location: , 'Thailand year: 2021 source: HSRI

title: A Study of Establishment of Central Collaboration Office for the Management of Non-Thai Health Insurance System

abstract: This study aimed to serve three principal purposes, first, to review lessons learned in administering health security for migrant workers and non- Thai within the international and local contexts; second, to critically analyze the roles and responsibilities toward health security system governance of central- coordinating agency and finally to synthesize the alternative model of central coordinating agency to ensure organization accountabilities in formulating applicable and accessible health security in Thailand. The study was undertaken by using qualitative research, relevant literature review, detailed semi-structured interview, and group brainstorm session for the data collection process. The study results revealed that socio- economic integration and expanding globalization have substantially influenced upon public health administration for migrant workers and non-Thai nationals, both global and regional contextualization. However, multi- stakeholder alliances in the healthcare system and departmentalism have resulted in problematic situations in governing health security for non-Thai. These four unsolved problems were: first, lack of working integration between political authorities, policy implementers, and responsible agencies; second, conflict of law and overregulation including ambiguity in non- Thai national’ s legal rights to access health security system; third, lack of integration between levels of management across the external organization and inefficient segregation of duties, together with inharmonious relationship between the regulator, user, and service provider in the healthcare system, finally, inefficient service from the unclear guideline on the multinational customer, triggering higher additional cost. Based on previous problem statements, this study presented five options under two frameworks as the solution approaches to establish a central- coordinating agency that governs the health security system for foreign workers and non- Thai nationals. The mentioned frameworks consist of; Framework No. 1: adjusting responsible departments or agencies within the Ministry of Public Health, first option: Promoting Division of Health Economics and Security to be Central Collaboration Office, administering health security system for migrant workers and non-Thai. Second option: Establishing a new division within the Office of the Permanent Secretary, Ministry of Public Health to mainly operate as Central Collaboration Office, working together with the Division of Health Economics and Security as a finance department. Framework No. 2 Promoting organization structures and legal frameworks for related government agencies governing health security systems for migrant workers and non-Thai. First option: Establishing multinational fund as an independent entity working under a government agency or public organization. Second Option: Drafting National Health Security Act for non-Thai nationals. Third Option: Reinterpreting the Law that recognizes the rights holder specified in section no. 5 of National Health Security Act, B. E. 2545 to cover all Thai citizens, including Stateless and People with Citizenship Problems.


location: , 'Thailand year: 2022 source: HSRI

title: Development of Proposal for Rational Drug Use Indicators for Healthcare Facilities and Community Pharmacies

abstract: Rational Drug Use (RDU) has been set to be a strategic policy since the first issue of the National Drug Information. In the fiscal year of 2560 B.E., the Ministry of Public Health defined RDU and antimicrobial resistance management were projects under the National Strategy (2018-2037) regarding public health, and announced that all hospitals were RDU hospitals. RDU hospitals were evaluated with 18 hospital indicators according to the guidelines of service plan development. Some researches reflected limitations and obstacles of the RDU hospital indicators administration; however, this research was undertaken. The objective of this study was to review and develop rational drug use indicators for healthcare facilities. A cross-sectional, convergent mixed methods design was conducted between May 10, 2021 and November 9, 2022. Quantitative research was carried out with an online survey and analyzed with descriptive statistics. Qualitative research included documentary research, semi-structured in-depth interview, field study with group discussion, and modified Delphi technique, and analyzed data with thematic analyses. Also, a public hearing inquiry was held in representatives or experts of hospitals, professional organizations, and policy makers. Research population were all public healthcare facilities in primary, secondary, and tertiary care. Samples were selected from multi-stage sampling in both Bangkok and upcountry. In research summary, all hospital indicators should be kept, although some indicators were suggested to be terminated. The reason was to be the national database of all healthcare facilities until there will be better quality, efficient, and effective indicators. At present, RDU indicators will be divided into three categories. First, the Monitor (M) category included indicators Item no. 2 and 5. The Amendment (A) category were indicators Item no. 3, 4, 8 and 11. The Existence (E) category, lastly, were indicators Item no. 1, 6-7, 9-10, และ 12-18. Further studies will be needed to develop Thailand to be a RDU country. For examples, researches related to 1) spatial environment, 2) non-communicable diseases, 3) drug labelling and information, 4) RDU curriculum, 5) political research, 6) drug use in upcountry, grocery store or community pharmacy, 7) drug use in food chain cycle, and 8) information and exchange system.


location: , 'Thailand year: 2001 source: HSRI

title: The child-center's system, mechanism, effectiveness and efficiency for both public and private

abstract: The child-center’s system, mechanism, effectiveness and efficiency for both public and private.	This research aimed to study the child-center’s system, mechanism, effectiveness and efficiency for both public and private.	The research process included a survey of 149 child centers in 6 provinces, namely, Bangkok, Chiengmai, Songkhla, Khonkhaen, Chonburi, and Loburi. The questionnaire was constructed and sent to  776  teachers and teacher-assistants and 2,073 parents. The questions focused on the system, mechanism, effectiveness and efficiency of the centers. The survey results indicated the indept-interview of selected centers. Thus only 19 child-centers of 2 provinces namely, Bangkok and Loburi were chosen due to the complete information and cooperation.	The indept-interview of 19 child-center’s administrators, 195 teachers and teacher-assistants and 842 parents were done. The results showed that:only 9 out of 19 selected centers were considered to have good system, mechanism and more effective.more private child-centers tended to have better system, mechanism and effectiveness than those of public ones (6 out of 9 private centers versus 3 out of 10 public centers)more public child-centers tend to have more efficiency than those of private ones.


location: , 'Thailand year: 2022 source: HSRI

title: Benefits of Household Survey for Health Policy and Health System Development in Thailand

abstract: The International Health Policy Program (IHPP) has been using household surveys conducted by
the National Statistical Office (NSO) for more than two decades. These surveys contribute to the advancement
of several health policies. This article presents successful evidence of IHPP using household
statistics survey data to support the process of health policy and health system development. Nine NSO
surveys related to health under 12 health topics include 1) universal health coverage, 2) health financing,
3) the burden of disease, 4) health (in)equity, 5) antimicrobial resistance, 6) smoking and alcohol consumption,
7) food and nutrition, 8) breastfeeding, 9) physical activity and sedentary lifestyle, 10) non-communicable
disease risk factors, 11) health workforce and 12) health of urban refugees and asylum
seekers. Five predominant characteristics of NSO surveys include (a) one-stop data source available for
most health domains, (b) national representativeness due to large and probabilistic sampling techniques,
(c) standard proxies for global and national monitoring systems, (d) ability to track health equity, and (e)
compliance with international benchmarking systems. The future challenge lies on improvement of the
quality of data and ensuring the sustainability of surveys.


location: , 'Thailand year: 2014 source: HSRI

title: Healthcare Healing Environment Design

abstract: Healthcare Healing Environment Design research project consist of objective for: (1)
Surveying the problem of healthcare environment setting (2) To design an assessment tool for
Healthcare Healing Environment Design. Research focus on 12 of 30-120 beds community
hospitals countrywide with specific selection.
Research found that settings for healthcare healing environment in most of research
participant hospitals have problem on space management, way findings/ signage, knowledge
boards, visual objects, color tones, crowded waiting area, air quality in service area. Besides,
there are more problems outside buildings such as cars parking area, connecting corridor also
garden landscape those cannot support practical usage.
To design an assessment tool for healthcare healing environment, research team were
reviewing international literatures and related research papers combine with experiences from
working in Healthcare Accreditation Institute (Public Organization) and visiting countrywide
hospitals in order to get a preliminary self-assessment tool for participant hospitals. Core
principles of the assessment tool are based on the six factors that affect the human senses.
After trial implementation in participant hospitals, the assessment tool was developed to be
the final version for first year research program by dividing assessment parameters into 3 areas:
(1) buildings outdoor (2) common facilities and (3) indoor function; as (1) and (2) are common
area and (3) is for each units/ wards.
This Healthcare Healing Environment Assessment Tool Kit will be implementing in
participant hospitals as for evaluating the tool and develop to be a more complete tool in the
second year of the research program.


location: , 'Thailand year: 2008 source: HSRI

title: Tuberculosis Situation in Maung Mae Hong Son District, Thailand

abstract: Thailand and Myanmar are both among the 22 countries with a high burden of
tubercuosis (TB) cases identified globally. Population migration in Mae Hong Son Province
may have a great impact on the national TB-control program. Mae Hong Son’s Muang
district is close to Myanmar. Citizens of both countries travel back and forth across the
border for business or for temporary or permanent settlement. This phenomenon causes
problems in controlling tuberculosis in Thailand.
In the period 2001-2007, a total of 829 tuberculosis patients were registered at the TB
clinic of Srisangwan Hospital. They were taken for study and 795 newly registered cases
(Thai 49.6%, non-Thais 51.4%) were reviewed, reflecting a very high incidence of new
tuberculosis cases in this region. Detailed data were reported in the text.


location: , 'Thailand year: 2005 source: HSRI

title: Potential sources of finance for the universal health care coverage fund by the article 39 of the 2002 national health security act : Key informants perspective

abstract: Presently Universal Health Care Coverage in Thailand is nearly fully financed by government general budget. UC has adopted close ended budget which come from capitation rate multiply with number of registered members. Refer to past experience, budgeting process for UC faces with annual administrative hurdle without any guarantee on adequate budget according to capitation rate calculated by cost of service and use rate. National Health Security Fund should be established by National Health Security Office and Thai citizen according to National Health Security Act B.E.2545. Major source of finance for NHSF should not be solely relied on government general budget as existing situation.Objectives of this study are to provide advantage and limitation of eight sources of finance for UC according to Article 39 in National Health Security Act B.E.2545. This study applies two methods which are brain storming of researcher team and self answering questionnaire by 20 key informants in one day workshop. The result from brainstorming of researchers indicates that contributions by local government, co-payment by patients and contributions by beneficiaries have potential to be financial sources for UC with some limitation of each source. The result from the workshop of 20 key informants reveals that political feasibility is the most important domain to decide the source of finance for UC. Other less important domains are sustainability, equity, programmatic feasibility and social acceptance the least important. The key informant workgroup have preference on Additional Taxes from Tobacco, Alcohol and Beer and clearly earmark to the fund as long as it get high score on political feasibility, social acceptance, sustainability and programmatic feasibility. On the other hand, contributions by beneficiaries are the least feasible source and it appears to be judged as social unacceptable and administrative infeasible. Increases in the VAT are deemed politically infeasible and the worst for equity reason. Questionnaires used in the workshop were originally created by researchers with foundation of knowledge and thoroughly understanding in financing of Thai health system. All key informants were fully informed in the workshop in order to have the same understanding which leads to limitation in number of valid questionnaires. However, these key informants are heath experts in Thailand from several institutions both of academic and practical organization. This study contributes new knowledge of health care financing in Thailand. Moreover, it provides fundamental information for financing the UC scheme in long run.


location: , 'Thailand year: 2007 source: HSRI

title: Over-crowding Problems in Hospitals

abstract: Overcrowding in hospitals’ out-patient sectors is a chronic problem of public hospitals in Thailand.
Patient visitors have to wait for a long time no matter how serious their illnesses. A reasonable step in
solving this problem is to understand the nature of the attendants, i.e., who they are and why they come.
It is known that over half of the visitors live in the local district; they come with every type of problem;
most of the problems could be taken care of by practical nurses and general practitioners. The reasons for
attending the hospital include ineffective treatment at primary care units, and inconvenience because
there are not enough primary care units to cover the areas, and their quality is not well accepted. Therefore,
an important approach to solving hospital overcrowding is strengthening the function of primary
care units and forming them into a hospital network. Further, management is needed to find out which
outpatient sections are crowded and when, so that supplemental services could be organized accordingly.
Among the top five outpatients are those with diabetes mellitus and hypertension; these are chronic lifetime
patients. Thus, the service system for this group should be organized specifically and efficiently by
linking the provision of care with primary care units and/or private dispensaries to relieve the patient
pressure on big hospitals. Ultimately, owing to the complexity and variability of the problem, ad hoc
teams should be established specifically to be responsible for managing and monitoring the system effectively


location: , 'Thailand year: 2009 source: HSRI

title: Research Managers: From Concept to Action

abstract: Research management is a key supporting factor for systems research investment. The main objective
of research management is essential linkage between researchers and research users. This article describes
points of view in health systems research management from the authors’ direct experience in
reviewing and analyzing three issues: the research management concept, the research management process
and the role of the research manager.
Good research management helps in building qualified researchers, formulating interesting research
questions, and obtaining acceptable research results leading to suitable utilization. The key success factor
of research management depends on the linkage capacity of all partnerships within the research system.
The principal roles of health research management may be summed up in four major functions: (1) facilitating
formulation of the research scope by identifying problems and setting priorities; (2) facilitating
research involvement among researchers and stakeholders in the health system for selecting research
proposals; (3) facilitating research monitoring; and (4) facilitating research assessment for knowledge
utilization. Certainly, the key person in this process is the research manager. For this reason, research
managers should be strengthened both in terms of academic capacity and in management skills for qualified
research administration.


location: , 'Thailand year: 2019 source: HSRI

title: Outcome of Alcohol-Free Funeral Policy in Lampang Province, Thailand

abstract: This study aimed to assess outcome of alcohol-free funeral policy, firstly launched in Lampang in 2008, by comparing between three areas of campaign implementation (completed, ongoing, and no campaign). Methodology: A mixed methods study was carried out in 2012. A face-to-face interview of 1,445 villagers with a structured questionnaire was conducted to evaluate perceptions, attitudes and supports of the respondents toward the policy as well as exposure to the alcohol-free funeral. Twelve funeral hosts were elicited about their funeral details and perspectives on outcomes of the policy by a semi-structured questionnaire. Results: People who lived in the completed implementation areas ever attended fewer funerals with alcohol (26.7%) when compared to people who lived in the ongoing areas (37.4%) or in the areas without campaign (40.9%). The proportion of alcohol drinking experience among who had attended the alcohol-serving funeral in the completed implementation areas was quite low as 26% (6.8/26.7) when compared to 37% and 41% of those in the ongoing areas and the areas without campaign, respectively. The funeral hosts in the completed implementation area elaborated that the areas with no alcohol offering at the funeral complied with the community agreement, and hence, helping them to save money. While some of the funeral hosts in the ongoing and without campaign areas still offered the local white spirit for the participants, and hence, had the expenses and some drunk-driven quarrel and violence in the funerals. At the funeral without offering alcohol, there were fewer attendances because people in the community believed that offering alcohol at the funeral was a tradition. This study recommends that the community agreements and social agreements are needed to support the hosts conducting the alcohol-free funeral.


location: , 'Thailand year: 2009 source: HSRI

title: Study of Factors that Contribute to Successes of Narcotic Drug Prevention Efforts in Community : The Case of Ban Maehair Tai, Moo 9, Tambon Panghinfon, Maechaem District, Chiang Mai Province

abstract: A qualitative research, the study was carried out at Ban Maehair Tai Moo 9, Tambon
Panghinfon, Maechaem District, Chiang Mai, a Pakayaw community. The community has managed to
become a drug-free haven without support from outside organizations. The study has two major aims.
On one hand, it means to explore factors contributing to the successful campaign against drug abuse.
On the other, the model shall be developed to consider if its replication can be made to strengthen
other communities as far as efforts to combat drug problems are concerned in light of the social and
cultural aspects.
The study’s conceptual framework depends on the segregative method and the Buddhist
Law of Dependant Origination (Idappaccaya). The method has been used to guide the attempts to
come to terms with conditions in the community of Ban Maehair Tai to delve deeper into the
structures and how each element works relatively to each other. Five groups are the focus of the
study including community leaders from election (four in each group), natural leaders (four in each
group), village members including either the husband or wife, or any family member who fills out the
survey form, fraternity group (six persons) and individuals from outside working in the community of
Maehair Tai (a couple of them).
Two methods were used in the study including (1) the literary review related to Ban Maehair
Tai based on materials provided by relevant agencies, and (2) field survey. The researcher spent
three months to live in the community, conducted the community bioregional mapping, and carried out
basic household surveys, individual interview and focus group interview. Both non-participatory and
participatory observation methods have been used as well as formal/informal interview and note
taking.
It was found from the study that four major factors have contributed to the successful combat
against drugs in the community of Ban Maehair Tai, Moo 9, Tambon Panghinfon, Maechaem District,
Chiang Mai including the following (in order of significance);
1. Religious factor: Religious leaders, the local diocese, and the Church of Christ in
Thailand (CCT) have played significant roles in garnering faith of the villagers in God making them
adhere to good deeds as well as steering away from illicit drugs. 2. Social factors: This constitutes basically family network and kinships. The structure helps
to nurture the ground for morality and virtuous deeds and to training people on vocational skills as
well as to set example for the young generation to follow.
3. Political factors: The Village Committee, religious leaders and self-sufficiency savings
group have been the major impetus for mobilizing various activities in the village. Their roles can be
described in two major ways. Administratively, the Village Committee helps to oversee orderliness
and peace in the community through the enforcement of regulations and division of zones for the
involvement of local villagers. The Village Committee, religious leaders and the diocese and the selfsufficiency
savings group help collectively with the village governance.
4. Educational factors: The Ban Maehair Tai School, Maefahluang Mountain People
Learning Center and Ban Maehair Tai Village Health Post are instrumental in educating local students
and pregnant women about drug abuse and general health. They help to ensure that local students
stay away from illicit drug use.
The religious, social, political and educational actors have workers together in harmony to
make it possible for Ban Maehair Tai, Ban Sedosa and Ban Bloday to become drug-free communities
without support from outside organizations.


location: , 'Thailand year: 2001 source: HSRI

title: Payment systems, mechanisms and approaches for health services for equity, efficiency and quality

abstract: Payment Systems, Mechanisms and Approaches for Health Service for Equity, Efficiency and Quality Various payment mechanisms for health care and their impact on equity, efficiency and care quality were reviewed in this study. Recommendation for appropriate mechanisms for Thailand was also proposed to put in National Health Bill. Development of health insurance in Thailand and experiences of using various payment mechanisms in other countries were reviewed. A number of well experienced people, health care users and providers in both public and private sectors were interviewed. The study found diverse mechanisms in Thailand which could be grouped as following; out-of-pocket payment was directly made to providers, fee-for-services was remunerated to the insured under the Civil Service Medical Benefit Scheme and private insurance (some schemes having ceiling level per year),payment was made under fee schedule for example the Social Security Scheme and the Substitution Fund, capitation payment was used under the Social Security Scheme in order to contain medical costs and expenditures but was problematic to care quality, per-case payment on the basis of DRGs (Diagnosis-related groups) was made, budgeting by capitation was solely implemented in public sector, line item budgeting was used for allocating salary, operating and capital expenditure in public sector.


location: , 'Thailand year: 1998 source: HSRI

title: TB in some population groups in Thailand : 62 articles reviewed during 1968 to 1998

abstract: TB in some population groups in Thailand : 62 articles reviewed during 1958 to 1998TB has already communicated in community once a TB patient found. Then, number of TB patients is an indicator of TB communication in a community and shows a public burden to control TB infection. According to the review, children living with TB patient who is a family member, are at high risk to infection while those who are health personnel are more prone to get infected than other walks-of-life. Likewise, prisoners are at risk and male prisoners are riskier than female prisoners. Women are less likely to infect than men. Quality of information system which should be accessible and linked to relevant organisations, is recommended in addition to network building for monitoring and evaluation.


location: , 'Thailand year: 2016 source: HSRI

title: Prevalence and Factors Associated with Suicidal Behavior in Patients with Mental and Behavioral Disorder Due to Alcohol

abstract: Alcohol-drinking is one of the most important public health problems related to an increase risk of
suicidal behaviors. The objectives of this cross-sectional analytical study were to determine the prevalence
and factors associated with suicidal ideation and suicide attempt in mental and behavioral disorder
due to use of alcohol. Subjects were 303 patients diagnosed with ICD-10 code F10.xx and admitted in
Suanprung Psychiatric Hospital during 1 October 2012 to 30 September 2013. Data of various factors were
collected from medical records. Results of the study revealed that prevalence of suicidal ideation and
suicide attempt were 22.4% and 5.0%, respectively. Factors significantly associated with suicidal ideation were having psychological comorbidities (adjusted OR = 2.58 95% CI; 1.14-5.85, p-value = 0.023), previous
suicidal ideation and previous suicide attempt (adjusted OR = 3.00 95% CI; 1.40-6.40, p-value = 0.004 and
4.27 95% CI; 2.31-8.94, p-value < 0.001, respectively), numbers of problems or life-events, more than 3 and
2 life events (adjusted OR = 4.36 95% CI; 1.53-12.41, p-value = 0.006 and 3.22 95% CI; 1.08-9.57, p-value =
0.036, respectively), and patients who drank 40 degree-rice clear liquor (adjusted OR = 3.10 95% CI; 1.33-
7.20, p-value = 0.009). Regarding factors related to suicide attempt, it is found that previous suicide attempts
and psychological comorbidities were statistically significant associated with suicide attempts
(adjusted OR = 4.36 95% CI; 1.53-12.41, p-value = 0.006 and 3.22 95% CI; 1.08-9.57, p-value = 0.036, respectively).
In conclusion, close monitoring should be emphasized in patients who had problem associate
with alcohol drinking and had previous suicidal ideation or previous suicide attempt(s), particularly in
those with psychological comorbidity and had more than 2 life-events.


location: , 'Thailand year: 2008 source: HSRI

title: Study of Intentional Suicide in a District Hospital

abstract: This was a retrospective study on intentional self-harm among patients at
Khoksamrong Hospital in the years 2004-2006. The patients were those who intentionally
attempted suicide but survived, and who were brought to Khoksamrong Hospital
for treatment. Data were collected using a standard form for depression and a self-harm
surveillance system (report 506.DS) and a form to collect data from death certificates
( M.B.1.). Women comprised the majority of the cases (64.17%), married persons (58.33%)
and laborers (49.17%). Most of them (96.67%) had attempted suicide for the first time.
Common precipitating causes (48.33%) were “personal conflicts with a close person and
love affair problems.” A common self-harm method was “ingesting a sedative” (21.67%).
Of eight cases who died among the 120 suicidal patients hospitalized, the youngest was
25 years old and the oldest 70 years old. The most common stimulating event among the
cases of mortality were “personal conflicts with a close person and love affair problems.”
The most common method of committing suicide was “drinking chemical agents.” Of the
29 cases dead on arrival at the hospital, 17 were males and 12 were females, and 31.03
percent were aged 30-39 years. The most common methods were hanging (58.62%), following
by drinking chemical agents (31.03%). It is apparent that men used more aggressive
methods than women.


location: , 'Thailand year: 2014 source: HSRI

title: Development of a Key Performance Indicator reporting system for Subdistrict Health Promoting Hospital

abstract: Subdistrict Health Promoting Hospital was promoted from health station in order to increase its
capacity of primary care services, in both proactive and passive strategies. After studying the work process
of Subdistrict Health Promoting Hospital, the significant problem of service provider’s perspective
was the issue of data collection and querying to summarize the operational report according to the Key
Performance Indicator (KPI) system. KPIs could be changed annually, depended on the public health’s
situation. Normally, it took up to 10.22 working days a year to summarize the report. This research emphasized
on developing the KPI reporting system that users were able to identify parameters of indicators.
Moreover, KPIs during the fiscal year 2007 - 2013 were collected in this reporting system to support
the case of evaluating by the previous indicators. In the system, Application Program Interface (API) was
used as a tool to connect and manage the Relational Database Management System of JHCIS application
together with PHP, HTML, and JavaScript programming. This research could reduce time spent in collecting
data, querying data, and generating summary report about 7.93 working days a year or 77.97 percent.


location: , 'Thailand year: 2021 source: HSRI

title: Development of Good Health Promotion Model that Integrated with Buddhist Ways for the Prevention and Control of Non-communicable Diseases

abstract: The objectives of this research were to develop a model, and to study the effectiveness of a good health promotion integrated with Buddhist ways model for prevention and control of non-communicable diseases. It was designed as two group pretest-posttest design. The samples were 99 patients with uncontrolled diabetes and or hypertension, divided into two groups: 50-person group; the study group who were managed by the model, and 49-person group: the control group managed by routine care. Data were collected using mixed method, both quantitative and qualitative approach. The research tools were: 1) the good health promotion program integrated with Buddhist ways was named in Thai as 3 Sor, 3 Orr, 1 Nor from which comprised: pray, meditation, Buddhist dialogue, nutrition, exercise, emotion, biological clockwise daily activities with Buddhist integration. 2) health assessment form 3) self-report manual 4) the knowledge test 5) the happiness test 6) the satisfaction questionnaire 7) group discussion and in-depth interview guidelines. The KR 20 of the data collecting tools no. 4 was 0.8. The Cronbach's alpha coefficients of the data collecting tools no. 5, 6 were 0.85, 0.84 respectively. The quantitative data were analyzed using descriptive statistics, paired t-test and independent t-test. The qualitative data were analyzed using content analysis. The results of the model development found 3 components: 1) the good health promotion program integrated with Buddhist ways 2) self-reporting towards the program and 3) monitoring, supporting, and empowering by the health team. The findings on the effectiveness of the model found that 1) After try-out the model, the study group had lower average in health status namely weight, waist circumference, BMI, blood pressure and blood sugar levels were significantly decreased. 2) Before try-out the model, the study group had average in health status not different with those of the control group while after try-out the model, the average of health status in study group were significantly lower than those of the control group. 3) After try-out the model, the study group had significantly higher average in the knowledge scores and higher average in happiness score towards the activities of the program. And they were satisfied with the activities of the program at a high level.


location: , 'Thailand year: 2018 source: HSRI

title: Situation of Disability and Access to Essential Public Services of Children with Disabilities in the Community of Thailand

abstract: This study aims to determine situation of the prevalence of disabilities and the accessibility to health, education and social services of children with disabilities in the communities of Thailand. Mixed-methods of data collection were used. A community survey by a team of psychiatrists and clinical psychologists was conducted to estimate the prevalence of 7 disabilities in children aged between 2½ and 12 years in nine sub-districts of nine sampled provinces (except Bangkok) during October 2014-July 2015. Altogether, 6,334 children were investigated. Qualitative data were collected from home visit, in-depth interview, non-participant observation, and focus group discussion with parents and teachers of the children identified as having disability, and also with health care providers to explore problems of unmet demands. Results show that 66% of children aged 2½-12 were found normal, yet, 13% had at least one disability of which learning disability was most prevalent, and 21% with physical, psychological or behavioral problems. The availability of health services for children with disabilities in each area varied due to inadequacy or lack of type of health professionals. Community hospital is not allowed to recruit rehabilitation specialists, though policy on disability service provision is assigned to. The study also found that the term “disability” contained stigma connotation and was rejected by well-to-do and educated parents. When compared with the accessibility to service database of the Ministry of Social Development and Human Security, the National Health Security Office, and the Ministry of Education, this study showed much higher number children with disability in communities reflecting that there are still more unregistered children and inaccessible to necessary public services. The un-integrated and difficult-to-access service structure, poverty, cultural beliefs, and social unawareness are among factors that cause unmet demands. Main recommendations for concerned agencies are an urgent policy and program to increase access to care to reduce unmet need in children with disabilities and the integration of disability policy into the strategy to reduce poverty.


location: , 'Thailand year: 2021 source: HSRI

title: The Efficiency of the development of the language coordinator in health insurance for foreign workers, Chiangrai Province

abstract: A research study entitled “The Result of Capability Development of Language Coordinators' on Foreign Workers' Health Insurance, Chiang Rai Province” aims to provide foreign workers with access to health insurance by developing the capability of language coordinators on foreign workers health insurance and to provide foreign workers with knowledge of foreign labor health insurance. The samples were 120 language coordinators from Muang Chiang Rai District and Mae Sai District and a random survey of knowledge on foreign worker health insurance of 385 people. Survey tools used included general information query, before-after training knowledge quiz, knowledge evaluation form on foreign workers' health insurance, Supervising and tracking form as well as the collection of migrant worker’s health insurance registration statistics. Statistics used for analysis; descriptive statistics were frequency, percentage, mean and standard deviation, the inferential statistics are t-test. The results of the study showed that the capability development of the language coordinators in health insurance for foreign workers in Chiang Rai: starting with the survey of the language coordinators with required qualifications and setting up training sessions according to health insurance guidelines of the Ministry of Public Health. Most of language coordinators were 20-29 years of age, male, primary education qualification, freelance workers with monthly income from 5,000-10,000 baht, and were language coordinators based in Thailand for 5-9 years. Before the training, the language coordinators had a low level of knowledge and after the training they have a high level of knowledge. The test scores before and after the training were significantly different with statistical significance at the level of .05 After the training, the language coordinators' performance was monitored and supervised with result indicating that the most seek-for-advice topics were the benefits of health insurance, rates, required documents for health examination and health insurance, change of medical facility eligibility according to work location, and verification of health insurance eligibility. For the registration of health insurance of migrant workers, it was found that more foreign workers registered for health insurance cards after the development of capability of language coordinators. In assessing the knowledge of foreign workers on health insurance with the support of the trained language coordinators, it was found that foreign workers had a moderate level of knowledge of health insurance. The results of the research can be used to guide the development of language coordinators in other areas of Thailand. As a result, migrant workers have more access to health insurance.


location: , 'Thailand year: 2017 source: HSRI

title: In Vitro Antimicrobial Susceptibility Patterns of Burkholderia pseudomallei in Northeastern Thailand

abstract: Burkholderia pseudomallei is a causative agent of melioidosis. Ceftazidime is a drug of choice
for treatment of this infection but the mortality rate is high in some endemic areas. This study investigates
the effectiveness of antibiotics by an in vitro antimicrobial susceptibility test. A total of
1,340 B. pseudomallei samples were isolated from patients admitted to Sappasitthiprasong Hospital,
Sisaket Hospital, and Amnatcharoen Hospital between January 2013 and February 2015. Antimicrobial
susceptibility of B. pseudomallei were evaluated by the standard disk diffusion test and to determine
minimum inhibitory concentration (MIC). Ceftazidime, imipenem, trimethoprim+sulfamethoxazole,
and ciprofloxacin were used as antimicrobial agents for the standard disk diffusion test, and MIC was
determined for ceftazidime, imipenem, and trimethoprim+sulfamethoxazole. Bacteria strains were
randomly selected for conventional polymerase chain reaction (PCR) followed by gel electrophoresis
analysis for penA and oxa gene.
Results demonstrated that all the antimicrobial agents were effective against B. pseudomallei.
Trimethoprim+sulfamethoxazole was 100% effective, and ceftazidime and imipenem were 98.36%
and 99.10% effective respectively. Ceftazidime MIC was 0.25 to ≥32 mg/ml and imipenem MIC was ≤0.5
to 16 mg/ml. It was found that 1.27% of B. pseudomallei was resistant to ceftazidime and 0.37% was
resistant to imipenem. All random samples found oxa gene but not penA gene.
It was concluded that all antimicrobial agents tested effective. Ceftazidime and imipenem were
bactericidal drugs of choice for melioidosis treatment. The bacteriostatic agent for B. pseudomallei
was trimethoprim+sulfamethoxazole. Although, the activity of the antimicrobial agents was effective
in vitro, early diagnostic and prompt clinical treatment to which drugs be administered intravenously
still urgently needed.


location: , 'Thailand year: 2019 source: HSRI

title: Cost Analysis of HIV/AIDS Outpatient Service in Thailand

abstract: The objective of this study was to estimate outpatient cost of HIV/AIDs services provided at hospitals.
The cost data for fiscal year 2015 were gathered from seven hospitals; the data consist of hospital
service statistics and financial information. Then, cost per visit was analyzed as cost-to-charge ratio using
a traditional method following the cost guideline of the Ministry of Public Health. The results show that
majority of service cost was of labor followed by material and capital cost, amounting to 52%, 42%, and
6%, respectively. The study found that an average cost per visit of the civil servant medical benefit (CS)
patients was the highest at THB 2,401. An average cost per visit of the universal coverage (UC) patients
was THB 1,778. An average cost per visit of the social security (SS) patients was THB 1,658; and an
average cost per visit of out-of-pocket (OOP) patients was THB 803. In terms of an average annual cost
per person, the study found that the CS patients also had the highest cost at THB 12,305. The second
highest was the UC patients at THB 9,483 per person per year and the third was the SS patients at THB
7,197. The OOP patients incurred the lowest annual cost per person at THB 1,570. However, it should
be noted that these seven hospitals were selected by purposive sampling with limitation on representation.
More hospitals should be involved in further research to represent actual cost by hospital types.


location: , 'Thailand year: 2005 source: HSRI

title: Local media procedures for health communication

abstract: This research was aimed to study the health communication of 5 types of local media; local newspapers, provincial broadcasting radios, community radios, news broadcasting towers, and cable televisions. The main objectives of this research were to study health communication content and presentations, health communicators’ procedures, audiences’ exposure and expectation of receiving health information and the tendency of local media use for health communication.  The area of this research included six provinces; Prae, Nakhonpanom, Nakhonpathom, Chantaburi, Kanchanaburi and Stun.  The sampling group of this research included five kinds of local media (16 titles of local newspapers or 95 pieces, 14 provincial radio broadcasting stations, 6 community radio stations, 6 news broadcasting towers and 5 cable television station), 45 communicators in 5 fields of media work (14 communicators of local newspapers, 14 communicators of radio broadcasting stations, 6 communicators of community radio stations, 6 communicators of news broadcasting towers, and 5 communicators of cable television stations) and 643 local media audience from 6 provinces mentioned above.   The methodology conducted for this research involved surveys and interviews.  The data of local media was analyzed by content analysis methodology and the data of communicators and audiences was analyzed by statistics methodology.	As a result of the study, it was found that the health content presented by provincial radio was mostly related to “disease”, with the aim of making the audience know how to protect themselves from getting ill.  The content was presented in 4 forms; health programs, radio spots, trifling information inserted into other programs, and advertisements.  Regarding the community radio stations, the health communication management was mostly under the control of the station committee, supported by private organizations.  The content was presented in the forms of health programs and pieces of information in other programs.  The main issues of the content were mostly related to “disease” and “food” with the objectives of disease prevention and health promotion more than disease cure and rehabilitation.  In the case of the news broadcasting towers, health content was not presented in the form of health programs but the announcement of health service and spots from official organizations were found being broadcast instead.  Most of the cable television stations presented health information through local news programs to inform or report the events.  The content was mostly related to “disease” and “food”.  While small-size medium local newspapers, published from every five days to monthly, presented every type of health content in the forms of news reports, articles and advertisements.  	Regarding the health communicators, most of them were male, aged between 25-55, with 1 to 30 years work experience holding Bachelor degrees.  They usually worked in many fields of local media and also worked as stingers for the media in Bangkok while some of them do this work as the second job.  Most of these communicators had no knowledge of health so health columns and articles were brief with the use of many sources for health information.  The local audiences, aged between 31 to 60, mostly were female, and graduated from secondary schools.  They needed all 5 kinds of local media to communicate health information especially the provincial broadcasting radios.  The audiences expected to receive health information from cable televisions least. However, they expected every local medium to increase the presentation of health content especially the continuous practical information which is easy to understand, correct and serious.  The most needed content was information about “disease”.  	Although the communicators and audiences has desired an increase in the quantity of health content presentation, due to the limitation of knowledge, information, sources, budgets and also being attached to business interests of some media, the local media has been still unable to communicate health information with full-efficiency as they should do.


location: , 'Thailand year: 2015 source: HSRI

title: Raising Communities’ Positive Attitude and Awareness toward Fall Prevention in Elderly Population: An Embedded Mixed Methods Study

abstract: Despite substantial evidence about the benefits of fall prevention interventions, they have not been
well incorporated into primary care practice. Raising community awareness and attitude toward fall prevention
program is one of the effective strategies to translate the program into practice. The elderly patients need to be aware of the potentially deteriorating effects of their chronic diseases and falling, and
are prepared to manage to reduce fall risk. Educating the elderly and their family on fall prevention by
using audiovisual media and involving community volunteers can be key to successful intervention. This
embedded mixed methods study aimed to compare attitudes and awareness on fall prevention among
community-dwelling elderly (n =144) and their family (n = 100) before and after an educational program
that employed audiovisual media and involved community volunteers. A pre-test/post-test only design,
with structured questionnaires measuring attitudes and awareness on fall prevention, was used for the
quantitative arm. Focus groups were used to interview three groups (ntotal = 38: n1 = 8, n2 = 15, n3 = 15), and
these interviews generated narratives regarding the educational program for the qualitative arm. Quantitative
results showed that the attitudes and awareness scores were statistically higher after the educational
program. Statistically significant areas included exercise and fall prevention. In summary, educating
the elderly and their family by using audiovisual media and involving community volunteers was
found to be one of the important steps toward translating fall prevention guideline to Thai’s community
successfully.


location: , 'Thailand year: 2011 source: HSRI

title: Abnormalities of Body Mass Index, lipid profile and the risk of coronary heart disease development in health care workers of Health Promotion Center, Region 1, Bangkok at annual health check up 2010

abstract: The purpose of this study was to examine the abnormality in Body Mass Index(BMI), lipid profile
and evaluate risk for develop coronary heart disease in 10 years by Framingham Risk Score in Health care
and office workers, aged more than 35 years old, in Health Promotion Center, Region 1, Bangkok at annual
health check up 2010. The results of this study indicate overall prevalence of obesity (BMI ≥ 25 kg/
m2) was 35.5, man 45.5% and woman 34.2%. The most common lipid abnormalities were LDL-Cholesterol
(≥ 100 mg/dl) 78.3%, Cholesterol (≥ 200 mg/dl) 55% and Triglyceride (≥150 mg/dl) 22.2%. Risk for develop
of Coronary heart disease in 10 years by Framingham Risk Score, the study group had low risk
98.4% and no one was in high risk group.


location: , 'Thailand year: 2017 source: HSRI

title: Characteristics and Treatment Outcome of Prisoner and General Tuberculosis Patients in Mueang District, Chiang Rai Province, Thailand

abstract: Background: Prisoners are socially vulnerable population and have high risk for tuberculosis
(TB) and human immunodeficiency virus (HIV). This study was conducted to explore whether the TB
notification rate, patient characteristics, access to HIV care and TB treatment outcome of prisoners
differ from general TB patients in Chiang Rai province. Design/Methods: A retrospective analysis of two existing TB related electronic databases included TB registry (N=2,472, 11% were prisoners)
and drug-resistance surveillance TB database (smear positive=2,193, 6.6% were prisoners). The study
populations were patients aged over 18 years, living in Mueang District, Chiang Rai, and registered in
TB registry during 2007 to 2014. We analyzed data by classifying into prisoner and general TB patient
groups. Percentage proportions of each variable were compared using chi-Square test and p-value
for the difference between two proportions. Results: The TB notification rate of prisoners was 3.2
times higher than general population. Prisoner group was significantly younger (mean age = 36.5 vs
45 yrs), had higher proportion of male, smear positive, and higher rate of HIV co-infection (TB/HIV)
than general TB patients (p<0.05). The treatment outcomes of smear-positive in two groups were not
different. However, treatment outcomes of all types of TB in prisoners were better than general TB
population, i.e. higher success rate with lower rate for loss to follow-up (p=0.030). Prisoners with TB/
HIV significantly had less access to antiretroviral drugs (ARV) (p<0.001) but access to cotrimoxazole
was not different. Both groups had high proportions of regular alcohol drinking. Prisoners significantly
had higher proportions of smoking and drug use than general TB patients but lower proportions of
diabetes mellitus or hypertension. Almost 11% of general TB patients were previously incarcerated.
Conclusions: Although prisoners had higher notification rate for TB and higher HIV co-infection than
general TB patients, treatment outcomes were better. To enhance health equality, access to ARV
among prisoners with TB/HIV should be ensured.


location: , 'Thailand year: 2023 source: HSRI

title: Development of Indicators for Monitoring and Evaluation of Rational Drug Use Country

abstract: Background: Thailand has continued to develop strategies and actions to promote rational drug use. In 2019, a policy in promoting Rational Drug Use Country was issued and implemented nationwide. It is therefore necessary to develop national rational drug use country indicators (RDUCI) to monitor progress and assess national levels. Objectives: The objectives of this research were to develop a framework for developing RDUCI indicators and to develop a set of RDUCI indicators according to the specified framework for relevant agencies to use these indicators for monitoring progress and evaluation of RDU at the national level. The development of the indicator development framework and the development of a set of indicators were conducted by using desk review, literature reviews, conducting several meetings of experts for drafting and reviewing process. A survey of experts from different agencies involved in the policy and implementation of rational drug use promotion in Thailand was conducted. Content validity and usefulness of the indicators were rated by the experts. RDUCI templates had been developed and tested for their feasibility for data collection and processing from two sources, one from hospital databases of medium and large hospitals under the Ministry of Public Health (MOPH), and another from the Health Data Center of MOPH. Results: A set of 24 RDU Country indicators was selected based on the RDUCI Development Framework, addressing the National Strategy on RDU and the directions of RDU Country. The selected RDU Country indicators were consisted of 4 drug system structure indicators; a national body responsible for the development of RDU guidelines, establishment and action of pharmacy and therapeutic committee responsible for RDU in public and private healthcare settings, continuing education for prescribers and healthcare providers, and the establishment of RDU Province based on specific criteria. The RDU Country output indicators consisted of 14 indicators related the rational drug prescribing in health facilities, including prescribing of medications in the NLEM, antibiotic prescribing in outpatients, antidiarrhea drugs prescribing in children age <5 years, and prescribing of necessary drugs for treatment and prevention of disease complications in diabetes, cerebrovascular and cardiovascular diseases, and prescribing of non-necessary medicine. Health outcome indicators consisted of 4 indicators, 3 indicators suggesting the effectiveness of medicine in disease control, and 1 indicator for hospitalization related to preventable adverse event related to medicine in diabetes type 2. RDU Country indicators for impact of RDU consisted of 2 indicators, antimicrobial resistant rates, and equity of health expenditure among health insurance schemes. The RDUCIs consisted of the existing indicators of the Ministry of Public Health, the RDU Service Plan and the new indicators developed in the process of this study. The validity test of the data from the 43 standard report data from public hospitals indicated issues of inaccurate and incomplete drug codes. The feasibility test of the selected RDUCI templates on the Open Data of the Ministry of Public Health on RDU Service Plan indicators and AMR suggested that it was feasible to use the data from these sources for national RDU monitoring using the selected RDUCIs. Conclusion: This set of RDU Country indicators developed in this study focuses on the use of drugs in humans and the drug prescribing in hospitals, representing the ongoing RDU policies that have been implemented and have the most concrete results in Thailand. However, there is still a lack of financial indicators, pharmaceutical manufacturer and distributor, and drug information resources. Regarding the availability of the NLEM, it appears to integrate in the NLEM prescribing indicator. Another indicator that should be considered to add to the set of the RDUCI is the coverage of necessary pharmaceutical services such as medication counselling, medication reconciliation, and medication review, responsiveness, and efficiency of RDU. To improve the coverage of RDUCI, additional indicators should be considered, such as monitoring of ethical drug promotion of drug manufacturers and distributors, drug registration, availability of drug information for public, drug distribution control in community, self-medication behavior and its safety, and drug use in farms and agricultures. For the development of RDCI in the next phase, it is suggested that data collection using RDUCI, determination of the target goals, and the application of the RDUCI data for promoting RDU Country should be conducted.


location: , 'Thailand year: 2017 source: HSRI

title: Readiness and Decision of Community Pharmacy Preceptors in Providing Services with the National Health Security Office

abstract: Roles of community pharmacy are changing to extend cooperating services with the National Health
Security Office (NHSO). Its change could be a strategic policy to support patient service continuity. Objectives
of this study were to evaluate the readiness and decision of community pharmacy preceptors to coservice
with the NHSO, and to investigate factors affecting the co-service decision. Samples were 408
community pharmacies that provided experiential education to pharmacy students of 17 pharmacy faculties
across the country. This was a cross-sectional survey study design. A self-developed questionnaire
was administered during May-August, 2014. The survey questionnaire was validated by six experts, and
the reliability was tested with Cronbach’s alpha > 0.7. The survey response rate was 46.1% (n = 188).
Almost half (49.4%) of respondents were owners and practitioners as community pharmacists. Three highest
services provided in community pharmacy preceptors were 1) medication therapy management (MTM)
for individual patients (64.5%), 2) diseases screening and monitoring (60.1%), and 3) smoking cessation
counseling (58.0%). The two criteria that community pharmacy preceptors gave scores lower than 50% of
minimum requirements were: 1) accessing to data of health service units in the area, and 2) capacity of
prescription evaluation and patient referral system. Regarding the readiness of NHSO co-services participation,
the community pharmacy preceptors gave high scores on both quality and willingness to participate.
Significantly positive relationships with a decision to participate were found in service system (B =
0.248, p<0.05) and management towards customer’s need (B=0.214, p<0.05). All community pharmacy
preceptors for Year-6 Pharm.D. students should be supported to be in the accreditation program. This will
strengthen the readiness to co-service with the NSHO and be one quality assurance for pharmacy education
in experiential practices.


location: , 'Thailand year: 1999 source: HSRI

title: Asessing and improving the quality of care of hypertensive patients

abstract: Assessing and Improving the Quality of Care of Hypertensive Patients	Action research methodology was applied in this project which was carried out at Khoaksamroanng District (Lopburi Province) and Uthai District (Ayutthaya Province). At first, community survey was carried out at the two districts (2 subdistricts for each). It was found that the prevalence of hypertension among population aged 40 and above were 14.1%-24.6% (averagely 19.7%), and 59.8-78.5 (averagely 64.1%) of them had the history of hypertension before the survey. Among those knownn cases, 37.3%-48.5% (averagely 41.4%) had regular visits to health services during the last 3 months; and among those who had regular visits, 29.2%-46.0% (averagely 39.9%) had blood pressure below 140/90 mmHg. 	Among those knownn cases, 78.8% got the information about hypertension from physicians, 16.7% from health center personnels, and 8.8% from nurses. 51.8% of them got the information related to selfcare behaviors, 27.3% related to etiology and symptoms, and 24.1% related to complications. However, most of them actually have not much knownledge of the disease.  48.4% of those knownn cases had  > 25 Kg/M2 . 23.3% of them smoked and 30.4% of them drank alcohol. And 54.7-61.7% of them would do nothing when they had stress. 53.4%-70.0% (averagely 62.6%) of them were first diagnosed the disease at the governmental health services, and 22.4%-37.3% (averagely 30.0%) were diagnosed at private clinics. For the first diagnosis, 49.5%-65.9% (averagely 58.4%) of them had the presenting symptom of headache; 14.0%-28.4% (averagely 23.5%) were diagnosed when they went to see doctors with other diseases; and only 1.6%-6.0% (averagely 3.9%) were detected during health checkup. 27.1%-48.0% of the patients had modification in their dietary and 10.8%-24.0% (averagely 15.3%) in physical exercise.	The qualitative study found that most of the patients adjusted the dosage of antihypertensive drugs by themselves, according to their own perception. And those who could control the blood pressure were always due to the capability in weight control, salt restriction and stress management. 	After the situation analysis, the health services at both districts had been improved by developing standard practice guideline, information system, health education system, appointment and follow-up system, and referral system. The evaluation, after 6 month of implementation, found that 70.4%, 45.0% and 56.3% of the hypertensive patients who attended the service at Khoaksamroang Hospital, Uthai Hospital and Pho-sao-harn Health Center (Uthai District) respectively had the regular visits during these 6 months. And among those who had regular visits, 12.3%, 16.7% and 0.0 respectively had blood pressure <140/90 mmHg at every visit; and 43.9%, 44.4% and 44.4% respectively had BMI <25 Kg/M2 at every visit.


location: , 'Thailand year: 2017 source: HSRI

title: Case Study: Community Participation Development Model to Reduce Alcohol Consumption

abstract: Alcohol consumption is an important problem of Thailand which law and social measures for
reducing alcohol consumption have been provided. The purpose of this research was to develop
community participation model to reduce alcohol consumption behavior and study the effects of this
model. It was a research and development study, included 3 phases: the first phase was reviewing
documents and studying community context, the second phase was developing community participation
model and the final phase was studying the effects of the community participation model in reducing
alcohol consumption behavior. The sample size of 30 persons consisted of community leaders and
relevant persons. They were one village headman, one subdistrict headman, seven health volunteers,
one teacher, two health officers, five members of elderly club, one social development volunteer,
four members of Stopdrink network and eight young leaders, divided into two groups by simple random
sampling. Data were collected from in-depth interview and focus group discussion and analyzed
by content analysis.
The results showed that more than 80% of the sample had extensively participated in the process
of model development, that is, they participated in every step of health promotion activity. The
results of the model included social measures by the community, such as surveying drinking people in
community, the community leaders acted as role models to reduce alcohol consumption, asking for
alcohol free zone in the religious ceremony and the festival. The social measures highly empowered
the community and the network. The relevant agencies participated in the health promotion activities.
The people’s alcohol consumption behavior reduced, evaluated from sales in the community.
Temples, schools, and public offices were alcohol free zones. The people knew more about toxicity
of alcohol and they created innovation of reducing alcohol consumption behavior in the community
such as “Love friends, suggest friends” and “New people with strong heart” projects.
It could be concluded that the development of community participation model could reduce
alcohol consumption behavior.


location: , 'Thailand year: 2018 source: HSRI

title: Evaluation and lesson distilled on implementation of Chronic Kidney Disease clinic, under policy of Ministry of Public Health

abstract: The policy of Ministry of Public Health states that all hospitals under MOPH should establish Chronic Kidney Disease Clinics (CKD clinics). This study aims to evaluate the implementation of CKD clinics using mixed method research and the CIPP model. Results from 140 hospitals in 12 regional service providers showed that 70.71% of established CKD clinics in line with MOPH policy, while 22.14% already had CKD clinics prior to the MOPH policy statement, and the remaining 7.14% hospitals had not developed CKD clinic citing limitations due to area, personnel or budget. In total, 82.31% established sole purpose CKD clinics providing at least one day per week, but occupied the space used by other clinics. Whereas 17.69% did not separate CKD clinic from other health clinic and ran CKD services in parallel to other clinics. For example, some centers had a ‘CKD corner’ as part of their regular DM/HT clinic. In terms of the hospitals that had implemented CKD clinics, 44.62% of centers used both consultative meetings and two ways communication about policy, goals, future plans of CKD clinics to all health personnel and other stakeholders. Whereas, 27.69% used only two ways communication to realize policy, goals and planning of CKD clinic to among interested parties. The remaining 3.08% hospital used no clear consultative process in developing their clinics. Almost all hospitals reported that the supporting budget for CKD clinic was insufficient. Most hospitals (63.21%) funded the establishment of their CKD clinics from their own operating budgets and some fund support from National Health Security Office (NHSO). In terms of human resource, 58.46% have professional team (full) including physician, nurse, pharmacist physical therapist, and nutritionist or Dietitians. However, we found that 20.77% of hospital did not have funded position for nutritionists and in this cases, the advice about nutrition was provided by nurses. All hospitals with professional nutritionists funded this position of their own accord with temporary employee’s position. In addition, 95.38% of all hospital had implemented and maintained CKD patient databases, but only 42.31% of these contained all recommended clinical measures such as Serum Cr and eGFR, blood pressure, blood sugar, take ACE-I or ARB drug, and urine protein. For the most part, patient data were not utilized to track patient disease progression. Most personnel reported the reason for not using routine CKD patient data to gauge patient disease progression and outcomes was excessive workload. In general, CKD patient data was mainly used to report CKD’s KPI to the Ministry of Public Health.


location: , 'Thailand year: 2013 source: HSRI

title: Health Promotion and Disease Prevention Policies for Children aged 0-5 years in Thailand and lessons learned from the USA, Canada, Japan, Taiwan, and Middle East Region

abstract: This report aims to analyse and link between sub- studies under the research project entitled ‘the
development of health promotion and disease prevention policies for children aged 0-5 years old in
Thailand’. The two sub-studies employed in this analysis include the list of prioritized health problems
among children aged 0-5 years, review of relevant existing interventions and policies in Thailand, and the
studies of interventions and policies in five selected countries. The study of international experiences
aims to provide lesson learned that might be useful for the development of related policies in Thailand. Results: Basic care packages for children aged 0-5 years old and pregnant women are similar. Developmental
screening tests are mostly based onthe Denver Developmental Screening Test-II. All countries
provide vaccines against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps and rubella. Neonatal
screening for congenital hypothyroidism is implemented in every country, whereas screening for
other conditions in the neonates and pregnant women are varied. Screening for hearing loss in the neonates
is provided in the United States of America, Canada, Taiwan, and the United Arab Emirates. Legislative
measures are used in many countries for ensuring access to health promotion and preventionservices,
reduction of low birth rate, prevention and treatment of genetic diseases and metabolic disorders, control
of artificial fertilization and obesity, prevention of child abuse and quality control child care centers. Canada
has a comprehensive system for empowerment of parents for child care. Recommendations for the betterment
of well-being of Thai children from good practices in these countries have been proposed.


location: , 'Thailand year: 1998 source: HSRI

title: Study and index development for risk behaviour of sex in high school and technical colledge students in Nakornrajasrima

abstract: Study and Development of Indicators for Evaluating Risk Behaviour of Sexual Intercourse in High School and Technical College Students in Nakornrachasema ProvinceThe study objectives were to develop techniques of how to find risk behaviour indicators of sexual intercourse in high school and technical college students in Nakornrachasema. The technique which was used in this study was literature review in addition to organising brain storming meeting in order to determine the indicators. The study was grouped into 2 parts, 1) studying in high school and technical college students to find risk indicators by interviewing 1314 students sampled by multi-stage technique, 2) interviewing 12 school administrators to assess their interests in using the indicators.The study showed that 1 in 5 high school students and 46.7% of technical college students had had sexual intercourse while in female students, 10.5% of technical college students, 2.9% of high school students in Muang district and 3% of high school students in other districts had done so. Factors which were related to risk behaviour in male group, were drinking, independent living from their family, family income, age and inappropriate attitude for example having sex with their friends not risking AIDS infection. Sensitive indicators which were positive to high risk, were drinking, their living conditions, being technical college students, attitudes and family income.The results from interviewing educational administrators were some of them considered this issue as important whereas they were more interested in drug and learning problems. They expressed concern over independent living, less taken care by their family and lots of entertaining places where students were easily led to risk life behaviour. Most of them agreed with the use of indicators but felt hesitate to collect data by themselves. The study recommended that;the results of this study should be presented to all involved to promote issue awareness and process of exchanging views,high risk group which was the technical college students should be first targeted,process of data collection should be developed.


location: , 'Thailand year: 2000 source: HSRI

title: Recurrent of calculus depositions and gingivitis in primary school student that scaled by healthworkers at District Health Centers in Amphur Chokechai Nakhonratchasima province

abstract: การเกิดซ้ำของหินน้ำลายและเหงือกอักเสบในนักเรียนประถมศึกษาที่รับการขูดหินน้ำลายโดยเจ้าหน้าที่สาธารณสุขระดับตำบล  อำเภอโชคชัย  จังหวัดนครราชสีมาRecurrent of calculus depositions and gingivitis in primary school student that scaled by healthworkers at District Health Centers inAmphur Chokechai Nakhonratchasima provinceThe aims of this study were to compare the recurrent rate of calculas deposition and gingivitis in primary school children aged 10-12 years between a group of schools that performthe systematic tooth brushing after lunch program (implementation group; imgroup) and a group of schools without the systematic tooth brushing after lunch program (Comparison group: Cm group)  in Chokechai district. Groups of 4 schools with 141 and 147 schoolchildren were proposively selected from the related criteria. Every subjects received calculus scaling by trained health workers. Data collected by oral examination with Volpe - Manhold Index for calculus, and gingival Index for recording gingival status, 5 and 8 months after scaling by 1 examiner. The results showed that the recurrent rate of calculus deposition between the implementation and comparison groups were significantly different at both 5 months and 8 months after scalling (p=0.1, 0.2). The percentage of subjects in Im group who had no calculus deposited at 5 and 8 months period were 45.4% and 27.0% respectively. While the rate in Cm group were 30.6% and 19.0% respectively. Gingival status between two groups were not significant different at both 5 and 8  month period (p=0.25 and 0.94). It was found that only mild and moderate gingivitis were observed with out any subject with severve gingivitis. The results indicated the low effectiveness of the actual scaling campaign in primary schoolds.


location: , 'Thailand year: 2015 source: HSRI

title: Improving capacities for access to medicines (ATM) in Thailand

abstract: The main purpose of the research project, “Improving Capacities for Access to Medicines (ATM) in
Thailand” is to analyze national mechanisms and local-level situation for ATM and to propose policy
recommendations for an improved ATM with regard to the following issues: (1) use of the compulsory
licensing (CL) measure for innovative drugs; (2) national mechanisms for improved ATM; (3) access to drugs in
National Lists of Essential Medicines (NLEM), Sub-list Ngor; and (4) monitoring of purchasing prices and
reimbursed prices of medicines under sustainable financing.
Based on literature review of the ATM context, the main issue for Thailand is about getting access to
innovative medicines, of which various factors on intellectual property and international trade play important
roles. This resulted in unaffordable prices for most developing countries due to market exclusivity of the
patented, branded originator products, coupled with the delayed competition of generic drug industry.
Lessons learnt from international community that could be applied to Thailand include (1) counteracting the
evergreening patents by India using Sections 3(D) and 3(E) and by Australia using information on minimal
therapeutic values of the evergreening patented medicines; (2) regional pooled procurement by Pan-
American Health Organization (PAHO) for drugs used for non-communicable diseases (NCDs) additional to
antiretrovirals, drugs used for tuberculosis and malaria; (3) country’s integrated policies toward strengthening
domestic drug industries in Brazil and Argentina; (4) strong networks of civil societies that were synergetic with
public sectors in incorporating social value judgement additional to technical support in making policy
decision.
Success in the use of CL by the Thai government in 2006 shed light on the following critical success
factors, including (1) collaboration with civil societies and academia to counteract the reaction from original
drug industry, (2) availability of the clear and easily accessible patent databases, and (3) secured sources of
generic drug supply plus available information on production process and finished product quality. Other
alternatives including price negotiation and use of TRIPS flexibilities should be considered as well.
For management of ATM at the national level, the Thai government by Ministry of Public Health
(MOPH) has focused on drugs covered by National Lists of Essential Medicines (NLEM), which have been
established since the first National Drug Policy (in 1981). In early versions, the NLEM covered mostly basic
essential drugs. At present, several drugs were included and ranged from sublist Gor for the basic essential
drugs to sublist Jor(2) for the very expensive drugs.
An innovative policy for improved ATM in the Universal Health Coverage (UC) scheme has been
implemented through National Health Security Office (NHSO)’s Drug Fund. Drugs that have been managed by
the NHSO included those in the NLEM sublist Jor(2), chemotherapy or hormones for outpatients, drugs for thalassemia and hemophilia, clopidogrel, orphan drugs, methadone, drugs of opportunistic infections in
patients with HIV/AIDS, inhaled corticosteroids and long-acting bronchodilators, antituberculosis,
immunosuppressants, morphine, psychiatric drugs (risperidone and sertraline until 2013). Use conditions for
certain drugs might not be in accordance with those Indicated by the NLEM due to different committees.
However, this issue has now been being resolved. Apart from medicines, NHSO managed vaccines under the
Expanded Program for Immunization (EPI) and those under campaigns such as influenza virus vaccine and
Japanese encephalitis vaccine.
In implementing the national policies at the health care service level, because the three major
insurance schemes used different payment methods and mechanisms, pharmacists and hospital personnel
had to shoulder administrative burdens, such as separation of drugs and patients according to eligibility
criteria. Changes in the policies and practices from MOPH, NHSO and Government Pharmaceutical
Organization (GPO) required timely adaptive measures at the health care level and caused job stress to
implementers. Thus, a recommendation would be to reconcile fragmented administrative methods that
factor in limitation of the concerned parties.
For drugs in the NLEM sublist Ngor, of which several are for non-communicable, chronic diseases
such as diabetes (pioglitazone, repaglinide, insulin aspart, insulin glargine), epilepsy (sodium valproate,
lamotrigine, levetiracetam) and high-cost, broad-spectrum, injectable antibiotics for the hospital-discharged
patients, there existed the issues for the UC patients living in the district or sub-district levels. Therefore,
financing mechanisms of health insurance schemes should be available at the provincial or regional levels
(estimated budget for 240 million Baht). To reduce budget constraint, these drugs should be negotiated for
the lower prices using the national mechanism similarly to those in sublist Jor(2). In addition, capacities of
health professionals on proper use of these medicines should be built in order that patients could be
referred back to district hospitals where the medicines could be easily accessed.
For health financing to be sustainable, monitoring of purchasing prices and reimbursement prices is a
crucial mechanism. The quarterly provider price index during 2010-2013 had a decreasing trend for an overall
and for almost all therapeutic classes (166 items in 11 classes). This would make room for fiscal space to
support the ATM in hospitals. Controlling drug prices are the major role played by various committees,
whereby the focal point is MOPH (for the purchasing prices) and Civil Servant Medical Benefit Scheme
(CSMBS) (for the reimbursement prices). Medium prices for lipid modifying drugs announced publicly in 2014
which relied on methods other than mode or median is a stepping stone for controlling the purchasing prices;
whereby lessons learnt from Taiwan’s National Health Insurance on market survey-based price adjustment
shed light on technical feasibility for controlling the reimbursement prices despite limited administrative
feasibility in Thailand. Finally, delay in implementation of the CSMBS’ new reimbursement rates and controversy on cost structure as a required condition for drug registration in the new Drug Act are the latest
unsettled issues.


location: , 'Thailand year: 2009 source: HSRI

title: Devolution of Health Centers and Hospital Autonomy in Thailand: A Rapid Assessment

abstract: This research was undertaken to evaluate the devolution of health centers and hospital autonomy in Thailand. The assessment team conducted literature and document review and interviews with the Provincial Health Office (PHO), District Health Office (DHO), Provincial Governor’s Office and Department of Local Administration (DLA), the Contracting Unit for Primary Care (CUP) Hospital, Tambon Administrative Organization (TAO) and health center (HC) staff in five devolved health centers and five nondevolved health centers and a hospital-owned primary care unit (PCU) in six provinces. In relation to the three stated objectives of decentralization, the team’s findings concerned changes in flexibility, responsiveness and participation following devolution of health centers to TAOs.
Findings on the devolution of health centers were as follows: (1) increased management flexibility: three of the devolved health centers had positive perceptions of improvement in management flexibility, in the sense that future decision-making is expected to be faster and there should be greater scope for initiative; (2) increased responsiveness to the community and to patients: three devolved health centers could point to a number of ways in which service delivery had improved and new services had been provided in response to the needs and preferences of the community; and (3) increased participation of the community: all five TAO CEOs and Councils were active in obtaining community input on health and health service delivery.
Findings on hospital autonomy were as follows: (1) the Ban Phaeo Hospital model was found to be well-designed, clear and consistent. Its performance in improving service quality and increasing its revenue had been highly successful; (2) community support for the hospital has been a major success factor but mechanisms for patient and community feedback on priorities and service delivery performance could be strengthened to improve accountability and better align service priorities with the needs and preferences of users; (3) this model should be replicable in other MOPH hospitals, except small community hospitals serving small, dispersed populations.


location: , 'Thailand year: 2009 source: HSRI

title: A Systematic Review and Meta-analysis of the Efficacy of Statins Available in Thailand in Reducing Acute Coronary Syndrome and Stroke Events

abstract: Objectives: This study was a literature review assessing the clinical efficacy of statins available in Thailand (i.e., atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin) for use in reducing acute coronary syndrome (ACS) and stroke events.
Methods: A systematic review and a meta-analysis of randomized controlled trials (RCTs) of statins were studied. The clinical trials on an electronic Medline database were searched. Efficacy studies of statin monotherapy were compared with placebo or other statins on the occurrence of fatal and non-fatal ACS and stroke. Odds ratios (OR) and 95 percent confidence interval (CI) were used to determine the summary efficacy of statins. Indirect comparison of the random effect meta-analysis, using the Bayesian approach and WinBUGS14 software program, were applied.
Result: Twenty-nine RCTs in 26 studies enabled comparing statins with a placebo; one study compared statins with no treatment, another compared statins with usual care, and yet another compared atorvastatin with pravastatin. For ACS events, the relative risk reduction (RRR) of simvastatin was 42 percent (OR=0.58, 95%CI=0.51-0.65), the RRR of atorvastatin was 41 percent (OR=0.59, 95%CI=0.51-0.70) and the RRR of pravastatin was 26 percent (OR=0.74, 95%CI=0.66-0.83). For stroke events, the RRR of simvastatin was 26 percent (OR=0.74, 95%CI=0.66-0.83), the RRR of atorvastatin was 19 percent (OR=0.81, 95%CI=0.72-0.93) and the RRR of pravastatin was 14 percent (OR=0.86, 95%CI=0.75-0.97). However, fluvastatin did not significantly reduce ACS (OR=0.37, 95%CI=0.11-1.05) and stroke events (OR=0.85,
95%CI=0.46-1.55). No efficacy study of rosuvastatin on decreasing ACS and stroke events is yet available. Conclusion: The available evidence indicate that simvastatin, atorvastatin and pravastatin significantly reduced ACS and stroke events.


location: , 'Thailand year: 2009 source: HSRI

title: Claimants of Compensation for Adverse Clinical Events Occurring in Hospitals

abstract: When adverse events occur in the hospital the patients or their relatives often bring cases to court or
submit claims for compensation from the National Health Security Office (NHSO). A descriptive study
was carried out to determine the trend relating to claims for compensation in order to obtain information
for designing a new and better system.A survey employing questionnaires was used to obtain information at 230 hospitals in the country;
the response rate was 70 percent, among which 21 percent had experienced in 2008 claims for compensation
owing to adverse events occurring in the hospitals. The findings showed that community hospitals
were subjected to such claims more often than regional general hospitals, e.g., 23.4 vs. 15.7 percent. As
many as 43.1 percent of the studied cases were related to pregnancy and delivery. The median of the
compensation amounts was Baht 200,000; the highest claim was for Baht 15 million. The median amount
of money allowed was Baht 100,000. The main source of compensation was from NHSO (49.0%). Among
the claims, 13.3 percent of the cases were brought to court. Community hospitals had a higher chance for
claims brought to court than general/regional hospitals (14.3% vs. 10.0%).
The study concluded that 21 percent of the hospitals surveyed experienced claims for compensation.
Most cases were related to pregnancy and delivery. The money received was smaller than the claims
submitted. Therefore, some claimants brought their cases to court in lawsuits.


location: , 'Thailand year: 2009 source: HSRI

title: Perspective of Administrators on Extending Community Pharmacy Services under the National Health Security Scheme

abstract: The concept and perspectives of administrators can reflect the direction of development. This research
was aimed at studying the concept and perspectives of administrators regarding the issue of attempting to
extend community pharmacy services under the National Health Security Scheme (NHS). The study was
conducted using in-depth interviews of the administrators responsible for the status of pharmacies with regard to the possibility of providing pharmacy services under NHS, the direction of development for pharmacies,
the value of pharmacies in NHS, stakeholders and factors for success in extending pharmacy services
under the system. Data were gathered and analyzed by content analysis. The results showed that the
administrators agreed with the idea of incorporating community pharmacy services within NHS, but the
standard of practice and the quality of service first had to fulfill NHS criteria. Community pharmacy had to
have a clear status and position in the system. Reimbursement of the services would have to be specified.
The administrators saw the value of extending private pharmacy services as it would increase the accessibility
of the patients to another dimension of health care. Accredited pharmacy services may be an option for
increasing patients’ accessibility to health. To be successful, the administrators said that every stakeholder
would have to take part in his or her own roles according to the context. However, every partner would
have to aim for benefiting the patient, as the system is patient-centered.


location: , 'Thailand year: 2014 source: HSRI

title: Efficiency of extra-working time dental clinic of Thawung Hospital

abstract: This descriptive study aims to analyze the efficiency of the Thawung Hospital’s extra-working time
dental clinic. Efficiency indices used in this study were the operating unit costs and the charge cost ratios.
Three database sets for service and charge, material and medical supplies, and dental health information
from 1st October 2010 - 30th September 2013 were used. The results showed that at the 2011-price base,
unit costs of dental service in budget year 2011, 2012 and 2013 were 656, 552 and 498 Baht per visit, respectively,
while the charge-cost ratios were 1.61, 1.40, and 1.52, respectively. The most efficient year of dental
services with regard to resources used was 2013 due to its lowest unit cost. The most efficient year with
regard to the earning capacity was 2011due to the highest charge-cost ratio.


location: , 'Thailand year: 2014 source: HSRI

title: Correlation between Canadian Triage And Acuity Scale (CTAS) implementation and early outcome of patients in emergency department, Maharaj Nakorn Chiang Mai Hospital

abstract: The National Institute for Emergency Medicine specifies a criteria for triaging patients into five
levels according to the urgency of treatment needed. Canadian Triage and Acuity Scale (CTAS) is a five-level triage tool used worldwide that can rapidly assess patients, and is proved to be accurate and reliable.
However, no study in Thailand has confirmed CTAS as an initial predictor of the severity of patients. This
research aim study the correlation between CTAS level and early outcome of patients, including; 24-hour
mortality rate, intensive care unit (ICU) admission rate and rate of immediate life-saving interventions in
emergency department. Researchers conducted a retrospective observational study and reviewed medical
records from all patients presented to the ED and were triaged by using CTAS in August 2013. There
were 2,508 patients who were triaged by using CTAS and met the inclusion criteria. Five patients died in
24 hours after ED visit and CTAS levels were I and III in 4 (8.16 %) and 1 (0.12 %) patients, respectively. 84
patients were admitted to the ICU and theirs CTAS levels were ranged from I to IV in 18 (36.73 %), 47
(17.41 %), 17 (1.97 %) and 2 (0.17 %) patients, respectively. 115 of the patients received immediate lifesaving
interventions following their arrival and CTAS levels for these patients were from I to III in 29
(59.18 %), 59 (21.85 %) and 27 (3.12 %) patients, respectively. The differences were statistically significant
between each CTAS levels and each early outcomes of patients (p-value < 0.001), so the higher the patient’
s triage level, the higher the severity. Conclusion: Canadian Triage and Acuity Scale (CTAS) has a significant
correlation with early outcomes of patients, including 24-hour mortality rate, ICU admission rate and
rate of immediate life-saving intervention. Therefore, CTAS can be used as an effective five-level ED
triage tool.


location: , 'Thailand year: 2023 source: HSRI

title: Projection of Premature Mortality from Noncommunicable Diseases in Thailand: 2000-2030

abstract: This study aimed to assess the situation of premature mortality due to four noncommunicable diseases (cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases) between 2000-2018 in the Thai population aged 30 to 70 years, and the feasibility of achieving the Sustainable Development Goals (SDGs) of reducing premature death by one-third by 2030. We estimated premature mortality using civil registration and vital statistics (CRVS) from the Bureau of Registration Administration with cause of death coded by the Strategy and Policy Division. Verbal autopsy data were applied to improve accuracy of causes of death from the vital registry. We predicted the premature mortality up to 2030 using Bayesian model averaging (BMA). The findings showed that given the current historical trend, achievement of the SDG target of 9.9% by 2030 was unlikely, as we predicted it to be 12.0% (95%CI, 10.6-3.6). However, this goal is more likely to be achievable in women than men. Among the four NCDs, respiratory diseases are most likely to reach the target.


location: , 'Thailand year: 2010 source: HSRI

title: Synthesis of Knowledge The Health System in the Area Unrest Southern Border Province

abstract: Unrest affecting the health system in the area. Therefore, education and development. But the lack of synthesis and adoption benefits. This study was to synthesize findings about the health status. Public health sector management. Public Health and recommendations from research on 103 projects and project 10 project, projects from the year 2547-2551 by the synthesis of quality found that people with little stress to normal Stress management using positive thinking. Talk to your family. Religious principles is dependable. Young families that are affected will have aggressive behavior. For other activities to relieve stress. Widow and loss of mental health and social problems was high. The problems faced by the doctrine But the inability of leadership roles in family. Public Health System-wide emergency medical services and referral. And the remedy is clear, but people are unsure of work The problems  does not cover the public relations people have less access to services. Recommendations from the research project and present the application of research to practice. And in-depth study or research in other samples. Most research is basic research should develop research and evaluation research. To solve the health sector management and public health service public. Should be educated in all groups of health personnel disabled youth to prepare a database builds knowledge.


location: , 'Thailand year: 2002 source: HSRI

title: Core package for oral health care on universal coverage policy, Thailand

abstract: Core Package for Oral Health Care on Universal Coverage Policy, Thailand The purposes of this study were to review knowledge, concepts and experiences of the core package for oral health care, and to recommend the proper core package for oral health care in Thai context which was applicable and fit with needs of the oral health care. The study was conducted by reviewing literature, evaluating sample province and stakeholders’ opinion discussing.Results of the study, Pathumthani, sample province, had more dental patients since the Universal Coverage policy had started. For example, tooth filling, scaling, and extraction had increased 25.3%, 25.1%, and 16.2% respectively. However, waiting list or queue was also increased for instant, there were 164 dental substitution cases and 136 root canal treatment cases in February 2002. The focus group discussion of providers found that there were some problems of policy implementation such as unclear definition of package, increase in the number of patients, and management. The focus group discussion of consumers, another side, demanded for kinds of services which could alleviate pains and restore ability of chewing. Delphi stakeholders meeting prioritized all of services into three groups: 1) The first priority (4.8-5.0 score): Topical Fluoride, Systemic Fluoride, Periodontitis treatment, Celt lip & palate, Oral cancer, Oral infection, and Amalgam filling.2) The second priority (4.0-4.7 score): Scaling, Sealant, Oral patho, Full denture, Root canal treatment, Impacted tooth, Oral health examination, Consulting, Extraction, Pulp treatment in primary teeth, and Tooth-colored filling. 3) The third priority (less than score 4.0): Partial denture, Crowding teeth, and Fixed denture.There were three alternative concepts of the package establishment: 1) Full Treatment Need, 2) Treatment Need with some conditions, 3) Treatment Need by age groups (for example 0-13 age group: Fluoride, Sealant, Oral Exam, Amalgam filling, Root canal treatment, Extraction, Pulp treatment, Oral patho, etc / 14-59 age group: Fluoride, Oral exam, Scaling, Periodontitis, Amalgam filling, Root canal treatment, Impacted tooth, Extraction, Oral patho, Tooth-colored filling, Acrylic partial denture / 60+ age group: Fluoride, Oral exam, Scaling, Periodontitis, Amalgam filling, Extraction, Oral patho, Tooth-colored filling, Full denture, Acrylic partial denture). These options were subject to budget, manpower and capacity of services.  For policy establishment, there were some suggestions from the research: 1) the third concept was suitable for resource scarcity, 2) co-payment mechanism was a method to control over demand side, 3) condition of treatment care could increase awareness of self care, 4) some treatments with high cost and chair time might not suitable to be in package such as fixed and metal denture, 5) well-organized system of queue, referral system and finance were required. This research may contribute to improve oral health care service. However, it’s needed to have further studies such as, cost of services, public-private mixed service, consumers’ behavior, etc.


location: , 'Thailand year: 2015 source: HSRI

title: Time-to-treatment of stroke patients: Experience  from Ubon Ratchathani Province, Thailand.

abstract: Treating ischemic stroke patients with rt PA no more than 3 hours or 180 minutes after the stroke can increase the chance of recovery or improved condition.  If, however, treatment is delayed, the potential outcome may be permanent disability or death.  This descriptive study was conducted with the objective of assessing time elapsed before treatment in ischemic stroke patients and analyzing the factors influencing the amount of time elapsed before ischemic stroke patients receive hospital treatment.  The sample group was composed of 300 ischemic stroke patients treated at Sanphasitthiprasong Hospital in the province of Ubonratchathani, Thailand.  Data were collected from November 2014 to February 2015.  The following three sets of instruments were employed:  1) Demographic Data Questionnaire; 2) Ischemic Stroke Evaluation Form and 3) Time to Treatment Evaluation Form.  Data were analyzed by descriptive statistics and by finding the correlations by using Spearman's correlation coefficient.
According to the research findings, 229 of the 300 ischemic stroke patients (76.3%) had pre-hospital times of more than 180 minutes.  The mean pre-hospital time from the occurrence of stroke to hospital arrival was equal to 1,117.7 minutes (SD=1,556.4).  The amount of time elapsed from arrival in the emergency room at Sapphasitthiprasong Hospital until receipt of treatment (in-hospital time) was equal to 134.0 minutes (SD = 93.4).  Therefore, the mean time from the initial presenting symptoms until treatment was equal to 1,218.7 minutes (SD = 1,602.0).  Furthermore, the pre-hospital time, the distance from the site of the incident to the hospital and the in-hospital time from arrival until laboratory test results were received were found to be positively correlated with the pre-hospital time from the initial presenting symptoms until receipt of treatment (rs= .661, .185, .235, p<.01).  The severity of symptoms evaluated with NIHSS scores was found to be negatively correlated with pre-hospital time (rs= -.129, p<.05).
In summary, most ischemic stroke patients within the boundaries of Ubonratchathani receive delayed treatment in which the pre-hospital time has the highest correlation with receipt of treatment and instructing patients, people at risk for ischemic stroke and their relatives.  Moreover, the development of an emergency medical service provision system and a hospital referral system that minimizes procedures and time in transferring ischemic stroke patients is vital to helping ischemic stroke patients receive timely treatment.