Provincial Analysis of Years of Life Lost and Economic Impact of Heart Disease Among the Working-Age Population in Indonesia (2018-2023)

Antokalina Sari Verdiana; Mitha  Cerinda; Rizal  Mansur; Fentya Yumna  Cahyani

doi:10.58344/ihj.v5i1.829

Authors

Antokalina Sari Verdiana BPJS Kesehatan, Indonesia
Mitha Cerinda BPJS Kesehatan, Indonesia
Rizal Mansur BPJS Kesehatan, Indonesia
Fentya Yumna Cahyani BPJS Kesehatan, Indonesia

DOI:

https://doi.org/10.58344/ihj.v5i1.829

Keywords:

Heart disease, Years of Life Lost (YLL), Productivity costs

Abstract

Heart disease is the leading cause of premature death in Indonesia, significantly impacting both health and the economy. In 2023, BPJS Kesehatan allocated IDR 23.52 trillion for heart disease treatment, the highest expenditure among all diseases. This study aims to quantify the burden of heart disease by calculating years of life lost (YLL) and productivity costs, highlighting the need for effective prevention strategies. Using BPJS Kesehatan mortality data from 2018–2023, covering 218,279 individuals, this study identified heart disease-related deaths and calculated YLL using the Burden of Disease framework and World Health Organization (WHO) life expectancy tables. The analysis focused on the working-age population (15–64 years) at national and provincial levels, linking YLL data to provincial minimum wages, with a gender-based analysis. Significant variations in productivity losses due to heart disease were found across provinces. Central Java had the highest loss (IDR 9.39 trillion), followed by East Java (IDR 9.20 trillion). Jakarta, with the highest minimum wage, had a comparatively smaller loss (IDR 7.92 trillion). Males accounted for 65% of productivity losses. These findings underscore the need for targeted health interventions to reduce YLL and mitigate economic burdens through early detection, improved healthcare access, and public health campaigns.

References

Biswas, A., Harbin, S., Irvin, E., Johnston, H., Begum, M., Tiong, M., Apedaile, D., Koehoorn, M., & Smith, P. (2021). Sex and gender differences in occupational hazard exposures: A scoping review of the recent literature. Current Environmental Health Reports, 8(4), 267–280. https://doi.org/10.1007/s40572-021-00326-0

Bloom, D. E., Chen, S., & Kuhn, M. (2022). The economic burden of disease and mortality. Health Economics, 31(6), 1201–1219. https://doi.org/10.1002/hec.4506

BPJS Kesehatan. (2024). Laporan statistik pembiayaan penyakit katastropik tahun 2023. BPJS Kesehatan.

Darmawan, E. S., Hasibuan, S. R., Permanasari, V. Y., & Kusuma, D. (2025). Disparities in health services and outcomes by national health insurance membership type for ischemic heart disease and stroke in Indonesia: Analysis of claims, 2017–2022. Global Health Research and Policy, 10(1), 33. https://doi.org/10.1186/s41256-025-00333-0

Hanly, P., Soerjomataram, I., & Sharp, L. (2015). Measuring the societal burden of cancer: The cost of lost productivity due to premature cancer-related mortality in Europe. International Journal of Cancer, 136(4), E136–E145. https://doi.org/10.1002/ijc.29143

Hanvold, T. N., Kines, P., Nykänen, M., Thomée, S., Holte, K. A., Vuori, J., Wærsted, M., & Veiersted, K. B. (2019). Occupational safety and health among young workers in the Nordic countries: A systematic literature review. Safety and Health at Work, 10(1), 3–20. https://doi.org/10.1016/j.shaw.2018.08.003

Kochovska, S., Luckett, T., Agar, M., & Phillips, J. L. (2018). Impacts on employment, finances, and lifestyle for working-age people facing an expected premature death: A systematic review. Palliative & Supportive Care, 16(3), 347–364. https://doi.org/10.1017/S1478951517000361

Kozlova, O. A., Nifantova, R. V., & Makarova, M. N. (2017). Methods of the assessment of economic losses caused by the mortality of the population employed in regional economy. Ekonomika Regiona, 13(2), 511–523.

Kozlova, O. A., & Zubarev, N. Y. (2020). Comprehensive assessment of economic losses from premature mortality of the population in regions. Ekonomika Regiona, 16(3), 845–858.

Kumar, G. A., Pandey, A., & Dandona, R. (2025). Economic loss attributable to premature deaths and morbidity among adolescents in India and its states. BMC Medicine, 23(1), 51. https://doi.org/10.1186/s12916-025-03251-4

Morev, M. V., & Korolenko, A. V. (2018). Assessment of demographic and socioeconomic losses due to premature mortality in the populations of Russia and Vologda Oblast. Studies on Russian Economic Development, 29(2), 191–201. https://doi.org/10.1134/S1075700718020093

Norheim, O. F., Jha, P., Admasu, K., Godal, T., Hum, R. J., Kruk, M. E., Gómez-Dantés, O., Mathers, C. D., Pan, H., & Sepúlveda, J. (2015). Avoiding 40% of the premature deaths in each country, 2010–2030: Review of national mortality trends to help quantify the UN sustainable development goal for health. The Lancet, 385(9964), 239–252. https://doi.org/10.1016/S0140-6736(14)61591-9

Nurwahyuni, A., Soewondo, P., Nadjib, M., Farianti, Y., Mukhlisa, M. N., Wahyuningsih, H., Mangunsong, E. R., Athiyah, A., Yunita, Y., & Sayekti, S. A. H. (2023). Health care spending for cardiovascular disease under national health insurance scheme in Indonesia before and during COVID-19: Descriptive analysis and policy recommendations. Journal of Indonesian Health Policy and Administration, 8(2), 10.

Ortega-Ortega, M., Hanly, P., Pearce, A., Soerjomataram, I., & Sharp, L. (2023). Projected impact on labour productivity costs of cancer-related premature mortality in Europe 2018–2040. Applied Health Economics and Health Policy, 21(6), 877–889. https://doi.org/10.1007/s40258-023-00805-4

Qiu, Y., Chen, X., & Shi, W. (2020). Impacts of social and economic factors on the transmission of coronavirus disease 2019 (COVID-19) in China. Journal of Population Economics, 33(4), 1127–1172. https://doi.org/10.1007/s00148-020-00778-2

Roth, G. A., Mensah, G. A., & Johnson, C. O. (2020). Global burden of cardiovascular diseases. Journal of the American College of Cardiology, 76(25), 2982–3021. https://doi.org/10.1016/j.jacc.2020.11.010

Santoro, P. E., Borrelli, I., Gualano, M. R., Amantea, C., Tumminello, A., Daniele, A., Rossi, M. F., & Moscato, U. (2022). Occupational hazards and gender differences: A narrative review. Journal of Sex- and Gender-Specific Medicine, 8(3), 154–162.

Shi, P., Yang, X., Fang, J., Wang, J., Xu, W., & Han, G. (2016). Mapping and ranking global mortality, affected population and GDP loss risks for multiple climatic hazards. Journal of Geographical Sciences, 26(7), 878–888. https://doi.org/10.1007/s11442-016-1303-6

World Health Organization. (2023). Global health estimates: Life expectancy and health statistics. WHO Press.

Zakiyah, N., Afina, C. A., & Sinuraya, R. K. (2024). EE299 economic burden of cardiovascular diseases in Indonesia: Analysis of BPJS Kesehatan national health insurance claims data 2021–2022. Value in Health, 27(12), S113. https://doi.org/10.1016/j.jval.2024.09.XXX