Runchana Parnicharoende, MD
Lecturer, Academic Affairs
Faculty of Medicine, Chulalongkorn University
Pathum Wan, Krung Thep, Thailand
Ponthakorn Kaewkanha, MD
Attending Physician
Department of preventive and social medicine, King Chulalongkorn Memorial Hospital
Pathum Wan, Krung Thep, Thailand
Patiphan Techanirattisai, MD
Physician
Department of Preventive and social medicine, King Chulalongkorn Memorial Hospital
Pathum Wan, Krung Thep, Thailand
Unnop Jaisamrarn, MD
Secretary General, WHO CCR, President of Thai Menopause Society
Faculty of Medicine, Chulalongkorn university
Pathumwan, Krung Thep, Thailand
Wasuwat Kitisomprayoonkul, MD
Associated Professor, Department of Rehabilitation Medicine
Faculty of Medicine, Chulalongkorn University
Pathum Wan, Krung Thep, Thailand
Hip fractures are a significant health problem in Thailand requiring rehabilitation programs for recovery and regaining independence in patients with hip fractures. The cost of each rehabilitation session is estimated at 12 US dollars (USD). This study aims to examine the disparities in rehabilitation access.
Design:
This cross-sectional study included patients who underwent surgery for hip fractures from 2018 to 2023. Data were obtained from the Thailand Universal Healthcare Coverage system. The primary objective was to evaluate the association between inpatient rehabilitation costs and factors such as sex, age, and geographic differences in Thailand. The statistical analyses were performed by The Mann-Whitney U test, Chi-square test, and regression model.
Results:
The study included 159,453 patients with a median age of 72 (58–82) years, of whom 63.2% were female. The rehabilitation cost was significantly higher among females, at 18.20 USD (10.20–31.80), compared to 15.40 USD (9.40–28.90) for males (p< 0.001). Patients in the central region had higher rehabilitation costs, with 18.80 USD (10.80–36.50), compared to 16.50 USD (9.60–29.10) in other regions (p< 0.001). Female sex and central region residency were associated with higher odds of receiving rehabilitation, with odds ratios of 1.10 (95%CI: 1.07–1.13) and 1.09 (95%CI: 1.06–1.12), respectively. Additionally, patients aged ≥65 years had lower odds of receiving rehabilitation, with an odds ratio of 0.77 (95%CI: 0.75–0.79, p< 0.001), despite higher rehabilitation costs (18.80 vs. 14.50 USD, p < 0.001) compared to aged < 65 years.
Conclusions:
This study suggested that age, sex, and geographic location are associated with rehabilitation costs and access to rehabilitation services in Thailand. Females and patients residing in the central region were more likely to receive rehabilitation programs compared to other groups. Older patients were less likely to receive rehabilitation. Interventions to address these disparities are needed for better resource allocation and improving access to rehabilitation services.
