Trends in Economic Burden and Mortality of Hospitalized Patients With Aortic Stenosis in Thailand

Abstract

This study aimed to assess the temporal trends in aortic stenosis (AS)-related hospitalizations, in-hospital mortality, and economic burden in Thailand. The study cohort was derived from the electronic claim system of the National Health Security Office, which serves as a reimbursement database for all Thai beneficiaries under the Universal Health Coverage Scheme, covering ∼70% of the entire population. Hospitalization, mortality, and costs were estimated by year, with the primary diagnosis for AS-related hospitalizations identified using code I350. The Cochrane Armitage test was used to examine trends in AS-related hospitalization and in-hospital mortality, whereas a nonparametric trend test was used to analyze the trend of hospitalization costs. Of the 8-year period, 10,406 adults were admitted with a primary diagnosis of AS. AS-related hospitalizations increased from 1,274 in 2015 to 1,945 in 2022 (p = 0.251), with the most significant observed in the age group 60 to 79 years (p <0.001). In-hospital mortality increased from 4.8% to 6.1%. Hospitalization cost significantly increased from $2,879 to $3,443 (p <0.001), with an average length of stay of 6.6 ± 9.2 days. The trend of patients admitted with primary diagnosis of AS in Thailand has significantly increased in the age group 60 to 79 years. In-hospital admission is found at older age and is likely to have high mortality rate. The increased hospitalization cost may impose a substantial economic burden on the Thai health care system.