Table 3.
Association of individual, household, and district level characteristics with outpatient healthcare costs related to the presence of CVDs with or without other chronic disease comorbidities
| Variable | Outpatient costs | |||||
|---|---|---|---|---|---|---|
| Model 1 a coefficient (n = 215,660) | (95% CI) | Model 2 b coefficient (n = 215,660) | (95% CI) | Model 3 c coefficient (n = 215,660) | (95% CI) | |
| Individual level | ||||||
| Group | ||||||
| (1) No CVDs, but with single chronic morbidity | REF | REF | REF | REF | REF | REF |
| (2) No CVDs, but with multimorbidity | 0.55*** | (0.54, 0.56) | 0.49*** | (0.47, 0.51) | 0.49*** | (0.48,0.51) |
| (3) CVDs, but no comorbidity | 0.21*** | (0.18, 0.23) | 0.17*** | (0.14, 0.19) | 0.17*** | (0.14,0.19) |
| (4) CVDs and one comorbidity | 0.56*** | (0.53, 0.58) | 0.49*** | (0.47, 0.51) | 0.49*** | (0.47,0.51) |
| (5) CVDs and multimorbidity | 1.07*** | (1.05, 1.09) | 1.00*** | (0.98, 1.02) | 1.00*** | (0.99,1.02) |
| Household type | ||||||
| Non-subsidized | REF | REF | REF | REF | REF | REF |
| Subsidized | -0.08*** | (-0.11, -0.06) | -0.08*** | (-0.11, -0.06) | -0.08*** | (-0.11,-0.06) |
| Group*Household type | ||||||
| (1)*Subsidized | ||||||
| (2)*Subsidized | -0.16*** | (-0.19, -0.13) | -0.16*** | (-0.19, -0.13) | -0.16*** | (-0.19,-0.13) |
| (3)*Subsidized | -0.14*** | (-0.19, -0.09) | -0.14*** | (-0.18, -0.09) | -0.14*** | (-0.18,-0.09) |
| (4)*Subsidized | -0.17*** | (-0.22, -0.12) | -0.16*** | (-0.21, -0.12) | -0.16*** | (-0.21,-0.12) |
| (5)*Subsidized | -0.24*** | (-0.29, -0.19) | -0.24*** | (-0.29, -0.19) | -0.24*** | (-0.29,-0.19) |
| Household level | ||||||
| Proportions of household members with multimorbidity | - | - | 0.16*** | (0.14, 0.18) | 0.16*** | (0.15, 0.19) |
| The mean number of household members | - | - | 0.01*** | (0.01, 0.02) | 0.02*** | (0.01, 0.03) |
| District level | ||||||
| Proportion of primary care per 10,000 | - | - | - | - | 0.02** | (0.00, 0.03) |
| Proportion of hospitals per 10,000 | - | - | - | - | 0.06*** | (0.02, 0.11) |
| % of NHI members who utilized healthcare | - | - | - | - | -0.01 | (-0.15, 0.12) |
| Fiscal category | ||||||
| Low | 0.01 | (-0.01, 0.02) | ||||
| Middle | - | - | - | - | -0.01 | (-0.02, 0.01) |
| High | - | - | - | - | -0.03 | (-0.05, -0.01) |
| Very high | - | - | - | - | ||
| Intercept | 4.51 | (4.47, 4.55) | 4.45 | (4.40, 4.49) | 4.41 | (4.34, 4.49) |
| District level’s variance | 0.16 | (0.15, 0.17) | 0.16 | (0.15, 0.17) | 0.16 | (0.15, 0.18) |
| Household level’s variance | 0.69 | (0.68, 0.69) | 0.68 | (0.68, 0.69) | 0.69 | (0.68, 0.69) |
| ICC (district level) | 0.02 | (0.01, 0.02) | 0.02 | (0.01, 0.02) | 0.02 | (0.01, 0.02) |
| ICC (household level) | 0.35 | (0.34, 0.35) | 0.35 | (0.34, 0.35) | 0.35 | (0.34, 0.35) |
| Likelihood ratio test (LR) | 18,666.79 | 18,441.15 | 17,485.34 | |||
All models were also adjusted for sex, age, marital status, type of primary health care centres registered, and regions
a Model 1: Multilevel linear regression with transformed outcome, cross-level between individual and controlled for individual-level covariates
b Model 2: Multilevel linear regression with transformed outcome and controlled for individual and household-level covariates
c Model 3: Multilevel linear regression with transformed outcome and controlled for individual, household, and district-level covariates
Coefficient is transformed using an inversed hyperbolic sine transformation (sinh −1, IHS). We retransformed β coefficients to U.S. dollar (USD) using cost value (x) = (exp2x−1)/(2expx). P-values were statistically significant at 1 percent (***), 5 percent (**) or 10 percent (*)