Increasing trends in admissions due to non-communicable diseases over 2012 to 2017: findings from three large cities
Ei Ei Swe1, Kyaw Ko Ko Htet1, Pruthu Thekkur2,3
11Department of Medical Research (Pyin Oo Lwin Branch), Pyin Oo Lwin, Myanmar.
Insights
Non-communicable disease (NCD) hospital admissions in Myanmar significantly increased by 2.2-fold over six years. This rise necessitates enhanced healthcare infrastructure and workforce for managing these growing NCD cases.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Non-communicable diseases (NCDs) are leading causes of global mortality.
- Myanmar has seen a significant rise in NCD mortality, increasing from 46.9% in 2000 to 68% in 2017.
- Trends in NCD hospital admissions in Myanmar were previously unknown.
Purpose of the Study:
- To assess trends and profiles of hospital admissions for four major NCDs in Myanmar.
- To analyze NCD admission data using International Classification of Diseases-2010 (ICD-10) codes.
- To understand the patterns of cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes admissions.
Main Methods:
- Retrospective analysis of medical record data from large tertiary hospitals in Myanmar.
- Inclusion of final diagnoses coded in ICD-10.
- Analysis of 774,970 total admissions over a six-year period.
Main Results:
- Total NCD admissions increased 2.2-fold, with their proportion rising from 18.8% to 25.4% between 2012 and 2017.
- Significant linear increasing trends were observed in admissions for cancers, cardiovascular diseases, and chronic respiratory diseases annually.
- Colorectal, breast, and lung cancers; stroke and ischemic heart disease; and COPD and type 2 diabetes were the most common diagnoses within their respective NCD categories.
Conclusions:
- Myanmar is experiencing a disproportionate increase in NCD hospital admissions.
- Tertiary healthcare facilities require expansion of infrastructure and workforce to manage the rising NCD burden.
- Strengthening primary healthcare for NCD prevention, early detection, and management is crucial to avert severe complications.
Background:
Globally, cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes are the four major non-communicable diseases (NCDs) contributing to more than 80% of mortality and morbidity due to NCDs. In Myanmar, the proportional mortality rate due to NCDs increased from 46.9% in 2000 to 68% in 2017. However, the trends and patterns of four major NCDs or their hospital admissions are not known. In this regard, we aimed to assess the trends and profile of admissions with four major NCDs using final diagnosis coded in International Classification of Diseases-2010 version (ICD-10) from medical record data of the large tertiary hospitals in different regions of Myanmar.
Results:
Of the 774,970 total admissions in the study hospitals, the median and interquartile range (IQR) age was 39 (25-55) years and 51.6% were males. Over a 6-year period, there was not only 2.2-fold increase in the number of admissions due to any of four major NCDs but also their proportion increased significantly from 18.8% in 2012 to 25.4% in 2017 (chi-square for trend, p value < 0.001). The number of admissions due to cancers, cardiovascular diseases, and chronic respiratory diseases also showed linear increasing trends at the rate of 1741 (95% CI 766 to 2715), 1797 (95% CI 345 to 3249), and 597 (95% CI 530 to 612) per year, respectively. Though the admissions with diabetes increased over the years, the rate of increase of 284 (95% CI - 60 to 628) per year was not statistically significant. Among cancer admissions, colorectal (13.1%), breast (13.0%), and lung (11.0%) cancers were the commonest. Stroke (30.6%) and ischemic heart disease (21.9%) admissions were the highest among the cardiovascular diseases. Chronic obstructive pulmonary disease (35.5%) and type 2 diabetes (53.9%) were commonest among chronic respiratory diseases and diabetes, respectively.
Conclusion:
There was a disproportionate increase in NCD admissions which requires tertiary health facilities to increase their infrastructure and trained workforce to cater to such admissions. The primary health care facilities have to be strengthened for prevention, early detection, and efficient management of NCDs to prevent life-threatening complications requiring hospitalization.
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