The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study
Journal Title: Annals of Hepatology - Year 2015, Vol 14, Issue 6
Abstract
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.
Authors and Affiliations
Kittiyod Poovorawan, Sombat Treeprasertsuk, Kaewjai Thepsuthammarat, Polrat Wilairatana, Bubpha Kitsahawong, Kamthorn Phaosawasdi
Keywords
Related Articles
- EP ID EP78516
- DOI 10.5604/16652681.1171773
- Views 126
- Downloads 0
Risk factors for acute kidney injury and 30-day mortality after liver transplantation
Introduction. The aim of this study is to evaluate the risk factors for acute kidney injury (AKI) and 30-day mortality after liver transplantation. Material and methods. This is a retrospective cohort of consecutive adul...
Observational cohort study of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt (TIPS)
Introduction and Aim: Hepatic encephalopathy (HE) is a common complication of transjugular intrahepatic portosystemic shunting (TIPS). It is associated with a reduced quality of life and poor prognosis. The aim of this...
The function of MicroRNA in hepatitis B virus-related liver diseases: from Dim to Bright
MicroRNAs represent a class of non-coding RNA molecules that negatively regulate gene expression either by repressing translation or by inducing degradation of messenger RNA. Studies have shown that, as regulators of gen...
Building a Spanish-Latin American network on drug induced liver injury: much to get from a joint collaborative initiative
Cholestasis as the initial presentation of relapsing polychondritis
Relapsing polychondritis is an immune-mediated disease associated with inflammation in cartilaginous structures and other tissues throughout the body, particularly the ears, nose, eyes, joints, and respiratory tract. Alt...