Factors Affecting Health-Care Costs and Hospitalizations among Diabetic Patients in Thai Public Hospitals.
Chaikledkaew U1,2, Pongchareonsuk P1, Chaiyakunapruk N3,4,5, Ongphiphadhanakul B6.
1Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok,Thailand;
2Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi,Thailand;
3Department of Pharmacy Practice, School of Pharmacy, Phitsanulok, Naresuan University,Thailand;
4Setting Priority Using Cost-effectiveness Analysis, Ministry of Public Health Nonthaburi,Thailand;
5School of Population Health,The University of Queensland, Brisbane,Australia;
6Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok,Thailand
The study investigated the factors affectinghealth-care costs and hospitalizations among diabetic patients in Thai public hospitals.
A retrospective study was conducted by usingadministrative claims data obtained from diabetic patients during October 1, 2002 and September 30, 2003. Dependent variables were total health-care costs and the occurrence of hospitalizations. Independent variables included demographic factors, health-care utilizations, complications, comorbidities, and payment methods. Multivariate statistical analyses were applied.
The results of this study suggested that demographic factors of patients (i.e., age and male sex), payment methods (i.e., capitation, fee-for-service, and out-of-pocket) were significantly associated with higher health-care costs and probability of hospitalization. Patients receiving treatment from teaching hospitals significantly consumed higher health-care costs. In addition, the more health-care utilizations (i.e.,occurrence of hospitalization, number of outpatient visit, and insulin utilization), the higher health-care costs the patients significantly had. Diabetic patients taking insulin had significantly higher health-care costs and risk of hospitalization. Furthermore, comorbidities (e.g., hypertension and cancer) and diabetes-related complications (e.g., nephropathy, neuropathy, retinopathy, coronary artery disease,cardiovascular disease, and peripheral vascular disease) were significantly associated with an increase in health-care costs and hospitalization.
Factors affecting health-care costs and hospitalizations may help health-care providers intervene to improve patient management and possibly reduce health-care costs in the future. Keywords: diabetes, health-care costs, hospitalizations, risk factors.