ArticleBMJ open2022
Effective coverage of diabetes and hypertension: an analysis of Thailand's national insurance database 2016-2019.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- How lifestyle counselling supports behaviour change among Thai adults with non-communicable diseases: a rapid realist review.BMJ open · 2026Review
- Implementation of a learning health system for the management of non-communicable diseases in Thailand: a realist evaluation protocol.BMJ open · 2026Article
- Nationwide trends and geographic variations of diabetes in pregnancy in Thailand: Epidemiology, neonatal outcomes, and healthcare costs under the universal health coverage scheme (2013-2023).Preventive medicine reports · 2026Article
- Nature Medicine Commission on dialysis policy in low- and middle-income countries.Nature medicine · 2026Article
- Ecological assessment of extreme temperature and fine particulate matter (pm2.5) impact on diabetes service and outcomes in Thailand.BMC public health · 2025Article
- The Lack of Impact of Primary Care Units on Screening Services in Thailand and the Transition to Local Administrative Organization Policy.Healthcare (Basel, Switzerland) · 2025Article
- Unlocking health equity by eliminating copayments for essential antihypertensive medications.EClinicalMedicine · 2025Review
- Examining determinants of control of metabolic syndrome among older adults with NCDs receiving service at NCD Plus clinics: multilevel analysis.BMC health services research · 2024Article
- Perceptions and experiences of adult caregivers receiving mindfulness-based behavioural education: A qualitative study.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study assesses effective coverage of diabetes and hypertension in Thailand during 2016-2019.
designMixed method, analysis of National health insurance database 2016-2019 and in-depth interviews.
settingBeneficiaries of Universal Coverage Scheme residing outside Bangkok.
participantsQuantitative analysis was performed by acquiring individual patient data of diabetes and hypertension cases in the Universal Coverage Scheme residing outside bangkok in 2016-2019. Qualitative analysis was conducted by in-depth interview of 85 multi-stakeholder key informants to identify challenges. OUTCOMES: Estimate three indicators: detected need (diagnosed/total estimated cases), crude coverage (received health services/total estimated cases) and effective coverage (controlled/total estimated cases) were compared. Controlled diabetes was defined as haemoglobin A1C (HbA1C) below 7% and controlled hypertension as blood pressure below 140/90 mm Hg.
resultsEstimated cases were 3.1-3.2 million for diabetes and 8.7-9.2 million for hypertension. For diabetes, all indicators have shown slow improvement between 2016 and 2019 (67.4%, 69.9%, 71.9% and 74.7% for detected need; 38.7%, 43.1%, 45.1% and 49.8% for crude coverage and 8.1%, 10.5%, 11.8% and 11.7% for effective coverage). For hypertension, the performance was poorer for detection (48.9%, 50.3%, 51.8% and 53.3%) and crude coverage (22.3%, 24.7%, 26.5% and 29.2%) but was better for effective coverage (11.3%, 13.2%, 15.1% and 15.7%) than diabetes. Results were better for the women and older age groups in both diseases. Complex interplays between supply and demand side were a key challenge. Database challenges also hamper regular assessment of effective coverage. Sensitivity analysis when using at least three annual visits shows slight improvement of effective coverage.
conclusionEffective coverage was low for both diseases, though improving in 2016-2019, especially among men and ัyounger populations. The increasing rate of effective coverage was significantly smaller than crude coverage. Health information systems limitation is a major barrier to comprehensive measurement. To maximise effective coverage, long-term actions should address primary prevention of non-communicable disease risk factors, while short-term actions focus on improving Chronic Care Model.
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