PMID- 34197492 OWN - NLM STAT- MEDLINE DCOM- 20211103 LR - 20231102 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 16 IP - 7 DP - 2021 TI - Hospital admission for type 2 diabetes mellitus under the Universal Coverage Scheme in Thailand: A time- and geographical-trend analysis, 2009-2016. PG - e0253434 LID - 10.1371/journal.pone.0253434 [doi] LID - e0253434 AB - BACKGROUND: Descriptive analyses of 2009-2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. METHODS AND FINDINGS: The database of T2DM patients aged 15-100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009-2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. CONCLUSION: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM. FAU - Laowahutanon, Tanapat AU - Laowahutanon T AD - National Health Security Office, Bangkok, Thailand. FAU - Nakamura, Haruyo AU - Nakamura H AD - International Development Center of Japan Inc., Tokyo, Japan. FAU - Tachimori, Hisateru AU - Tachimori H AUID- ORCID: 0000-0001-6401-2885 AD - Institute for Global Health Policy Research (iGHP), Bureau of International Health Cooperation National Center for Global Health and Medicine, Shinjuku City, Japan. AD - Endowed Course for Health System Innovation, Keio University School of Medicine, Minato City, Japan. AD - Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Japan. FAU - Nomura, Shuhei AU - Nomura S AD - Department of Health Policy and Management, Keio University School of Medicine, Minato City, Japan. AD - Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. FAU - Liabsuetrakul, Tippawan AU - Liabsuetrakul T AD - Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. FAU - Lim, Apiradee AU - Lim A AD - Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University Pattani Campus, Pattani, Thailand. FAU - Rawdaree, Petch AU - Rawdaree P AD - Department of Internal Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand. FAU - Suchonwanich, Netnapis AU - Suchonwanich N AD - The Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand. FAU - Yamamoto, Hiroyuki AU - Yamamoto H AUID- ORCID: 0000-0003-3337-7595 AD - Department of Health Policy and Management, Keio University School of Medicine, Minato City, Japan. AD - Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Bunkyo City, Japan. FAU - Ishizuka, Aya AU - Ishizuka A AD - Institute for Global Health Policy Research (iGHP), Bureau of International Health Cooperation National Center for Global Health and Medicine, Shinjuku City, Japan. AD - Department of Health Policy and Management, Keio University School of Medicine, Minato City, Japan. FAU - Shibuya, Kenji AU - Shibuya K AD - Soma COVID Vaccination Medical Center, Fukushima, Japan. FAU - Miyata, Hiroaki AU - Miyata H AD - Department of Health Policy and Management, Keio University School of Medicine, Minato City, Japan. FAU - Chongsuvivatwong, Virasakdi AU - Chongsuvivatwong V AUID- ORCID: 0000-0002-9850-4463 AD - Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210701 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Adolescent MH - Adult MH - Aged MH - Aged, 80 and over MH - Cataract/complications/therapy MH - Diabetes Complications/*therapy MH - Diabetes Mellitus, Type 2/etiology/*therapy MH - Diabetic Foot/complications/surgery MH - Diabetic Retinopathy/complications/therapy MH - Female MH - Humans MH - Male MH - Middle Aged MH - Myocardial Infarction/complications/therapy MH - Patient Admission/statistics & numerical data/*trends MH - Renal Insufficiency, Chronic/complications/therapy MH - Thailand MH - Universal Health Insurance/*statistics & numerical data MH - Young Adult PMC - PMC8248737 COIS- The authors have declared that no competing interests exist. EDAT- 2021/07/02 06:00 MHDA- 2021/11/04 06:00 PMCR- 2021/07/01 CRDT- 2021/07/01 17:22 PHST- 2019/09/17 00:00 [received] PHST- 2021/06/06 00:00 [accepted] PHST- 2021/07/01 17:22 [entrez] PHST- 2021/07/02 06:00 [pubmed] PHST- 2021/11/04 06:00 [medline] PHST- 2021/07/01 00:00 [pmc-release] AID - PONE-D-19-26129 [pii] AID - 10.1371/journal.pone.0253434 [doi] PST - epublish SO - PLoS One. 2021 Jul 1;16(7):e0253434. doi: 10.1371/journal.pone.0253434. eCollection 2021.