Khunakorncharatphong Anon, Pudpong Nareerut, Suphanchaimat Rapeepong, Julchoo Sataporn, Phaiyarom Mathudara, Sinam Pigunkaew
International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi 11000, Thailand.
Educational Service Unit, Sirindhorn College of Public Health, Chonburi 20000, Thailand.
Int J Environ Res Public Health. 2021 Sep 15;18(18):9721. doi: 10.3390/ijerph18189721.
Global morbidity associated with noncommunicable diseases (NCDs) has increased over the years. In Thailand, NCDs are among the most prevalent of all health problems, and affect both Thai citizens and non-Thai residents, such as expatriates. Key barriers to NCD health service utilization among expatriates include cultural and language differences. This study aimed to describe the situation and factors associated with NCD service utilizations among expatriate patients in Thailand. We employed a cross-sectional study design and used the service records of public hospitals from the Ministry of Public Health (MOPH) during the fiscal years 2014-2018. The focus of this study was on expatriates or those who had stayed in Thailand for at least three months. The results showed that, after 2014, there was an increasing trend in NCD service utilizations among expatriate patients for both outpatient (OP) and inpatient (IP) care. For OP care, Cambodia, Laos PDR, Myanmar, and Vietnam (CLMV) expatriates had fewer odds of NCD service utilization, relative to non-CLMV expatriates (-value < 0.001). For IP care, males tended to have greater odds of NCD service utilization compared with females (AdjOR = 1.35, 95% CI = 1.05-1.74, -value = 0.019). Increasing age showed a significant association with NCD service utilization. In addition, there was a growing trend of the NCD prevalence amongst expatriate patients. This issue points to a need for prompt public health actions if Thailand aims to have all people on its soil protected with universal health coverage for their well-being, as stipulated in the Sustainable Development Goals. Future studies that aim to collect primary evidence of expatriates at the household level should be conducted. Additional research on other societal factors that may help provide a better insight into access to healthcare for NCDs, such as socioeconomic status, beliefs, and attitudes, should be conducted.
多年来，与非传染性疾病（NCDs）相关的全球发病率有所上升。在泰国，非传染性疾病是所有健康问题中最普遍的疾病之一，影响着泰国公民和非泰国居民，如外籍人士。外籍人士利用非传染性疾病医疗服务的主要障碍包括文化和语言差异。本研究旨在描述泰国外籍患者中与非传染性疾病服务利用相关的情况和因素。我们采用横断面研究设计，并使用了2014 - 2018财年公共卫生部（MOPH）下属公立医院的服务记录。本研究的重点是外籍人士或在泰国停留至少三个月的人。结果显示，2014年之后，外籍患者在门诊（OP）和住院（IP）护理方面的非传染性疾病服务利用率呈上升趋势。对于门诊护理，柬埔寨、老挝人民民主共和国、缅甸和越南（CLMV）的外籍人士利用非传染性疾病服务的几率低于非CLMV外籍人士（P值<0.001）。对于住院护理，男性利用非传染性疾病服务的几率往往高于女性（调整后的比值比=1.35，95%置信区间=1.05 - 1.74，P值=0.019）。年龄增长与非传染性疾病服务利用存在显著关联。此外，外籍患者中的非传染性疾病患病率呈上升趋势。如果泰国要按照可持续发展目标的规定，让其境内的所有人都能通过全民健康覆盖获得幸福保障，那么这个问题表明需要迅速采取公共卫生行动。未来应开展旨在收集家庭层面外籍人士原始证据的研究。还应开展关于其他社会因素的额外研究，这些因素可能有助于更好地了解非传染性疾病的医疗保健获取情况，如社会经济地位、信仰和态度。
