title: Comparative effectiveness of three national healthcare schemes in Thailand: in-hospital medical expenses for diabetes and hypertension in 2010.
abstract: OBJECTIVE
  To compare the health insurance schemes regarding treatment of diabetes (DM) and hypertension (HT).
  
  
  METHODS
  In-patient expense data for all ICD-10 DM and HT for 2010 were accessed from the National Health Security Office (UC), the Social Security office (SS) and the Civil Servants Benefit System (CSMBS). Mean hospital stay charges and mortality rates were calculated and compared across schemes and types of hospital.
  
  
  RESULTS
  Thais > or = 19 years accounted for 4,863,939 admissions (12.6% DM-All; 17.9% HT-All). Average admission per case was higher for DM-All (1.66) than HT-All (1.46). CSMBS patients trended to be older than UC and SS. Most under UC were admitted to primary care (51.9% DM-All; 50.0% HT-All) vs. tertiary under CSMBS (45.5% DM-All; 48.4% HT-All). Median of stay under CSMBS was longer (1.3-2.0x) and charges higher (1.3-1.6x) than UC for all levels for both DM and HT Mortality rate under CSMBS was higher than UC in primary care for both DM and HT while respective rates were higher under UC than CSMBS for secondary (DM-All: 9.9 vs. 8.1; HT-All: 8.2 vs. 6.6) and tertiary care (DM-All:11.7 vs.8.6; HT-All: 9.8 vs. 6.8).
  
  
  CONCLUSIONS
  Inequalities among three health insurance schemes for DM and HT including hospital charge, hospital stay and mortality rate according to health care settings for DM and HT were shown, effectiveness improvement is needed.
authors.affiliation: Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Pyatat@kku.ac.th
authors.forename: Pyatat
authors.initials: P
authors.lastname: Tatsanavivat
authors.forename: Yupa
authors.initials: Y
authors.lastname: Thavornpitak
authors.forename: Chatlert
authors.initials: C
authors.lastname: Pongchaiyakul
mesh_terms: D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D013785:Thailand / Q000453:epidemiology