Mortality Risks of Pneumonia Patients with Different Levels of Health Insurance Coverage in Thailand
Summana Moolasarn, Ph.D.,Nattee Sirisuth, Ph.D.,Saksit Sripa, M.S.
*Faculty of Pharmaceutical Sciences, Unon Ratchathani University, Warin Chumrad, Ubon Ratchathani Province 34190, Thailand.
Objective : To compare mortality risks of pneumonia patients with different levels of health insurance coverage. Design : Retrospective cohort study Sample : Pneumonia patients admitted to hospitals owned by the Ministry of Public Health (MOPH 4) of Thailand in 1999. Results : Of the 3,725,847 patients admitted to the Thai Ministry of Public Health hospitals, 73,560 patients were diagnosed with a type of pneumonia. Patients with differences in the level of health insurance coverage had significantly different mortality risks. Compared to patients under the Thai government Low Income Scheme, patients with higher levels of health insurance coverage were significantly move likely to have lower mortality risks, such as those patients who had the ability to pay their health service cost (OR=.73,p <.00.1), those who were in the civil servant medical benefit plan (OR= .51,p <.001), or those who were under another MOPH health insurance coverage plan such as health volunteers (OR= .48, p = .003) after controlling for age, gender, marital status, hospital types, and length of stay. Conclusion : Pneumonia patients who had lower levels of health insurance coverage had a significantly higher mortality risk than those of insured or self-insured patients. Whether the results reflected unmeasured differences in quality of care, restricted or delayed to access to care, or differences in comorbidites remains to be determined.
Keywords: Pneumonia; Health insurance; Mortality risk; Thailand