The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study



Título del documento: The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000413460
ISSN: 1665-2681
Autores: 1
2
3
1
4
4
Instituciones: 1Mahidol University, Faculty of Tropical Medicine, Bangkok, Phra Nakhon. Tailandia
2Chulalongkorn University, Faculty of Medicine, Bangkok, Phra Nakhon. Tailandia
3KhonKaen University, Faculty of Medicine, Bangkok, Phra Nakhon. Tailandia
4Vichaiyut Hospital and Medical Center, Bangkok, Phra Nakhon. Tailandia
Año:
Periodo: Nov-Dic
Volumen: 14
Número: 6
Paginación: 862-868
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés 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
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Salud pública,
Cirrosis,
Costo de tratamiento,
Servicios de salud,
Mortalidad
Keyword: Medicine,
Gastroenterology,
Public health,
Cirrhosis,
Treatment cost,
Health services,
Mortality
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