In-hospital outcomes of percutaneous coronary intervention (PCI) patients with different medical funds: an analysis from Thai PCI registry.
The limited literature provides minimal information on clinical outcomes among patients undergoing percutaneous coronary intervention (PCI) under different healthcare funding systems, especially in Thailand.
The study aimed to investigate the association between in-hospital clinical outcomes of patients treated with PCI and different types of healthcare funding in Thailand.
The Thai PCI registry is a multicentre, prospective national registry with 39 participating medical centres. Web-based data entry, collected between May 2018 and August 2020, was centrally managed and analysed, providing clinical characteristics, medical management and in-hospital outcomes.
A total of 22 741 patients were analysed and classified into four groups: the Universal Health Coverage Scheme (UC) (63.1%), Government Service Scheme (GS) (26.8%), Social Security Service Scheme (SS) (6.8%) and other payment fund (3.2%). The SS group was younger and predominantly male, whereas cardiovascular risk factors were higher in the GS group. After adjusting for baseline characteristics and management strategies, in-hospital MACE outcomes of ACS patients were significantly higher in patients in the SS (OR=1.81 (1.38, 2.37), p<0.001) and UC group (OR=1.22 (1.04, 1.44), p=0.017) compared with the GS group. Post-procedural myocardial infarction was also higher across all groups. Though differences in all-cause death and cerebrovascular accident/stroke were not statistically significant.
Healthcare funding policies in Thailand significantly associated with disparities in-hospital outcomes of patients undergoing PCI. Patients receiving treatment under the GS scheme demonstrated better clinical outcomes compared to other schemes. These findings highlight the need for policy adjustments aimed at reducing healthcare disparities to improve patient outcomes.
The study aimed to investigate the association between in-hospital clinical outcomes of patients treated with PCI and different types of healthcare funding in Thailand.
The Thai PCI registry is a multicentre, prospective national registry with 39 participating medical centres. Web-based data entry, collected between May 2018 and August 2020, was centrally managed and analysed, providing clinical characteristics, medical management and in-hospital outcomes.
A total of 22 741 patients were analysed and classified into four groups: the Universal Health Coverage Scheme (UC) (63.1%), Government Service Scheme (GS) (26.8%), Social Security Service Scheme (SS) (6.8%) and other payment fund (3.2%). The SS group was younger and predominantly male, whereas cardiovascular risk factors were higher in the GS group. After adjusting for baseline characteristics and management strategies, in-hospital MACE outcomes of ACS patients were significantly higher in patients in the SS (OR=1.81 (1.38, 2.37), p<0.001) and UC group (OR=1.22 (1.04, 1.44), p=0.017) compared with the GS group. Post-procedural myocardial infarction was also higher across all groups. Though differences in all-cause death and cerebrovascular accident/stroke were not statistically significant.
Healthcare funding policies in Thailand significantly associated with disparities in-hospital outcomes of patients undergoing PCI. Patients receiving treatment under the GS scheme demonstrated better clinical outcomes compared to other schemes. These findings highlight the need for policy adjustments aimed at reducing healthcare disparities to improve patient outcomes.
Authors
Hongsakul Hongsakul, Chumsantivut Chumsantivut, Siriyotha Siriyotha, Athisakul Athisakul, Sansanayudh Sansanayudh, Thakkinstian Thakkinstian, Limpijankit Limpijankit, Srimahachota Srimahachota
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