Measuring and Comparing Health System Delays in Leprosy Detection Based on the First Healthcare Service Visit in Tegal Regency, Indonesia

Abstract

The prevalence of leprosy patients with disabilities among new cases in Tegal Regency was high in 2021, reaching 10%. This problem is due to the delays in the diagnosis and treatment of leprosy, including health system delays associated with patients’ visits to healthcare services. This study aims to measure and compare health system delays based on the types of healthcare service first visited by leprosy patients. This study employed a cross-sectional design involving a sample of 125 leprosy patients recruited in 2022. Data were collected through interviews with leprosy patients using a validated case detection delay questionnaire. Descriptive and inferential statistics were performed using Kruskal-Wallis test. Among the respondents, 67% were male. Patients sought initial care at various types of healthcare services, with community health centers being the most frequently visited (53%). The average health system delay was 3.3 months, with the longest delay observed when the first visit was to a medical doctor (5.4 months). A significant difference in health system delays was found across the types of healthcare services first visited by leprosy patients (p = 0.001). Further research is recommended to enhance the leprosy detection capacity of healthcare staff in Tegal Regency.