Comparing the Hospital Admission Rates in Chronic Conditions of Contracting Unit for Primary Care Management between a Dedicated Primary Care Unit and a Tertiary Care Hospital

Nualchavee Permthongchoochai PhD*, Amorn Premgamone MD, MPH**

Affiliation : * Department of Social Medicine, Maharat Nakhon Ratchasima Hospital, Thailand ** Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

Background : Currently, the people with chronic illness are increasing and attending the primary care unit (PCU). The hospital admission rate with short-term complications of chronic disease can be decreased by the quality of care. The quality of care may be related to the administration of the service providers.
Objective : To compare the rates of hospital admission for short-term diabetic complications, hypertension, and hypertension complications between two administration contexts of PCUs, a dedicated PCU, and a tertiary care hospital. Material and Method: The present study was a retrospective cohort study between October 2006 and September 2012. To study 33 PCU of Muang Nakhon Ratchasima primary care network under dedicated PCU (the study area) compared with 25 PCU of Muang Khon Kaen primary care network under Khon Kaen Hospital (the compared area). Hospital admission data of the referral hospital and hospital network were collected according to ICD 10 code. Relative risk was used in data analysis.
Results : The hospital admission rates with short-term diabetic complications of the study area between 2010 and 2012 declined significantly from the compared area (RR 0.51 to 0.63). The hospital admission rate of hypertension and complications of hypertension were increasing in both areas. The hospital admission rate of the study area between 2007 and 2010 were statistical significantly lower (RR 0.32 to 0.65).
Conclusion : The hospital admission rate of chronic diseases in the study area is lower than the compared area especially short-term complications of diabetes. Future research should focus on health promotion and prevention outcomes such as prevalence of chronic diseases.

Keywords : Hospital admission, Diabetic, Hypertension, Primary care unit, Short-term complications

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