PMID- 26436358
OWN - NLM
STAT- MEDLINE
DCOM- 20160721
LR  - 20190919
IS  - 1665-2681 (Print)
IS  - 1665-2681 (Linking)
VI  - 14
IP  - 6
DP  - 2015 Nov-Dec
TI  - The burden of cirrhosis and impact of universal coverage public health care 
      system in Thailand: Nationwide study.
PG  - 862-8
LID - 10.5604/16652681.1171773 [doi]
AB  - 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.
FAU - Poovorawan, Kittiyod
AU  - Poovorawan K
AD  - Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol 
      University, Bangkok, Thailand.
FAU - Treeprasertsuk, Sombat
AU  - Treeprasertsuk S
AD  - Department of Medicine, Faculty of Medicine, Chulalongkorn University and King 
      Chulalongkorn Memorial Hospital, Bangkok, Thailand.
FAU - Thepsuthammarat, Kaewjai
AU  - Thepsuthammarat K
AD  - Clinical Epidemiology Unit, Faculty of Medicine, KhonKaen University, Thailand.
FAU - Wilairatana, Polrat
AU  - Wilairatana P
AD  - Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol 
      University, Bangkok, Thailand.
FAU - Kitsahawong, Bubpha
AU  - Kitsahawong B
AD  - Vichaiyut Hospital and Medical Center, Thailand.
FAU - Phaosawasdi, Kamthorn
AU  - Phaosawasdi K
AD  - Vichaiyut Hospital and Medical Center, Thailand.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Mexico
TA  - Ann Hepatol
JT  - Annals of hepatology
JID - 101155885
SB  - IM
MH  - Adult
MH  - Aged
MH  - Databases, Factual
MH  - Female
MH  - *Hospital Costs
MH  - Hospital Mortality
MH  - Humans
MH  - Length of Stay/economics
MH  - Liver Cirrhosis/complications/diagnosis/*economics/mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - National Health Programs/*economics
MH  - Public Sector/*economics
MH  - Risk Factors
MH  - Thailand/epidemiology
MH  - Time Factors
MH  - Universal Health Insurance/*economics
MH  - Young Adult
EDAT- 2015/10/06 06:00
MHDA- 2016/07/22 06:00
CRDT- 2015/10/06 06:00
PHST- 2015/10/06 06:00 [entrez]
PHST- 2015/10/06 06:00 [pubmed]
PHST- 2016/07/22 06:00 [medline]
AID - S1665-2681(19)30955-X [pii]
AID - 10.5604/16652681.1171773 [doi]
PST - ppublish
SO  - Ann Hepatol. 2015 Nov-Dec;14(6):862-8. doi: 10.5604/16652681.1171773.