ArticleBMJ public health2025
Variation in coronary revascularisation and mortality after myocardial infarction across three public health insurance schemes in Thailand: an observational analysis from nationwide claims data.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Evidence on the impact of diverse healthcare insurance arrangements on healthcare variation is limited in low-income and middle-income countries. In Thailand, the Civil Servant Medical Benefit Scheme (CSMBS), Social Health Insurance (SHI) and Universal Coverage Scheme (UCS) have different provider choice and reimbursement arrangements and cover different populations. We explored to what extent use of revascularisation in patients with ST elevation myocardial infarction (STEMI) varied by insurance scheme. Methods: We used claims data, including all admissions for patients with STEMI between 2015 and 2020. Outcomes were any type of revascularisation, primary percutaneous coronary intervention (PPCI) and mortality. Regression models were used to estimate absolute differences (ADs) by scheme, adjusted for age, sex, comorbidities and admission year. Results: Of 98 142 patients, 75.7% were covered by UCS, 13.3% by CSMBS and 11.0% by SHI. Overall, 76.3% underwent revascularisation and 53.8% received PPCI. Mortality rates were 13.2% in-hospital and 20.7% at 180 days. Compared with UCS, use of revascularisation was slightly higher with CSMBS and slightly lower with SHI (AD: CSMBS 1.3% (95% CI -0.2 to 2.8), SHI -0.8% (-2.6 to 1.0), p=0.0264) and use of PPCI was slightly higher with CSMBS and SHI (AD: CSMBS 2.4% (-0.3 to 5.2), SHI 5.2% (3.1 to 7.2), p<0.0001)). CSMBS and SHI-insured patients had lower mortality compared with UCS (AD for in-hospital: CSMBS -1.3% (-2.1 to -0.5), SHI -0.9% (-1.8 to -0.1), p<0.0001; AD for 180-day mortality: CSMBS -4.5% (-5.3 to -3.6), SHI -1.9% (-3.0 to -0.8), p<0.0001). Effects of insurance scheme varied by hospital type for all outcomes (p for interaction<0.0001). Conclusion: Three-quarters of patients with STEMI received coronary revascularisation, suggesting potential undertreatment. We identified relatively small differences in access to revascularisation by insurance scheme which are unlikely to explain the lower mortality with CSMBS and SHI. Claims data can be used to assess the impact of insurance on access to effective treatments.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.