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Background: Descriptive analyses of 2009–2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. Methods and findings: The database of T2DM patients aged 15–100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009–2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. Conclusion: Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM. [ABSTRACT FROM AUTHOR]

Background: Demographic changes in the pattern of disease burden, escalating health expenditures and inequitable access to healthcare are global challenges. Irrespective of their level of development, all countries need to reform their health systems to prepare for the future emerging health needs, in order to meet their commitments of health systems strengthening, universal health coverage (UHC) and explicit targets in the Sustainable Development Goals (SDGs). We propose three core principles for the future health system as described herein. A health system is not simply a 'cure delivery machine' but part of a 'social security system' that engages all stakeholders through a shared vision and value of health and well-being, not merely an absence of diseases. The future health system shall provide people-centred, affordable care, tailored to the individual's needs, accessible at any time and any place, and reflect the notion of leaving no one behind through a life course approach - underpinned by the SDGs. Information and communications technology (ICT) offers the potential to facilitate the realisation of these principles by improving the information flow between different parts of the health system through electronic means. We introduce Japan's new data platform - Person-centred Open PLatform for wellbeing (PeOPLe) - planned to be introduced in 2020 as one example of an ICT-based intervention to realise the three proposed principles. PeOPLe integrates data collected throughout the life course to enable all people to receive affordable, personalised health and social care at any time and any place throughout their lifetime. Furthermore, we discuss the applicability of these principles and PeOPLe to the health systems context of Thailand and the Philippines, including elaborations on ICT transformation challenges.Conclusion: Current rising momentum and scale for ICTs in the UHC era offers a great opportunity to make a difference for countries. The PeOPLe concept is not only relevant to resource-rich countries; its applicability to other Asian countries could be feasible though it will need to be adapted to the various country contexts. We hope that this paper contributes to wider discussion around policy choices of ICT application for future health systems strengthening and UHC in order to achieve the SDGs. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effect of the asthma care program available under the Universal Coverage Scheme (UCS) in Thailand on hospital admissions per 100,000 population, its regional and seasonal variation, readmission within 28 days, and the asthma-specific fatality rate of patients aged 0-29 years in 2009-2016 compared with those in 2007-2008. A retrospective study was conducted using data sources from the UCS register and in-patient databases from the National Health Security Office (NHSO), Thailand. Hospital admissions per 100,000 population was the highest among those aged 0-4 years, but the trends decreased from 470.8 to 288.1 per 100,000 population in 2010-2014. The hospital admission rates were high in Southern Thailand and common in rainy seasons. The readmission rates within 28 days slightly decreased in all age groups in 2016 compared to those in 2007. The case fatality rate of patients aged 20-29 years decreased from 0.40% in 2007 to 0.34% in 2016. The readmission rate within 28 days and case fatality rate were the highest in patients aged 20-29 years. In conclusion, the asthma hospital admission, readmission, and case fatality rates declined over time along with the investment in the asthma care program under the UCS in Thailand. The highest hospital admission rates in patients aged 0-4 years and the readmission and case fatality rates in patients aged 20-29 years should be given more attention. Recordings of individual service utilization data in asthma patients, including quality of care provided, should be monitored to improve the asthma care system.