Burdens and patterns of gastrointestinal diseases in Thai children: an analysis based on Thai national health coverage data

Abstract

Background: Gastrointestinal (GI) diseases are significant health problems worldwide. Due to the limited number of national reports among upper-middle-income countries, we aimed to study burdens and patterns of GI diseases in Thai children. Methods: The study retrospectively analyzed data on inpatients aged <18 years provided by Thailand’s National Health Security Office (NHSO) from 2015 to 2023. Results: The primary diagnosis of GI diseases during the study period ranged from 134,000 to 296,040 admissions per year (10.2-16% of all inpatient diagnoses). The most common diagnosis group was intestinal infectious diseases (58.6%-66.3%), of which other gastroenteritis and colitis of infectious and unspecified origin (A09) was prevalent in every age group. Admission mainly was found among children aged 1-5 years (36.5%-48.1%) and in the secondary hospitals (67.8-71.2%). In 2015-2022, the mortality rate of GI diseases was 0.5-0.7 deaths per 1,000 admissions (2.3-3.2% of the total inpatient deaths). In 2023, the mortality rate of GI diseases reduced to 0.4 deaths per 1,000 admissions, describing the highest rates in the groups of malignant neoplasms of digestive organs and diseases of the peritoneum (17.4 deaths per 1,000 admissions, both), followed by diseases of the liver (15.1 deaths per 1,000 admissions). Hepatic failure, not elsewhere classified (K72), had the highest mortality (106.4 deaths per 1,000 admissions). The total paid by the NHSO for GI diseases was 77,370,498 Thai Baht or 2,230,790 US dollars in the fiscal year 2022-2023. Conclusions: Pediatric GI diseases burdened the Thai healthcare system, particularly intestinal infectious diseases. Malignancy, peritoneal, and liver diseases had less prevalence but higher mortality. Trial registration Number: TCTR20241030014 (https://www.thaiclinicaltrials.org/show/TCTR20241030014), Date of Registration: 19/9/2024.