Abstract
This study examined the efficiency of resource use in Thailand’s three health insurance schemes:
Universal Coverage (UC), Social Security Scheme (SSS), and Civil Servant Medical Benefit Scheme (CSMBS).
It analyzes the length of stay (LOS) in hospital and early readmission rate in diabetes mellitus (DM) patients,
using as a tracer for efficiency the use of resources and the quality of services, respectively. The
data came from the claims that hospitals servicing all three major health insurance schemes have to send
for reimbursement. The aim of the analysis was to compare the effects of the insurance schemes and other
factors on resource use, LOS as a proxy for resource use, and on quality as proxied by the readmission rate
within 30 days after discharge. The analysis compares three conditions of DM requiring hospital admission:
acute complications, chronic complications, and DM without complication, to prove that there were
no differences in the quality of service in patients’ condition, especially the acute complication condition.
The study found that CSMBS patients had longer LOS than UC and SSS patients. This implied the
efficient use of resources by patients of SSS and UC compared with those covered by CSMBS. However,
SSS patients showed no difference in early readmission within 30 days after discharge, while UC patients
had a higher rate of readmission in chronic DM and without the complication condition.
