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Coronary artery disease in the Thai population: data from health situation analysis 2010.

BACKGROUND
The rate of cardiovascular disease marked by coronary artery disease (CAD) is increasing in low-middle income countries including Thailand. The burden of CAD will have a significant impact on the healthcare system and the national budget.


OBJECTIVE
To identify the CAD-related hospitalization rate over one year; to determine in-hospital mortality in various subgroups of patients with CAD and to examine the hospitalization costs of patients with CAD.


MATERIAL AND METHOD
The data were extracted from in-patient discharge forms from the three main health insurance schemes in Thailand for the fiscal year 2010 (October 1, 2009 to September 30, 2010. The data included the three major health insurance schemes which provided coverage for about 62 million people (96% of the population). Data regarding coronary artery disease using the ICD-10 (I20-angina, I21-acute myocardial infarction (AMI) and I25-chronic ischemic heart disease) were extracted and analyzed for number of admissions, mortality rate, length of hospital stay and hospital charges.


RESULTS
In 2010, the total admissions of patients with coronary artery disease were 22,507. The most common presentation of CAD was angina pectoris (10,822 admissions)followed by AMI (6,391 admissions) and chronic ischemic heart disease (5,294 admissions). The respective in-hospital mortality rates in patients admitted with AMI, chronic ischemic heart disease and angina pectoris were 11.3%, 2.9% and 0.7%.


CONCLUSION
Thailand is entering a period of epidemiologic transition marked by an increase of cardiovascular disease and hospital expenses dominated by cardiovascular disease. Information on the burden of CAD--indicates a need to improve health care system.