COVID-19’s impact on hospital stays, mortality, and readmissions for poverty-related diseases, noncommunicable diseases, and injury groups in Thailand

by Satiti Palupi, Kyaw Ko Ko Htet, Vorthunju Nakhonsri, Chumpol Ngamphiw, Peerapat Khunkham, Sanya Vasoppakarn, Narumol Atthakul, Sissades Tongsima, Chantisa Keeratipusana, Watcharapot Janpoung, Virasakdi Chongsuvivatwong

Aims

This study aims to compare the trends in the quality of hospital care for WHO’s three disease groups pre-, during, and post-COVID-19 pandemic peak in Thailand.

Methods

The study utilized existing hospital admission data from the Thai Health Information Portal (THIP) database, covering the period from 2017 to 2022. We categorized WHO’s three disease groups: poverty-related, noncommunicable, and injury groups using the International Classification of Diseases (ICD)—10 of initial admission of patients, and we analyzed three major outcomes: prolonged (≥ 90^th percentile) length of stay (LOS), hospital mortality, and readmission pre-, during, and post-COVID-19 pandemic peak. Relative weight (RW) of hospital reimbursements was used as a surrogate measure of the severity of the diseases.

Results

The average prolonged LOS of patients with poverty disease pre-, during, and post-COVID-19 pandemic peak were 7.1%, 10.8%, 9.05%, respectively. Respective hospital mortality rates were 5.02%, 6.22%, 6.05% and readmission were 6.98/1,000, 6.16/1,000, 5.43/1,000, respectively. For non-communicable diseases, the respective proportions in the prolonged LOS were 9.0%, 9.12%, and 7.58%, with respective hospital mortality being 10.65%, 8.86%, 6.62%, and readmissions were 17.79/1,000, 13.94/1,000, 13.19/1,000, respectively. The respective prolonged LOS for injuries were 8.75%, 8.55%, 8.25%. Meanwhile, respective hospital mortality were 4.95%, 4.05%, 3.20%, and readmissions were 1.99/1,000, 1.60/1,000, 1.48/1,000, respectively. The RW analysis reveals diverse impacts on resource utilization and costs. Most poverty-related and noncommunicable diseases indicate increased resource requirements and associated costs, except for HIV/AIDS and diabetes mellitus, showing mixed trends. In injuries, road traffic accidents consistently decrease resource needs and costs, but suicide cases show mixed trends.

Conclusions

COVID-19 had a more serious impact, especially prolonged LOS and hospital mortality for poverty-related diseases more than noncommunicable diseases and injuries.