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Table 3 Factors influencing high hospital charges (>50,000 baht/1470 USD) among hospitalized, Thai, adult, CKD patients

From: Mortality and treatment costs of hospitalized chronic kidney disease patients between the three major health insurance schemes in Thailand

Variables No. of admission (times) No. of high cost admission (%) Crude odds ratio (95% CI) p-value Adjusted odds ratio (95% CI) p-value
Sex
 Female 126,027 8490 (6.7) 1 <0.001 1 <0.001
 Male 110,412 9662 (8.8) 1.31 (1.27–1.36)   1.16 (1.12–1.20)  
Age
 19–30 4376 405 (9.3) 1   1  
 31–40 8392 715 (8.5) 0.92 (0.80–1.06) 0.24 1.03 (0.88–1.20) 0.70
 41–50 22,172 1682 (7.6) 0.81 (0.72–0.92) 0.001 1.08 (0.94–1.24) 0.26
 51–60 46,571 3408 (7.3) 0.77 (0.68–0.86) <0.001 1.05 (0.92–1.20) 0.49
 61–70 62,672 4324 (6.9) 0.72 (0.64–0.81) <0.001 1.01 (0.89–1.16) 0.85
 71–80 64,288 5065 (7.9) 0.82 (0.72–0.92) 0.001 1.02 (0.89–1.16) 0.82
  > 80 27,968 2553 (9.1) 0.95 (0.84–1.07) 0.40 1.01 (0.88–1.17) 0.85
Insurance
 CSMBS 42,348 6923 (16.4) 1   1  
 SHI 8930 1441 (16.1) 0.99 (0.93–1.06) 0.85 0.45 (0.41–0.49) <0.001
 UCS 185,161 9788 (5.3) 0.29 (0.28–0.30) <0.001 0.38 (0.36–0.39) <0.001
Hospital level
 Community 102,251 977 (1.0) 1   1  
 General 56,525 4049 (7.2) 7.54 (7.03–8.10) <0.001 3.58 (3.32–3.87) <0.001
 Tertiary 66,150 10,974 (16.6) 19.36 (18.11–20.70) <0.001 7.17 (6.67–7.70) <0.001
 Private 11,513 2152 (18.7) 23.09 (21.28–25.05) <0.001 13.82 (12.58–15.19) <0.001
Region
 Northern 48,110 2645 (5.5) 1   1  
 Northeast 104,067 3703 (3.6) 0.63 (0.60–0.66) <0.001 0.74 (0.70–0.78) <0.001
 Central 64,962 10,360 (16.0) 3.23 (3.08–3.39) <0.001 1.83 (1.74–1.94) <0.001
 Southern 19,300 1444 (7.5) 1.36 (1.27–1.46) <0.001 1.21 (1.12–1.31) <0.001
Co–morbidities
 Hypertension (yes/no) 125,565/110,874 11,037 (8.8)/7115 (6.4) 1.38 (1.34–1.42) <0.001 1.00 (0.96–1.04) 0.96
 Diabetes mellitus (yes/no) 101,664/134,775 8775 (8.6)/9377 (7.0) 1.27 (1.23–1.31) <0.001 1.12 (1.08–1.17) <0.001
 Hyperlipidemia (yes/no) 31,229/205,210 3449 (11.0)/14,703 (7.2) 1.51 (1.45–1.57) <0.001 1.06 (1.01–1.12) 0.016
 Ischemic heart disease (yes/no) 29,272/207,167 4406 (15.1)/13,746 (6.6) 2.42 (2.33–2.51) <0.001 1.75 (1.67–1.84) <0.001
 Heart failure (yes/no) 24,915/211,524 2679 (10.8)/15,473 (7.3) 1.53 (1.46–1.60) <0.001 1.11 (1.05–1.17) <0.001
 Gout (yes/no) 19,640/216,799 1407 (7.2)/16,745 (7.7) 0.92 (0.87–0.98) 0.005 0.99 (0.93–1.06) 0.76
 Sepsis (yes/no) 18,528/217,911 4586 (24.8)/13,566 (6.2) 4.62 (4.44–4.79) <0.001 2.75 (2.62–2.88) <0.001
 Pneumonia (yes/no) 14,732/221,707 4004 (27.2)/14,148 (6.4) 5.18 (4.98–5.40) <0.001 3.27 (3.10–3.45) <0.001
 Acute renal failure (yes/no) 12,133/224,306 3351 (27.6)/14,801 (6.6) 5.09 (4.88–5.31) <0.001 2.35 (2.23–2.48) <0.001
 Diarrhea (yes/no) 12,085/224,354 774 (6.4)/17,378 (7.75) 0.82 (0.76–0.88) <0.001 0.98 (0.90–1.07) 0.69
 Stroke (yes/no) 11,886/224,553 2313 (19.5)/15,839 (7.1) 2.97 (2.83–3.12) <0.001 1.82 (1.72–1.94) <0.001
 Respiratory failure (yes/no) 11,347/225,092 3080 (27.1)/15,072 (6.7) 5.02 (4.80–5.25) <0.001 2.30 (2.17–2.44) <0.001
Complications
 Anemia requiring blood 57,727/178,712 7442 (12.9)/10,710 (6.0) 2.38 (2.31–2.46) <0.001 2.25 (2.17–2.34) <0.001
  Transfusion (yes/no)
 Hyperkalemia (yes/no) 23,505/212,934 2532 (10.8)/15,620 (7.3) 1.57 (1.51–1.64) <0.001 1.17 (1.11–1.23) <0.001
 Volume overload (yes/no) 22,091/214,348 1966 (8.9)/16,186 (7.55) 1.30 (1.24–1.36) <0.001 0.99 (0.93–1.05) 0.67
 Metabolic acidosis (yes/no) 11,897/224,542 1549 (13.0)/16,603 (7.4) 1.90 (1.80–2.00) <0.001 1.11 (1.04–1.19) 0.003
Mode of dialysis
 Hemodialysis 17,143/219,296 5239 (30.6)/12,913 (5.9) 6.45 (6.22–6.70) <0.001 3.14 (3.00–3.28) <0.001
 Peritoneal dialysis 4584/231,855 1170 (25.5)/16,982 (7.3) 4.16 (3.89–4.46) <0.001 3.30 (3.04–3.59) <0.001
  1. Note: CKD chronic kidney disease, UCS Universal Coverage Scheme, CSMBS Civil Servant Medical Benefit Scheme, SHI Social Health Insurance, CI confidence interval