Health Insurance System Research Office, Health Systems Research Institute, Nonthaburi 11000, Thailand.
Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai 90110, Thailand.
Int J Environ Res Public Health. 2022 Mar 31;19(7):4130. doi: 10.3390/ijerph19074130.
This study aimed to evaluate the effect of the asthma care program available under the Universal Coverage Scheme (UCS) in Thailand on hospital admissions per 100,000 population, its regional and seasonal variation, readmission within 28 days, and the asthma-specific fatality rate of patients aged 0-29 years in 2009-2016 compared with those in 2007-2008. A retrospective study was conducted using data sources from the UCS register and in-patient databases from the National Health Security Office (NHSO), Thailand. Hospital admissions per 100,000 population was the highest among those aged 0-4 years, but the trends decreased from 470.8 to 288.1 per 100,000 population in 2010-2014. The hospital admission rates were high in Southern Thailand and common in rainy seasons. The readmission rates within 28 days slightly decreased in all age groups in 2016 compared to those in 2007. The case fatality rate of patients aged 20-29 years decreased from 0.40% in 2007 to 0.34% in 2016. The readmission rate within 28 days and case fatality rate were the highest in patients aged 20-29 years. In conclusion, the asthma hospital admission, readmission, and case fatality rates declined over time along with the investment in the asthma care program under the UCS in Thailand. The highest hospital admission rates in patients aged 0-4 years and the readmission and case fatality rates in patients aged 20-29 years should be given more attention. Recordings of individual service utilization data in asthma patients, including quality of care provided, should be monitored to improve the asthma care system.
本研究旨在评估 2009-2016 年泰国全民医保覆盖计划（UCS）下的哮喘护理方案对每 10 万人住院人数的影响，及其区域性和季节性变化、28 天内再入院率，以及 0-29 岁哮喘患者的特定病死率。本研究采用泰国全民医保登记处和国家健康保障办公室（NHSO）住院数据库的数据来源，进行了一项回顾性研究。每 10 万人的住院人数在 0-4 岁年龄组中最高，但 2010-2014 年期间，这一趋势从每 10 万人 470.8 例下降到 288.1 例。泰国南部的住院率较高，且常见于雨季。与 2007 年相比，2016 年所有年龄段的 28 天内再入院率略有下降。20-29 岁患者的病死率从 2007 年的 0.40%降至 2016 年的 0.34%。28 天内再入院率和病死率在 20-29 岁患者中最高。总之，随着泰国全民医保覆盖计划下哮喘护理方案的投资增加，哮喘患者的住院、再入院和病死率呈下降趋势。0-4 岁患者的住院率最高，20-29 岁患者的再入院率和病死率最高，应给予更多关注。应监测哮喘患者的个体服务利用数据记录，包括提供的护理质量，以改进哮喘护理系统。
