Epidemiology of Assault-Related Hospitalizations in Thailand in the Fiscal Year 2010: Comparison between With and Without Psychiatric Disorder
Pattharee Paholpak MD*, Poonsri Rangseekajee MD*, Niramol Patjanasoontorn MD*, Surapol Virasiri MD*, Sumitr Sutra MD**, Suchat Paholpak MD*
Affiliation : * Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ** Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Assault is a leading cause of injury and death; however, little is known regarding the psychiatric epidemiology
of assault-related hospitalizations (ARH) in Thailand.
Objective : To analyze the epidemiological data of ARH in Thailand for the fiscal year 2010 and to compare the epidemiology
of ARH between with and without psychiatric disorder.
Material and Method: The data analyzed were from the annual reports for the fiscal year 2010 (October 1, 2009-September
30, 2010), on every kind of hospitalization reimbursed by the Universal Health Coverage System, the Social Welfare System,
and the Civil Servant Medical Benefits Scheme, altogether provided medical coverage for more than 96% of the Thai
population. The information on ARH (X85-Y09: ICD-10 version for 2010) and comorbid psychiatric disorder(s) (F00-F99)
were extracted. Number of in-patient hospitalizations by sex, age, geographical region, month, hospital charges, length of
hospital stay (LOS) and mortality rate (MR) were analyzed. Frequencies (percentages) of ARH and subgroups were reported.
Results : The national ARH care cost was 0.98% of the overall national in-patient care expenses (88,964 million Baht). The
rate of ARH was 0.72 of every 100 hospitalizations or 7.74 incidents/100,000 general population. Assaults leading to
hospitalizations frequently occurred among males (80.86%); in 25-39 year-olds (35.60%), 40-59 year-olds (22.85%); by
sharp object (29.44%), blunt object (24.40%) and bodily force (23.71%); in the Central (39.48%) and Northeast region
(31.16%). There was a tri-modal monthly peak distribution: April (11.12%), December (9.45%) and October (8.90%). A
minority i.e. 0.4% (male to female ratio of 4.22:1) of ARH had a concomitant psychiatric disorder(s): the most frequent being
‘mental and behavioral disorders due to psychoactive substance use’ (66.54%) followed by ‘schizophrenia, schizotypal and
delusional disorders’ (14.23%). The MR of ARH with and without concomitant psychiatric disorder was 1.03% and 0.30%,
respectively. The LOS of overall ARH was 5.15 + 12.41 days, min-max was 1-568 days and the mode was 1 day. The LOS of
ARH with/without psychiatric disorder was 5.2 + 12.4 vs. 3.7 + 7.5 days. The expenses paid for ARH with/without psychiatric
disorder was 75,811,383.40 Baht vs. 791,214,659.90 Baht.
Conclusion : Assault accounted for 0.72 hospitalization of every 100 hospitalizations and 7.74 times/100,000 population. A
fraction (0.04%) of ARH had concomitant psychiatric disorder(s): most frequently psychoactive substance use disorders
followed by schizophrenia and related psychosis.
Keywords : Psychiatric epidemiology, Assault, Hospitalization
