Evidence map›Paper›PMID 34321299›Full record

ArticleBMJ open2021

Retrospective secondary data analysis to identify high-cost users in inpatient department of hospitals in Thailand, a middle-income country with universal healthcare coverage.

Waranya Rattanavipapong, Yi Wang, Rukmanee Butchon, Nitichen Kittiratchakool, Jadej Thammatacharee, Yot Teerawattananon, Wanrudee Isaranuwatchai

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Waranya RattanavipapongHealth Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.ORCID 0000-0001-8628-2149
Yi WangSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
Rukmanee ButchonHealth Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.
Nitichen KittiratchakoolHealth Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.
Jadej ThammatachareeNational Health Security Office, Bangkok, Thailand.
Yot TeerawattananonHealth Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand.
Wanrudee IsaranuwatchaiHealth Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand wanrudee.i@hitap.net.
Ministry of Public Health · THNational University of Singapore · SGSocial Security Office (Thailand) · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe study aims to identify high-cost users (HCUs) in the inpatient departments of hospitals in Thailand including their common characteristics, patterns of healthcare utilisation and expenditure compared with low-cost users, and to explore potential factors associated with HCUs so the healthcare system can be prepared to support the HCUs including those who have increased chances of becoming HCUs. DESIGN AND

settingA retrospective secondary data analysis using hospitalisation data from Thailand's Universal Coverage Scheme (UCS) obtained from the National Health Security Office over a 5-year period from October 2014 to September 2019 (fiscal year 2014-2018).

participantsStudy participants included Thai citizens who had at least one inpatient admission to hospitals under the UCS over the study period.

resultsOver the 5-year period, the top 5% of the hospitalised population (or HCUs) consumed almost 50% of the health expenditure each year. HCUs were more likely to have longer hospital stays, a higher annual number of visits and be admitted to multiple hospitals each year when compared with the low-cost users (the bottom 50% of the hospitalised population). The study further reported that the chance of becoming an HCU is associated with several factors such as increasing age, being male, having a comorbidity and being admitted to hospitals in Bangkok.

conclusionsThis study confirmed that the HCU phenomenon existed in Thailand, where a majority of inpatient care spending is concentrated in the top 5% of the hospitalised population. The study findings call attention to potential initiatives that can help monitor the magnitude and trend of HCUs and develop policies to prevent HCUs.

Indexed as

InpatientsUniversal Health InsuranceData AnalysisDelivery of Health CareHospitalsHumansMaleRetrospective StudiesThailandUniversal Health Carehealth economicshealth policypublic healthstatistics & research methods

Identifiers

PMID34321299
PMCPMC8319992
OpenAlexW3184105197

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.