Table 3.

The effect of multimorbidity on health service use

Variables	Health service use
	Outpatient				Inpatient
	Any visit*		Number of visits†		Any visit*		Number of visits†
	aOR (95% CI)	P value	IRR (95% CI)	P value	aOR (95% CI)	P value	IRR (95% CI)	P value
Number of NCDs (ref. no NCD)
Single NCD	1.35 (1.15 to 1.58)	<0.0001	1.45 (1.24 to 1.69)	<0.0001	1.07 (0.78 to 1.48)	0.671	1.06 (0.75 to 1.50)	0.755
Two NCDs	2.43 (2.00 to 2.95)	<0.0001	2.45 (2.04 to 2.93)	<0.0001	1.78 (1.23 to 2.57)	0.002	2.07 (1.39 to 3.08)	<0.0001
Three or more NCDs	4.66 (3.55 to 6.11)	<0.0001	4.25 (3.33 to 5.42)	<0.0001	3.69 (2.35 to 5.79)	<0.0001	3.68 (2.21 to 6.12)	<0.0001
Period (ref. 2007)
2014	1.40 (1.22 to 1.61)	<0.0001	1.46 (1.29 to 1.65)	<0.0001	1.79 (1.36 to 2.36)	<0.0001	2.20 (1.63 to 2.98)	<0.0001
Sex (ref. male)
Female	1.26 (1.08 to 1.47)	0.003	1.20 (1.04 to 1.39)	0.013	0.93 (0.70 to 1.24)	0.626	0.85 (0.62 to 1.16)	0.300
Age (ref. 50–60 years)
61–70 years	1.01 (0.86 to 1.18)	0.905	1.00 (0.87 to 1.16)	0.969	1.07 (0.78 to 1.45)	0.677	1.17 (0.84 to 1.65)	0.351
71+ years	1.10 (0.90 to 1.34)	0.351	1.06 (0.88 to 1.27)	0.567	1.49 (1.03 to 2.15)	0.034	1.66 (1.11 to 2.49)	0.014
Marital status (ref. not married)
Currently married	1.14 (0.97 to 1.34)	0.105	1.15 (0.99 to 1.34)	0.069	1.04 (0.77 to 1.40)	0.815	0.98 (0.71 to 1.37)	0.914
Educational level (ref. no education)
Primary	1.06 (0.90 to 1.25)	0.496	0.96 (0.82 to 1.13)	0.629	1.09 (0.80 to 1.50)	0.578	0.97 (0.69 to 1.38)	0.882
Junior high school	1.04 (0.80 to 1.35)	0.786	1.00 (0.78 to 1.28)	0.993	1.23 (0.78 to 1.95)	0.368	1.48 (0.90 to 2.42)	0.120
Senior high school	1.05 (0.81 to 1.36)	0.706	0.91 (0.71 to 1.17)	0.473	0.91 (0.57 to 1.46)	0.699	0.82 (0.49 to 1.37)	0.448
Tertiary	1.29 (0.90 to 1.84)	0.167	0.93 (0.66 to 1.32)	0.697	0.98 (0.53 to 1.80)	0.937	0.85 (0.42 to 1.69)	0.640
Ethnicity (ref. Javanese)
Sundanese	0.92 (0.74 to 1.14)	0.464	0.95 (0.77 to 1.16)	0.617	0.90 (0.61 to 1.34)	0.609	1.14 (0.75 to 1.76)	0.536
Others	1.06 (0.89 to 1.25)	0.525	0.99 (0.84 to 1.16)	0.877	0.90 (0.65 to 1.23)	0.495	1.08 (0.76 to 1.52)	0.676
Insurance coverage (ref. no)
Yes	1.48 (1.28 to 1.70)	<0.0001	1.51 (1.32 to 1.72)	<0.0001	1.90 (1.45 to 2.50)	<0.0001	1.65 (1.23 to 2.21)	0.001
Type of work (ref. unemployed)
Casual	0.76 (0.62 to 0.95)	0.014	0.69 (0.57 to 0.85)	<0.0001	0.49 (0.31 to 0.78)	0.003	0.44 (0.27 to 0.73)	0.001
Self-employed	0.85 (0.73 to 1.00)	0.056	0.82 (0.70 to 0.95)	0.008	0.60 (0.44 to 0.82)	0.001	0.60 (0.43 to 0.83)	0.002
Government/private	0.75 (0.58 to 0.96)	0.025	0.72 (0.57 to 0.92)	0.008	0.63 (0.39 to 1.04)	0.071	0.77 (0.46 to 1.31)	0.335
Per capita household expenditure (ref. Q1)
Q2	1.50 (1.21 to 1.86)	<0.0001	1.50 (1.23 to 1.84)	<0.0001	1.25 (0.81 to 1.92)	0.307	1.07 (0.67 to 1.70)	0.777
Q3	1.76 (1.42 to 2.18)	<0.0001	1.74 (1.42 to 2.13)	<0.0001	1.64 (1.08 to 2.49)	0.020	1.71 (1.10 to 2.66)	0.018
Q4	1.73 (1.38 to 2.15)	<0.0001	1.80 (1.46 to 2.21)	<0.0001	1.42 (0.91 to 2.20)	0.121	1.36 (0.86 to 2.18)	0.192
Q5	1.90 (1.51 to 2.40)	<0.0001	2.09 (1.68 to 2.59)	<0.0001	2.48 (1.60 to 3.85)	<0.0001	2.52 (1.59 to 4.00)	<0.0001
Residence (ref. rural)
Urban	0.92 (0.80 to 1.07)	0.283	0.95 (0.83 to 1.10)	0.500	0.96 (0.72 to 1.26)	0.744	1.05 (0.78 to 1.42)	0.726
Region (ref. Java-Bali)
Sumatra	0.83 (0.68 to 1.00)	0.052	0.98 (0.81 to 1.17)	0.798	1.23 (0.87 to 1.74)	0.236	1.25 (0.86 to 1.82)	0.250
Nusa Tenggara	0.64 (0.46 to 0.89)	0.007	0.60 (0.43 to 0.82)	0.002	1.25 (0.71 to 2.18)	0.437	1.11 (0.60 to 2.03)	0.745
Kalimantan	1.03 (0.74 to 1.43)	0.873	1.21 (0.89 to 1.65)	0.228	1.09 (0.58 to 2.05)	0.799	0.94 (0.47 to 1.89)	0.865
Sulawesi	0.64 (0.45 to 0.93)	0.019	0.63 (0.44 to 0.90)	0.011	0.63 (0.30 to 1.35)	0.235	0.63 (0.29 to 1.38)	0.249

*Multilevel logistic regression model.

†Multilevel negative binomial regression model.

aOR, adjusted OR; IRR, incidence rate ratio; NCD, non-communicable disease.