Diabetes is a significant problem worldwide and especially for developing countries including Thailand, where the disease has increased in prevalence rapidly, resulting in high healthcare expenditure and loss of productivity due to illness and premature death. Thailand has adopted multiple policies to control diabetes, such as screening through annual health checkups for people aged 35 and over, increasing healthcare access in rural communities, and developing diabetes clinical practice guidelines to improve the quality of care. However, multiple national health surveys still showed a rising pattern of diabetes in the country. To help understand and tackle the problem, we created a 10-year cohort using data from the national health exam survey (NHES) as a starting point and followed the population by linking to healthcare utilization and expenditure data from the universal health coverage scheme, the main health insurance program in Thailand. With this cohort, we study 3 topics. The first is to understand the burden of diabetes in the Thai health service system by calculating incidence of diabetes and its complications. Furthermore, we will identify factors which affect diabetes incidence and therefore can be used to create evidence-based control policies. Second, we seek to identify the bottleneck between each step in the “cascade of care” (screening, starting and adhering to treatment, and controlling disease). Finally, we will compare healthcare utilization patterns, expenditure, and outcomes related to diabetes between the overall population and vulnerable subgroups to identify factors that prevent vulnerable populations from obtaining better health outcomes.
Wasin Laohavinij is a physician at King Chulalongkorn Memorial Hospital and a research assistant at Department of Preventive Medicine, Faculty of Medicine, Chulalongkorn University. His research focus on non-communicable disease prevention policies and economic evaluation of health promotion and prevention. Wasin Laohavinij completed his MD at Chulalongkorn University.