Elderly healthcare at double utilization rate reveals NHSO

The National Health Security Office (NHSO) has revealed that the elderly in Thailand utilise healthcare services at twice the rate of other age groups, accounting for one-third of the system’s total costs.

The most common conditions found in this group are enlarged thyroid, chronic obstructive pulmonary disease, and arrhythmias. The majority of elderly patients utilise the state-provided universal healthcare coverage, known as the gold card. As Thailand edges closer towards becoming a fully-fledged ageing society, with nearly 20% of its population aged 60 or above, the NHSO is prioritising the development of benefits and services to support this demographic.

In examining data from the 2022 fiscal year, the NHSO found that Thailand has a population of 66.98 million with 13.16 million being 60 years old or above, representing 19.65% of the total population. The gold card is the most common health coverage, benefiting 10.27 million individuals, followed by civil servant benefits covering 2.10 million, social security covering 431,000 and local government employee benefits covering 202,000 individuals, said the NHSO Secretary-General.

“Data from the gold card system shows that the elderly use healthcare services at a rate double that of all other age groups. For outpatient services, the average use is 6.33 times per person per year, compared to 3.53 times for other age groups.

“Last year, this equated to 63.96 million visits or 38.22% of all outpatient visits. For inpatient services, the average is 0.22 times per person per year, compared to 0.13 times for other age groups.

“Last year, this equated to 2.17 million visits or 35% of all inpatient visits. The resources used to care for the elderly account for one-third of the entire system’s costs. Last year alone, 1.75 million elderly patients received care, resulting in 2.17 million visits and 11.43 million hospital bed days. “In contrast, all other age groups accounted for 5.41 million patients, 6.20 million visits, and 32.56 million hospital bed days.”

Common conditions

The most common conditions for which the elderly sought outpatient treatment were high blood pressure, diabetes, and chronic kidney disease. Among inpatients, the top three conditions were pneumonia caused by a virus, pulmonary edema, and end-stage chronic kidney disease.

The most common conditions among the elderly compared to all other age groups were enlarged thyroid, chronic obstructive pulmonary disease, arrhythmia for outpatients and senile cataracts, unspecified cataracts, and acute exacerbation of chronic obstructive pulmonary disease for inpatients.

In addition to these, the leading causes of death among hospitalised elderly patients were viral pneumonia, pulmonary edema, and urinary tract infections.

Diseases that had a higher proportion of deaths among the elderly than in other age groups were acute respiratory infections, urinary tract infections, sudden cardiac death, and aspiration pneumonia.

In terms of access to services under the gold card coverage for the elderly last year, there were 385,377 cases of elderly rehabilitation services, 176,553 cases of public health services for the elderly with dependency, 101,615 cataract surgeries, 33,687 dental prostheses, and 8,678 knee replacement surgeries for elderly patients with osteoarthritis, reported KhaoSod.

Diabetes treatment services were used 9.12 million times for outpatients and 99,000 times for inpatients, high blood pressure treatment services were used 17.26 million times and 334,000 times respectively, and colorectal cancer screening with FIT- test was conducted for 622,000 individuals aged 50 to 70 years, with 7.49% of the results being abnormal and requiring treatment, said the NHSO Secretary-General.

“The gold card is the system that provides the most health coverage for the elderly, with more than 10 million elderly individuals under its care.

“Therefore, a significant portion of the NHSO’s budget is used to care for the elderly, ensuring they have access to necessary medical care and public health services as comprehensively and widely as possible, and to improve the quality of life for elderly gold cardholders. This data will also be beneficial in the continued development of the health system to care for the elderly.”

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