Objective: To examine the trend of avoidable hospitalization related to diabetes in the UC patients who registered at Rajavithi Hospital.

Material and Method: This cross-sectional study collected data from electronic medical record from Rajavithi Hospital and the National Health Security Office (NHSO). DM and related diseases based on a list of diagnosis codes (ICD-10) were selected as an ambulatory care sensitive condition (ACSC) to reflect the avoidable hospitalization. Outpatient and inpatient data between 2007 and 2011 were studied. The ACSC rate was calculated by number of hospitalizations on DM and related conditions divided by number of the DM patients visited as ambulatory care.

Results: The ACSC rate in DM patients registered to Rajavithi Hospital was on average 25.85 per 1,000 (22.62 per 1,000 to Rajavithi Hospital, and 6.67 per 1,000 to non-Rajavithi hospital). Hospitalizations of DM related diseases were only observed at other hospitals. The median length of stay in Rajavithi Hospital was 5.0 (interquartile range 2.0-8.0) vs. 4.0 (IQR 2.0-6.0) days in other hospitals. The risk of DM hospitalization in male was 1.21 times higher than that of female (95% CI 1.03-1.42, p = 0.02). The risk of DM hospitalization in patients younger than 60 years old was 1.07 times of those 60 years and above (95% CI 0.95-1.21, p = 0.28).

Conclusion: The avoidable hospitalization for DM patients registered at Rajavithi Hospital was stable during the five years of the study. Future study on avoidable hospitalization should cover admissions to other hospitals and DM related conditions. Further studies should investigate the reasons of avoidable hospitalization.

Keywords: Ambulatory care sensitive condition (ACSC), Diabetes, Universal coverage scheme