ArticleBMC health services research2022
Geographical inequality in service utilization for primary aldosteronism screening: spatial epidemiological study in Southern Thailand.
Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- The Burden, Outcomes, and Management of Patients with Aldosterone Dysregulation: A Targeted Literature Review.Advances in therapy · 2026Review
- Prevalence of apparent treatment-resistant hypertension and screening rates for primary aldosteronism in an asian ambulatory care setting.Journal of human hypertension · 2026Article
- Is It Possible to Screen for Primary Aldosteronism Effectively in Primary Care?Clinical endocrinology · 2025Observational
- Medical Insurance Reimbursement and the Effects of Tuberculosis Management in Guangxi Province, China: A Retrospective Cross-Sectional Study.Risk management and healthcare policy · 2025Article
- Health Care Challenges in the Management of Primary Aldosteronism in Southeast Asia.The Journal of clinical endocrinology and metabolism · 2024Article
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4 authors.
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Abstract
backgroundPrimary aldosteronism (PA), the most common cause of secondary hypertension is considered as a "major public health issue" due to higher risk of cardiovascular complications compared to blood-pressure-match hypertension and increase in prevalence around the world. In Thailand, though PA screening is provided under the universal health coverage, the service can be offered only at some centers. Hence, the service availability affects an accessibility of health care in patients. Our study aimed to evaluate the service utilization in PA screening and diagnosis in terms of geographical inequality in health resources in Southern Thailand.
methodsData of 688 patients who underwent PA screening from 2011 to 2017 were obtained from the electronic database of Songklanagarind Hospital, a super-tertiary center in this region. The patients' residence in the province, district and subdistrict were transformed to a 6-digit numbers corresponding to the global one (GADM©). The areas with PA screening and diagnosis were visualized by disease mapping procedures. A general log linear model was used to identify the factors affecting patient's service accessibility.
resultsFrom the geographic distribution, patients living in or near the area of the super-tertiary center (Songkhla) had high probability of receiving PA screening. The analysis of factors contributing to PA screening by multivariate log-linear model demonstrated that the distance from the super-tertiary center was a predictive factor for screening while the presence of endocrinologists and cultural differences were not. The chance of patients living in Songkhla, living less than 200 km, and more than 200 km from Songkhla to receive PA screening was 100, 82, and 66%, respectively. The crude incidence rate of PA in Southern Thailand was 1.66/10
conclusionsThere is still geographical inequality and the strategy to decrease the barrier should be resolved. The policymaker should develop a transfer system of blood tests for PA investigation from the local hospital to reduce the burden such as transportation costs in patients who live far away from the super-tertiary hospital. In addition, PA screening should be implemented in hypertension care plan.
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