Factors Associated with Healthcare Expenditures and Hospitalizations in Thai Patients with Diabetes at Four Public HospitalsU. Chaikledkaew, P. Pongchareonsuk, B. Ongphiphadhanakul and N. Chaiyakunapruk
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The objective of this study is to investigate factors associated with healthcare expenditures and hospitalizations in patients with diabetes in four public hospitals in Thailand. A retrospective study was conducted by using electronic claims data of diabetic patients from October 1, 2002 to September 30, 2003. Dependent variables were total healthcare expenditures and hospitalizations. Demographic factors, healthcare utilization, complications, comorbidities and payment methods were used as independent variables. Multivariate statistical analyses were applied. The results of this study suggested that demographic factors of patients (e.g. age and male gender), payment methods (i.e. CSMBS and UC) were significantly associated with higher healthcare expenditures and probability of hospitalization. Patients receiving treatment from teaching hospitals significantly consumed higher healthcare expenditures. In addition, the more healthcare utilizations (e.g. hospitalization, outpatient visit and insulin utilization), the higher healthcare expenditures the patients significantly had. Diabetic patients taking insulin had significantly higher risk of hospitalization. Furthermore, comorbidities (e.g. hypertension, hyperlipidemia and cancer) and complications (e.g. nephropathy, neuropathy, retinopathy, CAD and PVD) were related to an increase in healthcare expenditures and hospitalization. Factors associated with healthcare expenditures and hospitalizations may help healthcare providers intervene to improve patient management and possibly reduce healthcare expenditures.
Keyword:
Healthcare Expenditures, Diabetes,Public Hospitals ,Demographic factors,healthcare utilization,complications,comorbidities,payment methods
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