degenerative diseases like hypertension, diabetes, and stroke. To mitigate these risks, the elderly must undergo regular health checkups at the Integrated Healthcare Center (IHC). However, the utilization rate of IHC among the elderly in Indonesia is currently below the government target (70%). This study aimed to identify individual and clinical characteristics that influence the use of IHC among the elderly. This study used a cross-sectional design and analyzed data from the 2014 Indonesian Family Life Survey (IFLS-5), which included 5,581 respondents aged 45 or older. The dependent variable was IHC utilization, while the independent variables were age, gender, education level, employment status, location, health insurance, smoking status, hypertension, diabetes, stroke, blood pressure, central obesity, and body mass index (BMI). Univariate, bivariate, and multivariate analyses were conducted using STATA 13. The study findings revealed that IHC utilization was 5.38%. The elderly aged 60–74 years (OR=2.01; 95%CI=1.55-2.61) and 75+ years (OR=3.35; 95%CI=1.99–5.64), women (OR=3.45; 95%CI=2.26–5.27), those with low (OR=1.76; 95%CI=1.05-2.94) and medium education (OR=2.09; 95%CI=1.19–3.69), having health insurance (OR=1.87; 95%CI=1.44–2.42), residing in urban areas (OR=1.32-2.35), and those with hypertension (OR=1.59; 95%CI=1.23-2.07) and central obesity (OR=2.56; 95%CI=1.85–3.54) were more likely to be concerned about visiting IHC. Stratification analysis based on gender showed that the influence of IHC utilization among male was diabetes mellitus (adj OR=2.64; 95%CI=1.28-5.45), therefore among female were hypertension (adj OR=1.51; 95%CI=1.21-2.02) and normal BMI (adj OR=2.63; 95%CI=1.17-4.75). The Indonesian government needs to raise awareness among the elderly regarding the importance of using IHC as a preventive measure.