The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study
Background and rationale. Cirrhosis is responsible for significant health-care costs and morbidity. This study aims to evaluate the burden of illness associated with cirrhosis, its impact on the universal coverage public health care system in Thailand.Material and methods. We used data from the 2010...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-11-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S166526811930955X |
| _version_ | 1798032929165672448 |
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| author | Kittiyod Poovorawan Sombat Treeprasertsuk Kaewjai Thepsuthammarat Polrat Wilairatana Bubpha Kitsahawong Kamthorn Phaosawasdi |
| author_facet | Kittiyod Poovorawan Sombat Treeprasertsuk Kaewjai Thepsuthammarat Polrat Wilairatana Bubpha Kitsahawong Kamthorn Phaosawasdi |
| author_sort | Kittiyod Poovorawan |
| collection | DOAJ |
| description | Background and rationale. Cirrhosis is responsible for significant health-care costs and morbidity. This study aims to evaluate the burden of illness associated with cirrhosis, its impact on the universal coverage public health care system in Thailand.Material and methods. We used data from the 2010 Nationwide Hospital Admission Data, the National Health Security Office (NHSO), Thailand. Their baseline characteristics, hospital costs, and outcomes were analyzed according to national health insurance categories including medical welfare scheme (MWFS), social security scheme (SSS) and civil servant medical benefit scheme (CSMBS).Results. 92,301 admissions were eligible for analysis. The mean age was 55 ± 12.8 years, and 63.3% of patients were above 50 years old. The majority of patients (79%) belonged to the MWFS group. The MWFS group incurred the lowest medical expense and had the shortest hospital stay compared to the SSS and CSMBS groups. Overall in-hospital mortality was 10.7%. Cirrhosis complications include bleeding esophageal varices, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma. These complications significantly increased mortality rates compared to patients without complications (26 vs. 8.9%, p < 0.001). In-hospital mortality of patients with cirrhosis complications did not differ among the three national health insurance groups. Respiratory failure and septicemia were associated with the highest risk of death (HR 5.4; 95% CI: 4.8-5.9 and HR 5.2; 95% CI: 4.9-5.6 respectively; P < 0.001).Conclusions. Illness associated with cirrhosis is a significant public health problem in Thailand. Outcomes of cirrhosis complications did not differ between universal public health care coverage systems in Thailand. |
| first_indexed | 2024-04-11T20:20:35Z |
| format | Article |
| id | doaj.art-d3862b9996164d058110ee18d280ef09 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T20:20:35Z |
| publishDate | 2015-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-d3862b9996164d058110ee18d280ef092022-12-22T04:04:48ZengElsevierAnnals of Hepatology1665-26812015-11-01146862868The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide studyKittiyod Poovorawan0Sombat Treeprasertsuk1Kaewjai Thepsuthammarat2Polrat Wilairatana3Bubpha Kitsahawong4Kamthorn Phaosawasdi5Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Correspondence and reprint request:Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, ThailandClinical Epidemiology Unit, Faculty of Medicine, KhonKaen University, ThailandDepartment of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandVichaiyut Hospital and Medical Center, ThailandVichaiyut Hospital and Medical Center, ThailandBackground and rationale. Cirrhosis is responsible for significant health-care costs and morbidity. This study aims to evaluate the burden of illness associated with cirrhosis, its impact on the universal coverage public health care system in Thailand.Material and methods. We used data from the 2010 Nationwide Hospital Admission Data, the National Health Security Office (NHSO), Thailand. Their baseline characteristics, hospital costs, and outcomes were analyzed according to national health insurance categories including medical welfare scheme (MWFS), social security scheme (SSS) and civil servant medical benefit scheme (CSMBS).Results. 92,301 admissions were eligible for analysis. The mean age was 55 ± 12.8 years, and 63.3% of patients were above 50 years old. The majority of patients (79%) belonged to the MWFS group. The MWFS group incurred the lowest medical expense and had the shortest hospital stay compared to the SSS and CSMBS groups. Overall in-hospital mortality was 10.7%. Cirrhosis complications include bleeding esophageal varices, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma. These complications significantly increased mortality rates compared to patients without complications (26 vs. 8.9%, p < 0.001). In-hospital mortality of patients with cirrhosis complications did not differ among the three national health insurance groups. Respiratory failure and septicemia were associated with the highest risk of death (HR 5.4; 95% CI: 4.8-5.9 and HR 5.2; 95% CI: 4.9-5.6 respectively; P < 0.001).Conclusions. Illness associated with cirrhosis is a significant public health problem in Thailand. Outcomes of cirrhosis complications did not differ between universal public health care coverage systems in Thailand.http://www.sciencedirect.com/science/article/pii/S166526811930955XLiver-related mortalityCirrhosis complicationsHealth care reformPopulationCost |
| spellingShingle | Kittiyod Poovorawan Sombat Treeprasertsuk Kaewjai Thepsuthammarat Polrat Wilairatana Bubpha Kitsahawong Kamthorn Phaosawasdi The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study Annals of Hepatology Liver-related mortality Cirrhosis complications Health care reform Population Cost |
| title | The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study |
| title_full | The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study |
| title_fullStr | The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study |
| title_full_unstemmed | The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study |
| title_short | The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study |
| title_sort | burden of cirrhosis and impact of universal coverage public health care system in thailand nationwide study |
| topic | Liver-related mortality Cirrhosis complications Health care reform Population Cost |
| url | http://www.sciencedirect.com/science/article/pii/S166526811930955X |
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