Burden of Skin Diseases in Thailand: Analysis of Prevalence and DALYs Using Real-world Healthcare Service Data

Abstract

BackgroundThere is little evidence to describe the burden of skin diseases in developing countries and its accuracy remained questionable. The objective of this study was to examine prevalence and disability adjusted life years (DALYs) of skin diseases in a Thai general population in Ubonratchathani. MethodsBased on real-world healthcare service data (diagnoses, prevalence, and cause-specific mortality) retrieved from the National Health Security Office reimbursement database, we used a simplified prevalence-based approach adopted in the Global Burden of Diseases to compute disease burden, measured as DALYs, of skin diseases. DALYs was calculated as the sum of years lost due to disability and years of life lost due to skin diseases, with adoption of previously published averaged disability weights and a 95% uncertainty interval (UI) estimated using a Bayesian bootstrap technique (normal distribution assumed). ResultsFrom a total population of 1,503,945, 110,205 people were affected by skin disease in 2018 – an overall prevalence of 7%. The prevalence varied across sex, age group and geographic areas. The most common skin diseases treated in Ubonratchathani’s healthcare services were dermatitis, bacterial skin diseases and urticaria (Prevalence of 2.35% (95%UI, 2.33-2.38), 2.21% (2.19-2.24) and 0.89% (0.87-0.90) respectively). Overall DALYs of skin diseases in Ubonratchathani population was 26,125 (95%UI 24,783 – 27,467), and this was higher in men than women. (DALYs 13,717 (12,846 – 14,588) and 12,408 (11,417 – 13,399) for men and women respectively). The greatest contributors of DALYs were cellulitis, decubitus ulcer and contact dermatitis (11,680, 4,806 and 1,598 years respectively). This pattern of skin disease burden was similarly observed in both sexes. Conclusionsskin disease caused substantial disease burden in this Thai population, with cellulitis being the largest contributor. This could be used to inform policy decision, health system planning and resource allocation regarding skin diseases.