location: , 'Thailand year: 2023 source: HSRI

title: People’s Perspectives and Expectations on Devolution of Health Promoting Hospital to Local Administration Organization

abstract: The main objective of this study was to determine the people’s perspectives and expectations on devolution of health promoting hospital to local administration organization. The alternative aims of this study to impact of devolution of health promoting hospital to local administration organization, health database management system, problem and obstacles on devolution. Conceptual framework based on system theory and six building blocks. The study design was conducted Mixed methods. Study areas were regional health 1 and 4. Data collection method both questionnaire and in-depth interviews from health promoting hospitals both devolution and not devolution. Study subjects composed of 3 groups: 1) executives in the area, including both ministry of public health and local administrative organizations (n=48), 2) Officer of health promoting hospitals (n=104), and 3) people in each area (n=3,912). Results found that people whose experiences services of all 46 health promoting hospitals had perspectives and expectations do not difference between devolution and non-devolution. They would doctor home visit, drug quality, receipt drug from health promoting hospitals and do not need got drug at hospital, laboratory in community, and staff enough to services. Although, the satisfaction of people towards the service of between health promoting hospitals that devolution was higher than non-devolution with statistical significance (P value <0.05). Impact of health promoting hospitals devolution found that local administrative organizations were affected in terms of personnel that were not transfers as well, budget issue was not clear to use, and issue of the land and buildings that need process with another organization, and including health database management system, referring, there were no clear guideline. Problems and obstacles encountered in operation due to unclear communication, distrustfulness, untrustworthiness, and the recently started responsible office for public health in local administrative organizations make the devolution are many obstacles to implementation. Therefore, clarifying communication and trustfulness between the Ministry of Public Health and local administrative organizations will make the transfer. able to meet the expectations of the people.


location: , 'Thailand year: 2017 source: HSRI

title: A Study of Work load and productivity among health personnel in District Health Promotion Hospitals

abstract: This descriptive mixed method study aimed to 1) investigate workload and factors associated with productivity of health personnel in District Health promotion Hospitals 2) describe relationship between workload and existing staffs and 3) formulate policy recommendations for health workforce planning and development. Stratified random sampling was applied to select samples for quantitative data collection. 48 District Health promotion Hospitals (DHPH) of 5 sizes (S,M,L,Extra and special size) were selected from 12 provinces in 12 health regions of Ministry of Public Health. All 336 health personnel in 48 selected DHPH were requested to record their daily time spent and productivity in electronic forms for 3 months. Purposive sampling was applied to select 8 outstanding DHPHs from 4 geographic regions across country. Focus Group Discussions were conducted, all health personnel who working in selected settings were participated. Descriptive statistic and content analysis were applied for data analysis. The main findings from this study indicated that 1) Health personnel in DHPH spent their working hours for curative activity 60%-70% more than health promotion and prevention activities which were their major responsibility 2) Comparing with staffing standard and current workload, there was shortage of health personnel in DHPH. In average each staff provided 1.2 FTE to complete their jobs. They also complaint about not balancing between their effort and reward, they did not get overtime payment and career advancement. 3) Health personnel had to share 30% of their working hours for administrative and clerical jobs which led to decrease time to provide health services. These jobs consisted of performance reporting associated with MOPH mandatory indicators, financial and accounting report, supply and inventory document and input data into management information system for various public agencies etc. These finding suggested that, MOPH should improve staffing standard and allocation, improve morale and optimize resources utilization. Moreover, development of administrative competency for directors of DHPH and re-orientation of mandatory reporting system need to be concerned as well.


location: , 'Thailand year: 2010 source: HSRI

title: Effects of the Direct Billing System on Prescribing Patterns in the Civil Servant Medical Benefit Scheme

abstract: In 2006, the reimbursement system for the Civil Servant Medical Benefit Scheme(CSMBS) in Thailand
was changed to a direct billing system. It was unknown how this new system affected drug expenditures
and the number of drugs given to beneficiaries. The aim of this study was to assess the effects of the
direct billing system on prescribing patterns in terms of the number of months of coverage per prescription
and over possession. The study was undertaken using a retrospective cohort approach on the data
recorded in the database of a university hospital in the northern part of Thailand. We gathered data on all
patients with CSMBS coverage who came to the out-patients department between Oct 1, 2005 and Mar 31,
2007. Mean cost of medication, the number of months of coverage per prescription and the medication
possession ratio (MPR) of the five highest prices of oral medication were calculated for the one-year period
before and after the system was changed.
Results: Out of 43,897 patients seeking out-patient care at the hospital, 15,632 (36%) were covered
under CSMBS. Eighty-eight percent (13,785/15,632) received medications as a result of their visit. The
total cost of medication increased from 2 million baht to 4 million baht in one year. Glucosamine,
atorvastatin, rosiglitazone, clopidogrel and diacerein were the most frequently used in terms of cost. The
average number of months of coverage based on these medications increased from 1.29 to 1.48 months per
prescription. The percentage who were prescribed medication for more than 3 months, was slightly increased
from 1.82 to 2.43. Three out of five MPRs were higher after the system was changed (relative risk
ranged from 1.19 to 2.32).
Conclusion: The direct billing system may affect prescribing patterns, as indicated by the trend of
the increased number of months of coverage per prescription and the higher medication possession ratio
found in our study. Further evidence is still needed. Policymakers need to consider all relevant and
important consequences associated with the new system prior to decision-making for policy purposes.


location: , 'Thailand year: 2018 source: HSRI

title: Community Care by Caregivers to Dependent Elderly under the Community-Based Long-Term Care Policy

abstract: The objective of this study was to examine role and process of care by caregivers to dependent older people in communities after the long term care (LTC) policy of the Universal Coverage Scheme was developed. This study used a purposive sampling method to select 20 caregivers who have looked after dependent older persons in communities for longer than one year. Research tools such as general information questionnaires, semi-structured interviews and voice recorders were used to collect qualitative data. The data were analyzed by content analysis. The findings illustrated that after LTC project was implemented, caregiver role and process of care to dependent elderly in communities have evidently changed. Obviously, the knowledge and practice skills of the caregivers, especially on activity of daily living (ADL) care, health issues, sanitation and environment management in the elderly’s home, have gained considerably through training. Team works, coaching and mentoring, and care buddy matching were explicitly formed, including a clear pattern of work namely a care plan. Details of elderly persons who need care, care goal planning or rehabilitation program and relevant information have been included in the care plan. Interestingly, ADL levels of dependent older persons under the guidance of care managers and multidisciplinary have been gradually improved or there was an appropriate aspect for each individual need. Caregivers have increasing important roles particularly being care assistants to dependent older people who have diseases required specific care. In order to be able to appropriately and sustainably providing care to dependent older people in the community, policies and measures to promote the advancement opportunities of caregivers and the continuous training for development of potential caregivers should be encouraged. Stimulating the proactive services enhancement of caregivers working together with multidisciplinary teams, motivating family members having the potential to provide care to elderly people having specific disease, and finally, the compensation and welfare policy should be appropriately promoted.


location: , 'Thailand year: 2020 source: HSRI

title: Initial Assessment of Experiences on Receiving Integrated People-Centered Care of Patients with Diabetes and Hypertension

abstract: An implementation research on the development of integrated-people centered care started a
pilot reform of service delivery system in 20 primary care clusters (PCCs). Patients with diabetes and/or
hypertension were employed in this pilot test model. An initial assessment was taken after a 4-months
implemention on patient’s experiences on receiving integrated people-centered care comparing between
PCC under the project with other primary and ambulatory care facilities in the same district. A community
survey of 200 samples was conducted from each district. There were totally 4,071 samples, 1,311
samples from hospital DM/HT clinics, 1,721 from PCCs in the project, 823 from other PCCs, and 216
samples from health centers.
Results showed that PCCs in the project had significantly better patient-family care team relationship
compared with other types of health facilities, a greater proportion of patients knew the name of family
physician, family care team, and had more convenient communication channel. However, the target of
receiving care from the same family doctor and team needed further improvement. The PCCs in the
project achieved significantly greater proportions of patients receiving care according to the guideline for
chronic illness care in most of the 5 dimensions (knowing health determinant factor, care plan, goal
setting, health behavior, and care result) compared with other types of facilities. However, the dimension
on health behavior modification got relatively low score compared with other dimensions. It is noticeable
that the other PCCs did not perform any better than hospital DM/HT clinics either in terms of patient-doctor/
family care team relationship or care for chronic illness. Further implementation research is needed
to evaluate implementation outcomes and service outcomes of the model.


location: , 'Thailand year: 2010 source: HSRI

title: Policy Options on Medical Injury Compensation Fund for Thailand

abstract: Unwanted outcomes of health services, either unavoidable occurrences or due to negligence, can
lead to damages and conflicts between health-care providers and patients. Consequently, this can have an
impact on the health service delivery system, in which the faith and credibility of the people has been
deteriorating. The current compensation mechanism implemented through the judicial system cannot
enhance good relationships between the providers and patients. The “no-fault” basic compensation system,
under which the affected patients are entitled to damages, according to article 41 of the National
Health Security Act of B.E. 2545, can alleviate their distress to a degree but the law covers only patients in
the Universal Coverage Scheme. This has led to the idea of drafting new laws to extend this protection to
all Thai patients. As a result, the authors have summarized the policy options and the pros and cons of
each option in order to inform the public, create symmetry of information between different groups of
stakeholders, and empower the society to assess by themselves the feasibility and long-term impact of the
policy options. This study found that non-judicial no-fault compensation for affected patients is widely
accepted and adopted in several countries (such as the Scandinavian countries and New Zealand) under
the principle which emphasizes the responsibility of the party who afflicts the damage before proving
who is right or wrong. There are two different sources of funds for no-fault compensation: (a) funds
collected from providers, public hospitals through health funds which are mainly from taxation, and
private hospitals which pay directly; and (b) contributions from people proportionate to their income
(with a certain income ceiling) and (c) from the government for low-income or unemployed people. Also,
the providers may need to contribute (as in New Zealand). It is the authors’ opinion that Thailand should
adopt a no-fault liability policy which could help in reducing conflicts between patients and providers. A
non-judicial mechanism should be developed for provision of full compensation, which if the patient
accepts, would mean that no further lawsuit could be filed. This would allow the affected patients to be
compensated in a timely manner. Regarding the funding source, we propose the use of the health funds
model through which the government contributes to public hospitals while private hospitals contribute
themselves. The estimation for compensation is about 341-679 million baht per year, with the average
being 5-10 baht per capita. Discussion by stakeholders on this topic would allow the facts to be revealed
to the public who could then participate more effectively in the policy-making process. One should be
aware that if the quality of the health service delivery system is poor and the problems are caused mostly
by complications or the system itself, then the amount of compensation paid for these damages would be
higher than the compensation for damages caused by the practitioners; hence, this would lead to rising
costs. Furthermore, the no-fault compensation process should also be protective of the providers’ reputation
and try to give encouragement and feedback in order for them to improve their performance.


location: , 'Thailand year: 2008 source: HSRI

title: Quality of Life of HIV-infected Persons and Patients: A Case Study of the "Ruam Nam Jai Rim Nam Lao Group, Mae Lao District, Chiang Rai Province

abstract: The objectives of this study were to: (1) examine the quality of life of HIV-infected
persons and patients; (2) identify the factors related to their quality of life, and (3) map
out the problems and seek ways to improve their quality of life.
A questionnaire was employed as the research instrument to obtain information
from 180 HIV-infected persons and patients who had been members of the Ruam Nam Jai
Rim Nam Lao Group in Mae Lao district, Chiang Rai Province, for at least three mouths.
Frequency, percentage, t-test and F-test were used for data analysis. About 50.6 percent of
the subjects were females, aged below 35 years (43.9%) and married. The majority (68.9%)
had finished elementary school. The majority (60%) were engaged in general employment
or in agriculture (33.9%), among others. The average monthly income was below
1,000 baht (42.80%). Most of them had been members of the Ruam Nam Jai Rim Nam Lao
Group for four years or more. The reason for joining the group was to access the facilities
to look after their own health and to get anti-AIDS medicines. They participated in the
group activities 1-4 times. They learned that they were HIV-infected at least six years
previously. They experienced a mild ill-feeling approximately once a month. The period
of treatment with anti-HIV medicines was one and a half years to three years. To a great
extent, they looked after their own health ( x = 0.74 out of 1).
Overall, the quality of life of the HIV-infected persons and patients was moderate
(x = 3.59 out of 5). When the individual dimensions were considered separately, it was
found that the quality of family life and that of community life were high ( x = 4.07 and
3.84, respectively). Their health and economic security were found to be moderate ( x =
3.43 and 3.03, respectively).
The factors relating significantly to their quality of life at the 0.05 level were gender,
marital status, income, length of time knowing about their HIV infection, and the nature
of their illness, respectively. In contrast, education, number of years of taking anti-HIV
medication and self-care were all found to have no relationship to their quality of life.
From the findings of the study, the researchers were able to compile some suggestions
for improving the situation of the HIV-infected persons and patients in the communities;
the details of the study are described in the text.


location: , 'Thailand year: 2008 source: HSRI

title: Effectiveness in the Reduction of Renal Complications of a Diabetes Clinic Model at Buengkan Hospital

abstract: The purpose of this retrospective descriptive study was to evaluate the effectiveness of the
Diabetes Clinic at Buengkan Hospital in reducing renal complications. The medical records of
patients from May 2006 to May 2008 were reviewed and the glomerular filtration rate (GFR) was
calculated by MDRD equation. The study materials included 916 patients (females 75%) out of a total of 1,970 diabetes
patients. The patients with increased GFR accounted for 63.3 percent of the total (average GFR
before the project was 55.5 ml/minute, and after project it was 60.9 ml/min); statistical significance
was determined by paired t-test (p=0.001). Staging of chronic kidney disease was reduced to the early
stage. It was concluded that the Diabetes Clinic at Buengkan Hospital had enhanced the condition of
diabetic patients by increasing their GFR and reducing chronic kidney disease to the early stage.


location: , 'Thailand year: 2011 source: HSRI

title: Controversial issues on efficacy of glucosamine

abstract: Objective: The purpose of this study was to review the efficacy and cost-effectiveness of Glucosamine.
Method: A review of meta-analysis, randomized controlled trial with at least 12-month follow-up
in patients and cost-effectiveness analysis of Glucosamine between 2005-2010 was undertaken. The review
did not consider old studies because there was evidence suggesting publication bias.
Results: Compared with placebo Glucosamine was no more effective than placebo (statistical nondifference)
in people with osteoarthritis on WOMAC pain and WOMAC function, RMDQ and EQ-5D
scores also showed no or small effect on narrowing the joint space width. Both generic and innovative
Glucosamine had ICER greater than one time Thai GDP per capita.
Conclusion: Available evidence suggests that Glucosamine has low effect, therefore low cost-effectiveness.
Up until now it is still a controversial issue among prescribers and health insurers, especially the
in the Civil Servant Medical Benefit Scheme that whether it should be included the cost of treatment in
public health insurance system.


location: , 'Thailand year: 2023 source: HSRI

title: Integration Mechanism and Integrated Health Area Management and Service Providing in Pilot Health Areas

abstract: This research is aimed to achieve this following objectives (1) to analyze and design measures to support and drive health area development of pilot health areas (regulatory sandboxes) including criteria/ indicators to monitor operations and evaluate achievement from developments, (2) to monitor implementation of regulatory sandbox measures in pilot health areas with health area teams, (3) to evaluate results from implementing regulatory sandboxes in pilot health area, and (4) to propose proposal to improve rules and regulations to support area health developments to become integrated and co-responsible development mechanism. This is an analytical, operation, and evaluation research with Health Area 1, 4, 9, and 12 as pilot health areas. Research team worked with ministry of public health executives, health area executives, and other related ministry of public health staffs to draft regulatory sandbox proposal to drive health area development in pilot health areas. The regulatory sandbox proposal covered 5 dimensions of health development building blocks which were (1) leadership and governance, (2) human resource, (3) health financing, (4) information and communication technology, and (5) health technology and innovation leading to delivering expected results in solving national level health agendas (Big Rock). Moreover, the research team also designed monitoring and evaluation framework by setting criteria and indicators for monitoring and evaluations adopting Objectives and Key results (OKRs) concept which allowed all relevant sectors from operators to executives to participate in operations, and express their opinions regarding problem solving, and improving overall operations in health area development to more innovative and creative development. Results of regulatory sandbox evaluation are as follows: 1) Comparative Evaluation between Before and After Pilot Health Area Development: It was found that pilot health areas had progresses in several issues which were leadership and governance, human resource management and development, and health financing as measures in the sandbox allowed easier and faster managements. Regarding information and communication technology, all health areas had significant development leading to faster and more convenience services. However, there was no significant progress nor operation that leads to introducing new investments in financing innovation or health technology that could match what was expected in reform purpose. But if we considered overall achievement of having health areas that could absolutely manage within their areas, we concluded that health area succeeded at their beginning phases, and the ministry level push is needed in improving rules and regulations that were obstacles to expected health area management, as well as integrating health policies with other health related agencies which would lead to absolute health area management. 2) Comparative Evaluation between With (Pilot or with regulatory sandbox) and Without (Non-Pilot or no regulatory sandbox) Health Area Development: It was found that Leadership and Governance: Pilot health areas could achieve all targets in this aspect while most of non-pilot health areas were in processes of appointing health area board of directing committees, and health area board of managing committees. However, non-pilot health areas already had their annual action plans which were guidelines of health area operations. Human Resource: Pilot health area’s integrated management and service mechanism allowed pilot health areas to have management tools to solve human resource management problems of each pilot health area, took shorter time, and had flexibility in human resource management, and allocation as health area board of directing committees were empowered to manage human resources in their health areas. On the other hand, non-pilot health areas still faced human resource management problems such as unclear manpower, and unmatched to health context changes in the health areas. Health Financing: All 12 health areas attempted to integrate sources of funds in health management with other health related agencies within health area such as National Health Security Office, Social Security Office, and Local Government Units. This was a key success factor for solving insufficient resources (especially budgets) in the areas as it would allow the health area to implement and emphasize in activities/ projects that could deal with specific problems or respond to health needs in the area. However, even the pilot health areas had measures from sandbox for integrated service providing and management in the area, they could not enhance the pilot health areas to have absolute financing management. Information and Communication Technology (ICT): In general, the pilot health areas had more concrete actions compared to non-pilot health areas as there were electronic patient health record development, health area database system, and digital transformation planning in hospitals in pilot health area. However, there was significant ICT development in Health Area#8 such as R8 Anywhere to connect all patients’ information in the health areas. Health technology and innovation: Pilot health areas had clearer attempts to uplift their service standards, and resource management, as well as more numbers of projects. However, researchers found significant operations in this aspect in Health Area#8 such as One Stop Service, public health developments for those in jails and foreigners. On the other hand, both pilot health areas, and non-pilot health areas still managed under single source of fund (budget), and had not considered having private sector participate in health service arrangement in the health areas, which might not be enough for solving resource scarcity and sustainable health financing within health areas. Evaluation results also indicated that rules and regulations were one of reasons behind problems and obstacles in health area development as it related to status of the health area office, as well as health area administration. In order to find solutions to clear these obstacles, the researchers proposed approaches to improve laws, rules, regulations, and notices to enhance integrated service provisions., and absolute administration in the health areas to achieve targets as follows: 1) Proposal to improve rules and regulations regarding leadership and governance such as Ministry of Public Health Regulation regarding Health Area Establishment for Health Area Development B.E. … 2) Proposal to improve rules and regulations regarding human resource management such as management within health area office, seeking and appointing people, exemption of rules and regulations in management. And 3) Proposal to improve rules and regulations regarding health financing such as allowing health area office to integrate all funds in the area.


location: , 'Thailand year: 2014 source: HSRI

title: Participatory Action Research on the Holistic Care Model for the Elderly

abstract: This is a participatory action research on the Holistic Care Model Development for the Elderly of
mechanisms involving Local Administrative Organizations, sub-district health promoting hospital,
volunteer, elderly, community leader, monks, teachers, caregivers and community people to share their
knowledge with the Mahidol University research team and the local research team in eight sub-districts of
Nakhon Pathom and Kanchanaburi provinces. The process was divided into 6 steps: 1) community preparation
2) the elderly-need assessment 3) Assessment of potential mechanisms 4) Community feedback
5) Additional activity development 6) Public data dissemination.We found that the holistic care model for
the elderly should cover health surveillance and care for the depressed, continuous development of occupation
for the elderly, distinguishing selection in urban and rural areas, coverage of every elderly group,
and the networking mechanism in the community


location: , 'Thailand year: 2019 source: HSRI

title: Trends of incidence and survivals of clipping and coiling for cerebral aneurysm in Thailand and their cost-effectiveness analysis

abstract: This research had two major objectives: 1) to determine incidence, access to treatment and clinical outcomes of patients with cerebral aneurysm who received clipping or coiling procedures; and 2) to examine whether coiling instrument should be included in the reimbursable list of beneficial package for patients under the Universal Coverage Scheme. Although coiling procedure has been performed worldwide, a slightly increasing rate of patients receiving coiling procedure in Thailand was observed during 2012-2018. In addition, increasing rate of patients under the Universal Coverage Scheme receiving clipping was significantly higher than that of those receiving coiling. Since the year 2012, survival rate among patients undertaking clipping was higher than the rate in 2006-2011. This finding did not support the hypothesis that patients receiving clipping had poorer prognosis than those receiving coiling or clipping was performed only in those who were not candidate to coiling. Survival rate of patients receiving clipping in the university hospitals was higher than those in the Ministry of Public Health (MOPH) hospitals and non-MOPH hospitals. Survival rate in hospitals with high volume of intervention (clipping or coiling >30 cases/year) was higher than the hospitals with low volume of intervention. Access to treatment and clinical outcomes varied across the health regions. Collaboration among the health regions to improve referral system for enhancing the service efficiency and patient outcomes should be addressed. Planning for neurosurgery or radiology manpower who have a specialized training for endovascular coiling should be considered, especially in the university hospitals. Based on the societal perspective, incremental cost effectiveness ratio (ICER) of coiling as compared to clipping was cost saving. Therefore, coiling instrument should be included in the reimbursable list of beneficial package for patients under the Universal Coverage Scheme.


location: , 'Thailand year: 2002 source: HSRI

title: The development of hazard surveillance in occupational and environmental health in Thailand

abstract: The objectives of the study were:To develop a model for occupational and environmental health hazard surveillance which focused on agricultural and industrial sectors,To collect data and information regarding occupational and environmental health at provincial level,To identify health hazard information for the development of surveillance system. In addition, all of this information was used to prioritize occupational and environmental health problems at provincial level.The methods of the study were designed to encourage all relevant organization participation. Six provinces, such as Nan, Uttaradit, Ayutthaya, Srakaew, Amnajchareun, and Yala, were invited to join the project.  The steps of the study included data collection and survey.  The secondary data, e.g., general information of province, number of working population, and number and type of factories, were collected from relevant organizations in provinces. After that, a survey of health hazards in agriculture was conducted by local health officers. A self-assessment health book for farmers from Bureau of Occupational and Environmental Diseases was used as a tool to collect the data. The target population was 150 farmers for each province. The sample was taken by cluster sampling from each household of three districts. Regarding the industrial sector, the information about number and type of factories was collected. Only one workplace from each type of factories was chosen to conduct a survey in order to get the information about workplace information, working process, and health hazards. This information including the data from Workmen’s Compensation Fund was analyzed to set up a priority of the problems in terms of type of factories.The results showed that working population among 6 provinces was about ¾ of total population. Most of them are farmers, e.g., 85% in Nan, and 70% in Uttaradit. Almost farmers are rice-farmers. However, the majority in Yala is rubber gardener. Regarding the industrial sector, the data showed that the leading factories were agricultural industry. Ayutthaya was the province where the number of factories and number of workers were highest. In spite of very high number of target population, there are very few numbers of occupational health professionals who can provide occupational health services in all of those provincesThe data from the survey showing that farmers’ health  hazards include  1) heat and sunlight, 2) ergonomic problems and accident,  and  3) unsafe use of pesticide. On the other hand, there were lots of health hazards, especially chemical, in industries. Types of industries that were  the most important for setting up the surveillance were firework factories (Nan), Auto-body and repair shops (Uttaradit), Shoe-making factories (Ayutthaya), wood factories (Srakaew), rice mill factories (Amnajchareun), and wood factories (Yala).In conclusions, hazard surveillance is very essential and important for occupational and environmental health surveillance system. The system can use all secondary data from several sources in province. Apart from that, a field survey is needed to assist in identifying other hazard information. The problems identified by the study included lack of some data, no system for data sharing, low capacity of local health officers in hazard identification, and lack of cooperation among relevant organizations and workplaces. However, the study showed its promising achievement as a first step for surveillance system development.


location: , 'Thailand year: 2008 source: HSRI

title: Factors effecting the social movement of diabetic patient groups in Saraphi district, Chiang Mai province

abstract: Social movement is a way to solve some of the problems of diabetes.  The aim of this
research was to study factors affecting the social movement of diabetic patient groups in
Saraphi district, Chiang Mai Province.  A descriptive cross-sectional survey was done
during the period from October to November 2007.  The study population were 469 diabetic patients in the primary care unit; they had been chosen by the stratified random
sampling method.  The contents of the study were knowledge about social movement,
social network density and frames of social movement.
Findings revealed that the majority had low social network density and inadequate
knowledge about social movement.  About haft of the diabetic patients had progressive
frames of social movement.  The conditions of these factors affected the lack of social
movement. Diabetic patient groups should be developed and supported by adequate
social movement knowledge, resulting in increasing social network density


location: , 'Thailand year: 2022 source: HSRI

title: The management system in private primary health care units for patients with chronic non-communicable diseases at risk of chronic kidney disease

abstract: Introduction: Chronic kidney disease (CKD) is the main health problem in Thailand and worldwide. Patients with CKD can progress to end-stage kidney disease (ESKD) requiring kidney replacement therapy which has high expense and burden to the national health budget. In addition, they have a poor quality of life. The major causes of CKD are diabetes and/or hypertension. There are many interventions, guidelines, and policies to prevent CKD that have been implemented but the number of patients with CKD is increasing leading to an overwhelming workload of healthcare providers especially those who work under public health. The objective of this study aimed to set up system processes of care to prevent CKD in high-risk patients and monitoring method by collaborating with private primary care clinics located in the communities. Methods: The owners of private primary care clinics registered with the National Health Security Office and located in the central part of Thailand were invited to participate voluntarily in the research. After they signed the contract, the healthcare workers in each clinic were trained in processes of intervention to prevent CKD or slow progression of the disease. The healthcare providers in each clinic identified patients with a high risk of CKD, educated them to raise awareness of CKD, invited them to participate in CKD prevention programs which were composed of providing education, counselling to identify individual problem obstructing the achievement to the goal of treatment, positive motivation and empowering them to be able to the self-management to prevent CKD. Each clinic was audited and monitored two times in the pattern of mentoring and coaching. The outcome of patients was determined in the rate of decline estimated glomerular filtration rate (eGFR) compared between pre-and post-intervention. Results: 42 private primary care clinics were participating in this study. The 35 (83.3%) of clinics having patients with diabetes and/or hypertension higher than 100 cases. The number of patients joining in CKD prevention programs at clinics was 847 cases. The ratio of male to female was 397 (46.9%) and 450 (53.1%) cases, respectively. The mean (SD) age of patients was 62.9 ± 10 years (95% confidence interval 62.3-63.6 years). The 66.9% of patients had education levels in illiterate or primary school. 46.4% of patients were unemployed, 31.8% were freelance, 21.4% were private employees, and 0.4% were civil service. Most of the patients were hypertension (51.6%) followed by diabetes and hypertension (40.1%), diabetes (8.1%), and others (0.2%). 46.6% of patients had eGFR less than 60 ml/min/1.73 m2 before starting the intervention. 74% of patients achieved a rate of eGFR decline of less than 5 ml/min/1.73 m2 after 6 months of intervention. Conclusion: The collaboration between the private primary care clinics and academics from the university was successful in setting up the processes of care to delay progression of CKD in high risk patients with diabetes and/or hypertension. They were the main groups of patients in private primary care clinics. In addition, the monitoring method in the pattern of mentoring and coaching was important to get the good collaboration. It would be a strategy to reduce the number of CKD patients, if this model could be expanded to other primary care clinics.


location: , 'Thailand year: 1998 source: HSRI

title: Analysis of outstanding health promotion organizations: lessons of future development

abstract: Analysis of Outstanding Health Promotion Organizations: Lessons of Future Development	This study aims to describe to process and success of various outstanding health promotion organizations include describe their factors and conditions of success as well as recommend for policy and management, and infrastructure for other health promotion organizations to develop their health promotion programs. The study was conducted through quality research  strategies in 4 outstanding health promotion organizations which represent for governmental organization (Health Promotion Centre, Zone1 Bangkhen, Bangkok), private sector (The Unilever Thai Holdings Co. Ltd.), non-government organization (Mission Hospital), and civic group (The Association of Thai Bicycle for health). Most data gathered from interview the organizations’ managers and their staff, and collected from reports and questionnaired the programs participants. The results of this study were found that;1.	Major Characteristics of the 4 case studies:	1.1	Mission Hospital (Private hospital) handles many health promotion activities for their service by the participants have to pay for those services. The hospital has a clear policy to develop and service for health promotion programs. The hospital has readiness for infrastructures, personnel, models which emphasize on holistic approach and practical model under the “NEWSTART” (nutrition-exercise-water-temperance-air-rest-trust) course that has been proved for its success.	1.2	Health Promotion Centre, Zone1 (The Ministry of Public Health) is a governmental organization that respond for research and development of health promotion models. The centre itself has a clear policy and good management strategies and techniques to enhance their staff capacities and emphasize their staff’s health promotion at first. The outstanding research projects of this centre are; LAMAZ, Thai Traditional Exercise for physical therapy Clinic, and Dental Health Model for children.	1.3	The Unilever Thai Holdings Co. Ltd. (Private Sector) emphasize on workers’ health as main policy. Their health promotion program started at “Lever Smoking Free Program”. This program used civic group of non-smokers as major factors to enforce and develop other health promotion activities eg. Selection of new good-health workers who are non-smokers, non-fat personnel, including other six health promotion programs (foods-exercise-emotion-drinks-AIDS-accident).	1.4	Thai Bicycle Organization for Health (Civic group) is a civic health promotion organization which all participants are willing to participate to all activities that have been set up, which then develop to good health and other beneficial public activities.2.	Lessons and Idea from the case studies	2.1	Variety of health promotion activities in different organizations indicates that health promotion belongs to every persons’ life-style and it can be developed and applied to other organization or non-target community.	2.2	These organizations are all freely managed by themselves under difference of their success conditions and readiness which hindrance their systematic development or the holistic development and their broad success. This needed to have a co-ordination organization to make network between each parties in term of policy, strategies, budget, research and development, and exchange of their knowledge and experiences.	2.3	Health promotion policy of an organization is an essential factor for its direction and condition of success. This needs a keen leadership for management and governmental public policy to support the success.	2.4	All these outstanding organizations can be leading organizations for health promotion, however, all these organization still need concrete support from govenmental sector to develop their activities and co-ordination to exchange their technology and other existing resources of thealth promotion development.	2.5	Variety of their health promotion strategies can be applied to other organizations such as development of personal life-skill, practical model, emphasis of the staff health promotion skill as a model, create supportive environment, and making partnership on the same issues etc.	2.6	These should be motivation for the success of any person and organization such as rewards, health bonus for a good health worker, tax-decreasion for such organization, decreasion of health insurance premium etc.	2.7	Governmental sector must have a clear policy and strategies to enforce health promotion issues as social movement to make population concern of good family health, school health, healthy work place, healthy society through mass media systematically.


location: , 'Thailand year: 2021 source: HSRI

title: Cost and Unit Cost of the Top 5 Most Common Diseases Hospitalized to the Queen Sirikit Medical Center, Ramathibodi Hospital in Fiscal Year 2016

abstract: The cost of health service is an important indicator for hospital administrators in making decision for efficient health service provision. The study aimed at exploring hospital care cost and unit cost of the top five diseases of patients hospitalized at the Queen Sirikit Medical Center, Ramathibodi Hospital, in fiscal year 2016. This was a retrospective study from health care provider’s perspective covering patients hospitalized to a special medical ward of a university hospital in Bangkok. Costing data were collected using a standard tool of unit cost analysis categorized by source of expenses, namely labor cost, material cost, and capital cost. Cost analyses consisted of two major processes: 1) hospital cost and 2) cost center analysis using top-down costing method. Top-down costing included four steps: 1) cost center identification, 2) direct cost determination, 3) indirect cost determination and 4) total cost determination. Unit cost analysis of top five diseases was classified by diagnosis upon hospital admission. Results show that the annual total cost was approximately 12,448,667 Thai baht: direct cost and indirect cost was 10,373,889 and 2,074,778 baht, respectively. For the direct cost; the proportions of labor cost, material cost, and capital cost were 88 : 8 : 4. Unit costs of the top five diseases were as follows: neoplasms 19,145 baht/day and 142,769 baht/admission, diseases of the genitourinary system 17,167 baht/ day and 182,710 baht/admission, diseases of the musculoskeletal system and connective tissue 15,495 baht/day and 122,765 baht/admission, diseases of the circulatory system 12,901 baht/day and 144,488 baht/admission, and diseases of the respiratory system 9,414 baht/day and 98,573 baht/admission. Results from this study could be utilized as guidance for cost management by reduction in the unnecessary admission days while maintaining quality. This will provide benefits and efficiency improvements in resource use to Ramathibodi Hospital and clients.


location: , 'Thailand year: 2016 source: HSRI

title: WE ME มีฉัน มีเรา เพราะชีวิต เกี่ยวเนื่องและเชื่อมโยง

abstract: There are a lot of stories in this world
the stories of “distress” and “happiness”:
smile, tear, laugh, tackle, misunderstanding,
uncomfortable, angry, fun, hate, fearful,
disappointed, tying, uncompromising, pround.
There have “fulfilled” a “tastes” life.
if we use our heart to feel the meaning of difference,
create the understanding, delete the judgement,
“autism” is the another perspective of difference,
waiting for the space of understanding and sharing
between us--fellow human beings.
using heart to learn the meaning of differences
and understand each other:
new friends, new thoughts, new lifestyles
from the difference angles.
Let them get inside our space
which is not only or individedly “me” or “them”
but literally our “space” that all of us can live together with equalily.


location: , 'Thailand year: 2011 source: HSRI

title: Patient- Self Reporting System of Adverse Drug Reaction: International Scheme

abstract: The current system of pharmacovigilance is mainly responsible to healthcare professionals for reporting
adverse drug reactions (ADRs) which major concerns are underreporting. Many countries had
initiated patient participation to the direct reporting of ADRs resulting in increased the reporting rate
especially possible new ADRs, non- serious ADRs which affect patients’ quality of life or ADRs which
patients could play an important role in drug safety. Those patient reports provided sufficient and thorough
details of the ADR outcome. However, they could be exaggerated, resulting from the ability to
distinguish between their illness and medications that might cause the adverse effects. Therefore, to
increase the report quality and the effectiveness of pharmacovigilance, the information about drugs and
adverse effects, and encouraging the patients’ awareness of ADR reporting are required.


location: , 'Thailand year: 2017 source: HSRI

title: Self Medication among Thai People by Buying Medicines from Community Pharmacy

abstract: Universal Health Coverage aims to increase access to essential health services to minimize household health expenditure. However, a number of people still do not use services provided under the Universal Health Coverage. These people prefer self-medication by buying medicines from community pharmacy. This research aims to study characteristics of these people and the expenditure for self-medication. Descriptive study design was used. The 2015 Health and Welfare Survey data conducted by National Statistical Office containing 139,848 individual persons were analyzed. Based on the survey, an individual who had at least one time of illness that did not require hospitalization within the last month was identified and then the data about self-medication and out-of-pocket payment were collected. Sampling weight was applied using appropriate statistics to make sure that the dataset could represent all Thai population in all 13 health regions. Findings showed that 27.2% of those who had at least one time of illness that did not require hospitalization had self-medication. The percentage of self-medication of region 7 (37.7%) was the highest compared to other regions. By scheme, the highest rate of self-medication was found in the social security members (35.0%). Rural population had 10.4% more self-medication than urban population. Most of the people who used self-medication strategy were in the lowest quintile and had no underlying diseases. Their symptoms included common cold/cough and running nose (44.4%). The median cost of self-medication was 60 Baht per visit. For patients with underlying diseases, cost was as high as 120 Baht per visit. Factors associated with self-medication should be examined in further studies. Quality development of community pharmacy should be implemented because community pharmacy is still the major source of self-treatment.


location: , 'Thailand year: 2010 source: HSRI

title: Health Promotion Decentralization in Three Countries

abstract: The Ottawa Charter has been adopted in many countries as a model for their health promotion policies which emphasize community participation. Mexico has developed a method for evaluating its
progress in implementing health promotion policies, and has developed a national policy on health promotion,
called Health Promotion Operation Model (MOPS,) which is based on the Charter and consists of
several components: management of personal determinants, health capacity-building, community participation,
development of a healthy environment, social marketing in health, and evidence in health
promotion. Sweden, a welfare state, developed its National Public Health Policy in 2003 with the main
aim of providing societal conditions for good health on equal terms for the entire population. It has 11
objectives which consider only the determinants of health. Interestingly, Pettersson summarized the evolution
of Swedish local authority in dealing with health promotion into “The Health Promotion Staircase
for Building Local Capacity”, which could be beneficial in the development of LAOs in Thailand. In New
Zealand, the Local Government Act of 2002 was passed which clearly defined the roles and responsibilities
of the central and local governments according to the risk-specialization model. Furthermore, to enhance
the role of the community, a long-term council community plan must be developed in line with the
expected ‘community outcome’ in order to improve community living conditions and address their health
concerns.


location: , 'Thailand year: 2015 source: HSRI

title: Oral Health Care Utilization Among Thai Working Age Population in 2013

abstract: The objective of this study was to analyze the utilization of oral health care among Thai working age
population by using database of the Health and Welfare Surveys conducted by the National Statistical
Office in 2013. The surveys covered 27,960 households nationwide. Data were then weighted to represent
the total population. It was found that in overall, 98.7% of working age population was covered by any
health insurance scheme, of which national health insurance scheme (UC) shared 64.8 %. Among those
insured, only 9.3% reported having oral health care during the past year. Regarding area and income, it
was found that Civil Servants’ Medical Benefit Scheme (CSMBS) with high income clients from Bangkok
Metropolitan have the highest accessibility to oral health care of 22.5% compared to those national health
insurance scheme of 7.0-8.5% or 2.7-2.9 times higher. Furthermore, 45% of cases reported abstain to use of
their health insurance for oral health care and even 51.7% for UC scheme. Among UC scheme holders,
84.4% preferred seeking private services. The result reflects the challenge in access to oral health care. It is
necessary to develop measures to increase access to public services with effective and appropriate mechanisms.


location: , 'Thailand year: 2014 source: HSRI

title: Substitutes for Leadership and Organizational Citizenship Behavior of Public Health Officers in Sub-District Health Promoting Hospitals

abstract: This study aims to investigate the association between substitutes for leadership and organizational citizenship behavior of 534 public health officers in subdistrict health promoting hospitals under the inspection of Region 10, the Ministry of Public Health. The sample group was randomly chosen using stratified sampling. Data were collected by using questionnaires. Statistical analysis was performed using the computer program of Pearson’s Product Moment Correlation Coefficient and Multiple Regression. Results revealed that public health officers had moderate organizational citizenship behavior. Substitutes for leadership had a low positive association with the organizational citizenship behavior of public health officers (r = 0.266, p-value ≤ 0.05). Substitutes for leadership could explain 11.90% (Adjusted R2 = 0.119) of the variance in organizational citizenship behavior. To achieve effective substitutes for leadership of public health officers at subdistrict health promoting hospitals, the creation of a self-development manual is suggested for public health officers to develop the leadership and train public health officers at every level, introduce the mentoring system and promote on the job training approach.


location: , 'Thailand year: 2023 source: HSRI

title: Policy Recommendation Synthesis for Nursing Practice Workforce Development: Production, Distribution, and Retention due to COVID-19 Pandemic

abstract: The purpose of this mixed-method study was to synthesize policy recommendations on nursing workforce development: production, distribution, and retention during the COVID-19 pandemic. The quantitative data were collected from 396 samples through the questionnaire on actual and expected workforce retention operations due to the COVID-19 pandemic. The qualitative data were collected from 120 subjects through in-depth interviews. The findings were as follows: 1) Pre-pandemic situations of production, distribution, and maintenance of nursing workforces relied on the production plans of educational institutions. The teaching style and the distribution of nursing profession were based on big hospital setting, and the maintenance of nursing workforce as a whole was inappropriate to workload. 2) During the pandemics, the production plan did not change. However, a variety of functions and skills needed to deal with changing situations were delivered through on-line and in class to learners to solve the skill shortage problems. The movements of trained nursing workforces to cover high nursing care needs at the primary, secondary and tertiary levels of field hospitals in the community up to the intensive units in hospital. Retention measures were found in various compensation plans appropriate to the increased burdens and risks. 3) Post-pandemic policy proposals for nursing workforce were on the production, distribution, and maintenance. On the production side, long-term production plans should take account of the actual needs of the country’s health service system. In terms of distribution, there should be a review and planning the distribution of nursing staff in health care facilities at the ministry level, regional health systems and health care facilities at all levels systematically to have appropriate number of workforces according to geographical contexts, population health needs and levels of nursing services complexity. In terms of workforce retention, guidelines should be developed for building nurses morale and motivation.


location: , 'Thailand year: 2012 source: HSRI

title: Why don’t Chiangmai people in need call emergency medical service?

abstract: Background: Acute illness and accidents are the leading cause of death in Thailand. Developing a
good systematic pre-hospital care can help reducing morbidity and mortality. To achieve this goal, the
Ministry of Public health has issued a policy for all hospitals in Thailand to set up an Emergency Medical Service (EMS) system. Nevertheless, this service system is not widely acknowledged in Chiang Mai. Most
of the patients did not use the service and go to the hospital by themselves Objective: To determine reasons
of underuse of Emergency Medical Service in patients visiting the Emergency room, Maharaj Nakorn
Chiang Mai hospital. Methods: This was a prospective observational study by means of questionnaires
filled by the patients or anyone accompanied them to the emergency room, Maharaj Nakorn Chiang Mai
hospital. Only 3 level of triage was used; level 1-Resuscitation, level 2-Emergency, and level 3-Urgency.
This study was conducted during the period from March to October 2011. Analysis was made by dividing
participants into 2 groups; patients coming to the emergency room by themselves, and the ones coming
by using EMS system. Results: There were 102 participants; 64 coming by themselves and 38 using EMS.
There were 44 traumatic patients, and 58 non traumatic patients. 4 participants were of triage level 1
Resuscitation, 42 of triage level 2 Emergency and 56 of triage level 3 Urgency. Sex, degree of education and
occupation were not related to EMS activation. Many reasons accounted for this problem; 64.1% of the
patients had their own vehicles, 50% did not know of the service, and 25% thought that their symptoms
were insufficient to activate EMS system. People in Chiang Mai learned of the EMS system through many
advertising media, in sequentially billboards, television, and radio programs. Conclusion: The reasons of
underuse of EMS system in Chiang Mai were: unknown of existence, failure to recognize the importance,
and doubt in the Emergency Medical Service systems.


location: , 'Thailand year: 2022 source: HSRI

title: The Development of the Community Health Management Models During the Post-Crisis of the COVID-19 Pandemic for Village Health Volunteers in the 5th and the 6th Health Regions

abstract: This study applied the research and development model aiming to propose policy recommendations for community health management approaches during the post COVID-19 crisis management for village health volunteers (VHVs) under the New Normal Medical Services policy. Both quantitative and qualitative data were obtained from the sample groups during the post COVID-19 pandemic, which consisted of the VHVs and the groups of stakeholders participating in community health management practices in both health regional zones 5 and 6. Samples were categorized using the Social Ecological Model-based study methodology as a framework. This comprises five levels; 1) Intrapersonal Factors are the collection of elements within the VHVs that influence behavior or performance abilities. These include knowledge, attitude, and skills or KAS of VHVs; 2) Interpersonal Factors or the environment surrounding VHVs that impacts their work performances, such as peer groups, patients and family members of the VHVs, reflecting their satisfaction towards VHVs' work performance with community participation; 3) Community Factors refer to community capitals including social, human, physical, financial, and natural capitals assisting VHVs in carrying out their duties efficiently in collaboration with community stakeholder groups, such as community committees, the District and the Subdistrict Quality of Life Development Committees in each neighborhood; 4) Organizational Factors refers to factors in sectors where the VHVs works or is associated and is related to the command or control lines. These include various key performance indexes (KPIs) with many groups of stakeholders including subdistrict health promoting hospitals, district and provincial health offices, the Provincial Communicable Disease Committees and inspectors of both health regional zones; and 5) Global Crisis and Policy refers to situations at home and abroad that impact other nations throughout the globe, including the public policies declared by governments. Stakeholders are top executives of the Ministry of Public Health from the Department of Health Service Support, the Department of Disease Control, and the Department of Medical Services. Data were collected between July 2021 and February 2022. Intrapersonal and Interpersonal Factors data gathering utilized both quantitative and qualitative data collecting methods. With regards to community, organizations, global crisis conditions and public policy factors, this study used semi-structured interviews to obtain qualitative data. According to the findings, the structure of the VHV prior to the COVID-19 pandemic consisted of the following four categories: 1) project writing and implementation, 2) health promotion and disease prevention, 3) use of health information technology, and 4) community leadership and participation. After designing a model to develop a handbook for VHVs, community health managers in post-crisis management, the responsibility of the VHVs in the fifth component was determined to be crisis management after the COVID-19 pandemic. It will be required for VHVs in the future to be able to deal with the context of future public health issues that are complicated and transnational.


location: , 'Thailand year: 2008 source: HSRI

title: Efficacy of Counseling on Self-care Behavior of Diabetic Patients with Fasting Plasma Glucose over 140 mg/dl

abstract: The objective of this quasi-experimental study was to determine the effects of counseling
on self-care behavior among diabetic patients in Nongpok Community Hospital,
Roi Et Province. The subjects included 30 diabetic out-patients with a fasting plasma
glucose level > 140 mg/dl who were selected by purposive sampling from those attending
the diabetic clinic and agreed to participate in the study. They received counseling on
self-care issues in respect of food modification, treatment and drug use, foot care, emotional
control, prevention of complications, and proper exercise. Data on self-care behavior,
fasting plasma glucose, and body mass index were obtained from the participants
before and three months after the program ended. Percentage and mean were used for
descriptive analysis; Pearson’s correlation, chi-square test or paired t-test were used to
determine the association between data before and after the program.
The results showed the mean scores of self-care behavior following the counseling
program were significantly higher than those obtained on commencing the program, and
the levels of fasting plasma glucose were significantly reduced after the counseling program.
The body mass index of the patients, however, remained unchanged. Counseling
on self-care behavior may be advocated for use in diabetic patients.


location: , 'Thailand year: 2007 source: HSRI

title: Development of a HIV-counseling System for Couples at the Antenatal Care Unit of Chun Hospital and Health Centers in Chun District

abstract: HIV-counseling for couples considering voluntary counseling and testing (VCT) is
very important in HIV prevalent areas. This research was carried out in this belief with
the objective of incorporating the counseling system into health centers and increasing the coverage of HIV counseling to more than 80 percent of couples. The work conducted
in the period 2004 -2006 covered 703 pregnant women and their partners who visited the
Antenatal Care Unit at Chun Hospital and health centers in Chun district, Phayao Province.
The results show the success of developing the counseling system so that it can be
incorperated into all health centers during the three successive years (2004-2006). The
coverage of couple HIV-counseling increased to 74, 94 and 89 percent, respectively. The
HIV infection rate in the pregnant women decreased to 1.8, 1.5 and 1.3, respectively. Moreover,
among 11 discordant infected couples with different blood mates, one couple was
evidently infected by each other. No infected born baby was born to these couples during
the period of study.
HIV couple counseling was very useful in protecting against the HIV epidemic; it
encourageed HIV-positive persons to join the system. The service at the Antenatal Care
Unit was suitable for inducing couples to be interested in HIV screening. Distributing the
service among the communities served by health centers was very important since it
made people feel very comfortable to take the service. Moreover, strengthening followup
programs and launching proactive public relations campaigns would produce more
success.


location: , 'Thailand year: 2022 source: HSRI

title: Thailand Environmental and Policy Level Physical Activity Interventions: A Critical Review

abstract: Increasing physical activity brings various benefits, not only preventing premature mortality and saving health care expenditure from non-communicable diseases, but also strengthening social solidarity, reducing social inequity, and improving quality of life. Environmental and policy-level interventions for physical activity are promising population-level interventions, however, the number of studies on those interventions were limited in the lower- and middle-income countries. Therefore, this study aimed to assess the existing environmental and policy interventions in Thailand for the future direction of the intervention design and development. A systematic scoping review was conducted in the primary databases (PubMed, Scopus, and Web of Science) and domestic secondary databases. To gain more understanding of the local context, 77 provincial administrative organizations’ strategic plans were further retrieved and analyzed by using the critical interpretative synthesis method. From the systematic review, 11 out of 1,681 studies were included. The results found that evidence on the active environment and active policy physical activity interventions in Thailand were limited in number and diversity, and were rather in sports facilities than physical activity. Infrastructures and urban planning for active transport were seen as a significant facilitating element by adults, while recreational amenities were the most essential factor in improving the elderly’s quality of life. At the local level, only nine provinces out of 77 invested in bicycle pathways, and 16 provinces invested in green spaces, while 42 provinces focused on sports facilities. Policy communication and translation at the local level on a comprehensive concept of physical activity, a collaborative platform between the Ministry of Public Health and Ministry of Interior to provide physical activity implementation, public communication, and routine policy evaluation should be prioritized. Further studies on physical activity policy designs for specific age groups of people were recommended.


location: , 'Thailand year: 2011 source: HSRI

title: Global Warming and Human Pathogens

abstract: Global temperatures have risen at a faster rate in the last 50 years than at any other time since
records began to be kept in 1850. The hydrologic cycle will be altered, since warmer air can retain more
moisture than cooler air. Some geographic areas will have more rainfall, some more drought and severe
weather events including heat waves and storms. The term “climate change” is now preferred over
“global warming.” Because of rising temperatures and changing rainfall patterns, increased burdens of
vector-borne and zoonotic diseases as well as water-borne diseases have been recognized. Infections of
dengue, chikungunya, malaria, West Nile virus, Lyme disease, plague, cholera, campylobacter and
salmonella cause emerging and re-emerging diseases. It is clear that climate change endangers human
health and that good systems for surveillance and preparedness are needed


location: , 'Thailand year: 2000 source: HSRI

title: Goal and Guideline for Developing Information Technology System for Public

abstract: According to the present constitution, the standardized and efficient health information service through information structure is the one required for the public equally.  The information infrastructure that is an alternative for providing public health information consists of three network; telephone, cable TV, and internet.The research team considered four alternatives in providing health information to the public using telecommunication technology and the internet.  The four alternatives were: Information service via Web site (one-way communication via internet), Consultation service via Web board (two-way communication via internet), Information service via audiotex (one-way communication via telephone), and Consultation service via audiotex (two-way communication via telephone).  The target group of the first two alternatives was teenagers, media, working people, doctors and public health officers whereas that of the last two alternatives was major population of the country.The study showed that the unit cost of the four alternatives in the year 2005, ranging from the least to the most, was Information service via Web site, Information service via audiotex, Consultation service via telephone, and Consultation service via Web board.  The difference in cost depended on three factors: frequency of using services, the necessity of using staff to provide information, and the cost of supporting equal information to all target groups.Before providing services to a full scale, it is recommended that the Ministry of Public Health (MoPH) evaluate the outcomes of each service provided at present as to how beneficial it is to the public, whether the service is provided right to the target group, and what the problems/obstacles are.  The MoPH should also play an important role in carrying out or promoting the services using three guidelines: providing direct services by the responsible unit, supporting the community in providing services, collaborating with private sectors and media, as well as developing network similar to Canadian Health Network and apply it to best suit the Thai situation.


location: , 'Thailand year: 2008 source: HSRI

title: Outcomes of the prevention of the mother-to-child HIV transmission project in Naknon Ratchasima province : 2003-2007

abstract: A study of the outcomes of the Prevention of Mother-to-Child Transmission Project in
Nakhon Ratchasima Province was aimed at assessing the achievements of 29 government
hospitals in the period from October 1, 2002 to September 30, 2007, and determining strategies for improving the effectiveness of the project.
This study follows a descriptive epidemiological study design. Secondary data on pregnant women attending antenatal clinics and giving birth at those hospitals, together with
the outcomes of children born to HIV-infected mothers during fiscal years 2003-2007, were
analyzed by the Epi Info V. 3.3.2. descriptive statistics program.
The percentage of pregnant women who were tested for HIV increased from 97.1 percent in 2003 to 99.7 percent in 2007. The HIV-positive rate among pregnant women peaked
in 2004 at 1.2 percent before declining to 0.8 percent in 2007. Women giving birth had relatively stable HIV infection rates (0.6-0.8%). However, the proportion of pregnant women
with HIV- positive status who received antiviral drugs (AZT) rose from 86 percent to 100
percent in the period from 2003 to 2007. Those who received AZT for at least four weeks
increased from 72.7 percent in 2003 to 91.9 percent in 2007, while the remainder received the
antivirals for fewer than four weeks. Newborn babies receiving AZT also increased from
46.2 percent to 78.4 in 2007.
The surviving babies had been monitored for HIV infection until reaching the age of
18 -24 months and the follow-up rates rose from 73.5 percent in 2003 to 81.6 percent in 2007.
Every baby (100%) was provided with infant formula powdered milk before leaving the
hospital. The rate of loss to follow-up decreased from 35.3 percent to 18.4 percent during the
period 2003-2007. The main reason was change of address (87.5%), followed by guardians
not wanting to know the HIV status of their child (12.5%). Among those infants whose
blood was available for HIV testing, the HIV-positive rate was highest in 2003 at 6.4 percent
(9 cases), then the number of HIV-positive infants decreased to 5 (2.6%), 6 (3.7%), 2 (1.6%),
and 1 case (0.7%), respectively, during the period 2004-2007.
Conclusions: Overall, the Prevention of Mother-to-Child Transmission Project in fiscal years 2003-2007 successfully achieved its objectives and was implemented at all government hospitals in Nakhon Ratchasima Province. The outcomes of the project improved during that period. The percentage of mothers and infants who were tested for HIV and received antiviral drugs increased and resulted in a drop in maternal HIV transmission in the
province. Given the significant decline in the trends of the HIV infection rate among children aged 18-24 months, the project achieved the national target of lowering maternal HIV
transmission below 6 percent.


location: , 'Thailand year: 2019 source: HSRI

title: Unit Cost of Services in Primary Care Cluster

abstract: The objective of this study was to estimate unit cost of services providing at the primary care cluster (PCC). Four PCCs including two urban and two rural were selected. This study was retrospective study using data from fiscal year 2017 and some data from 2018. Data on financial, services and staff workloads were gathered. Then, unit cost per activity and the unit cost per capita were calculated based on activity-based costing. The result showed that labour cost was the highest cost component in the PCC followed by material cost, whereas, capital cost was the lowest. Material cost in urban PCC was higher than in rural PCC. In addition, average unit cost per capita was 1,025.21 baht. It should be noted that all PCCs in the present study were in the stage of implementing and improving services in order to benefit their people. Therefore, the results described unit cost of initial stage of operation in the PCC.


location: , 'Thailand year: 2001 source: HSRI

title: Pattern of substance use in high school students : a high school study in Ubonratchathani

abstract: Pattern of Substance Use in High School Students: A High School Study in Ubonratchathani.The objective of this research is to study pattern of substance use in high school students; including alcohol, cigarette, and amphetamine especially. The factors associate to such behavior, progression of use, consequence, and management of substance use problem from the school were explored. The methodology of the study was a qualitative research. The study site was a high school in Ubonratchathani province, by purposive selection. Key-informants were the students who had experience in substance use or exposed to the user, and the teachers who were advisor of students. Data collection was done from August 1999 to February 2000, by in-depth interview (student 10 cases) and focus group discussion (teachers, 2 groups/18 cases). Then, the data was analyzed by content analysis method.	For the key-informants, the student group, the substance use began from alcohol drinking and then cigarette smoking in a short period of time, between grade 7-9. The use of amphetamine came later, depend on the exposure opportunity to the user and participation with the user group. The pattern of use was similar in each key-informant; initiate from group participation, expose to peer or sibling whom experienced of use, and then ask to try or encouraged by peers. Continue of use was follow because of pleasure and group participation. The significant factor associated with substance use, especially amphetamine use, was their own while the others were influence indirectly; such as social and school environment, family role and status, group participation, and availability of substance. And the factors associated with lowering of use or abstinence were intention of themselves and/or peer group to quit, avoidance from the user group, difficulty in drug seeking, less of money, appearance of the police in school and urinary testing for substance use. These factors influenced frequency of use by the time. However, among high school users, recreational or occasional use with regular use at times were the majority of them.	Among the user, it was no significant impact while taking alcohol and/or cigarette. But in case of amphetamine, there were both behavioral and physical changes when the frequent of use was increase. Behavioral changes might be delinquent or problem behaviors in school, alter school performance, use much more money, and lie their parents. From their viewpoint, physical changes were transient and no significant to worry about it. And no psychiatric sign and symptom or disorder was appearing. In opinion of student group, although alcohol drinking or cigarette smoking seems to be a part of adolescent life, but amphetamine use was only individual behavior.	When the situation about substance use in high school to be asked, the key-informants said that alcohol drinking and cigarette smoking initiated in grade 8, amphetamine use by smoking appeared in grade 9, the user rate increased in all type of substances between grade 10 and 11, and then decreased in grade 12. The favorite substances in boys were alcohol, cigarette, and amphetamine; while in girls were alcohol, amphetamine, and cigarette respectively. And evidence of inhalant or glue was not found in last 1-2 years.	About programs against substance use problem in school such as campaign or education, there were not interested and less participation from the user group and not influence their substance use behavior. In addition, it was no other action plan or relevance program from the school while the policy and strategy were not clear defined.


location: , 'Thailand year: 2021 source: HSRI

title: Situation analysis and requirement of health manpower at primary care level during the situation of COVID-19 pandemics

abstract: For disease control such as COVID-19, limiting the spread of epidemics is an important activity. Parts of activities are the roles of primary care or health centers in the area including contact tracing and active care finding. The objective of this study is to develop the methodology to assess the workload of health personnel at primary care in the normal situation and in the COVID-19 pandemics situation in order to identify human resource capacity and gap at primary care level for defending COVID-19 at different levels of epidemics. This study assessed the workload for 6 types of health services by analyzing the related databases and estimating average time of service using previous study and discussion with 9 health centers in 3 provinces. Subtraction of total working hours for 4 types of health personnel including doctor, nurse, public health technical officer, public health officer by service workload (6 types of services) and workload for community services and others (2 hours per person per day in average) was done. The remaining working hours were used for estimating capacity of COVID-19 control activities, in this case, the highest number of contact tracing and active case finding that can be performed in one day at health center level, district level and provincial level for the whole country (except Bangkok). The result of the study showed that in case of using 50% of remaining working hours after subtraction by the existing workload (6 services workload and community workload), there are about 85% of provinces that can perform 2,000 – 8,000 cases per day of contact tracing or active case finding. At district level, there are about 75% of districts that can perform 200 – 800 cases per day. At health center level, there are about 75% of health centers that can perform 20 – 80 cases per day. These figures are based on service data between January and June 2020 which was the first round of COVID-19 epidemics. The result reflects that health centers have different capacity (flexible working hours) for defending epidemics. District level seems to be more flexible and manageable to mobilize human resources within district for not severe epidemics situation and provinces can cover higher volume of active case finding per day. Therefore, the surge capacity plan should be developed at district and provincial level for mobilizing human resources within area in the situation of epidemics.


location: , 'Thailand year: 2017 source: HSRI

title: Utilization of Dental Services in Thailand: Results from Health and Welfare Survey 2015

abstract: This study used health and welfare survey 2015, national household survey, to explore pattern
of dental service utilization including use of health insurance, and expenditure among Thai population
in order to improve national policies related to dental services. The results showed that (1) 8.1
percent of Thai population received dental services in the past 12 months. More than 80% of dental
services were dental treatment. Thus, dental health policies should focus more on dental prevention
and promotion. (2) Main reasons of unmet need were no time to get the services and long waiting
time. So, the dental health service providers should be expanded. (3) Different access to dental services
associated with different health insurance schemes. The dental services should be harmonized
among health insurance schemes in particular payment methods, and benefit package and points of
service. Also, criteria, quality control, scope of services and payment mechanism should be considered.


location: , 'Thailand year: 2009 source: HSRI

title: Potential and Readiness of Tripartite Member Concerning the Development of the Community Health System in 12 Sub-districts

abstract: This research study concerns the situation, potential and readiness of local government organizations,
communities and networks of health service units at the primary health care level which work in partnership
for local health. It is aimed at bring about improvements in the direction of and the role played by networking
of the tripartite members of the community health system. The study emphasizes the process of both the quantity
and quality approaches. The selection of the study area was made using the purposive method, with the
distribution being two provinces each in four regions of Thailand. They were included in both the primary area
with regard to their experience with the transfer of the mission of primary health care units to local government
organizations and with the cooperative efforts of 12 sub-districts. The method of this qualitative study involved
the use of a questionnaire with guidelines for interviews and focus group discussions, all of which had been
passed and tested by professionals. With regard to the study of the potential and readiness of local government
organizations, a scale was set up concerning the criteria and use of descriptive analysis.
The study resulted in significant information on the situation, capacity, and readiness of the network of
health services relating to policy dimensions and the system of support for health service providers, which still
has an incomplete structure, especially at the provincial level. However, at the district and sub-district levels,
the clearing structure has worked more effectively in some of the study areas with regard to the principles or policies governing the transfer of the health service mission to local government organizations in a different
manner. The number of health service providers, their capacity regarding knowledge, and their experience,
including duration of work, all have had a positive impact on their work as partners because, while individual
relationships are important, the supporting system still lacks capacity for the development of more effective
health officers working in communities and local areas. However, most health personnel possess understanding
regarding the management and use of information; they can report on the level of the working unit more
effectively than use the information for planning to solve problems at the area level. The capacity and the
readiness of individual communities were found to depend on the variety, role, and strengths of the community
leaders and the development groups within those communities. This observation includes the level of acceptance
of health service units and the local government organization in the area concerned, as well as the focus on
management, and bringing about good governance. Concrete negotiations on health from the community level
are still limited, particularly with regard to funding. The capacity and the readiness of the local government
organizations regarding the structure of the health system in most of the study areas varied by specific unit of
management capacity. The entire study unit was accepted by the communities with regard to the local politics.
However, the ability to obtain local revenues and generate income differs according to the size of each organization.
For expenses on health development in those areas, each obtains a little over 6.6 percent of the total
expenses from the study area. It was found that participation in the universal health insurance coverage scheme
in these areas was still limited, with regard both to policy setting in the area in order to extend the coverage to
all people in the areas concerned, involvement in providing and purchasing health services, including service
monitoring and practice management.
Important suggestions arising from the study as it concerned the health service network and communities
comprised the following: (1) support is needed for learning more about the local mechanisms for working
cooperatively for health; (2) improvement in capacity-building should be promoted in each sector clearly and
continuously according to their capacity and ability; (3) a mechanism and support system should be developed
such as a management system, and information system for planning, and implementing, and for monitoring
and evaluation.
Other suggestions called for (1) modifying the development goal regarding the transfer of the responsibility
for providing health services to the local government organizations in order to promote the concept and
process of partnership development among those in the health sector, local government organizations, and
community; (2) advocating policy mechanisms and organizational management at the district and provincial
levels for developing public policy on health, as it relates to social marketing and public communication on
health; (3) supporting clear and continuous capacity-strengthening measures for local governments, such as
databases developed to cover interesting case studies, and organizing appropriate activities for improving the
learning process on networking issues in all sectors.


location: , 'Thailand year: 2023 source: HSRI

title: Development of a Transgender Medical Health System

abstract: Introduction: Transgender people are well recognized in Thai society nowadays and need specific care. There are challenges in the transgender medical health system in Thailand. Aims: This study aims to assess the current situations of a transgender health care service from providers' and patients’ perspectives and to evaluate the effect of a gender-affirming hormone therapy on health in general, mental health and sexual transmitted diseases in order to provide recommendations to improve the transgender medical health system in Thailand. Methods: The study is divided into 4 sub-studies. The sub-studies 1, 2, and 3 assessed the effects and complications from hormone therapy on general health, HIV and sexually transmitted diseases (STI), and mental health among Thai transgender people. The sub-studies 4 assessed the current situation of the health care system through panel discussions. Results: The hormone therapy effectively induces body changes in all transgender people. Complications in transgender men include elevated systolic and diastolic blood pressure, elevated uric acid levels without gouty attack, elevated hematocrit levels, and a decline in the glomerular filtration rates. There is no effect on liver function and blood sugar. In transgender women, decreased blood pressure was found without adverse effects on liver function, blood sugar, uric acid, and lipid profiles. There is no HIV or STI in this study. However, there is a low rate of protection in sexual activity among transgender men, and hepatitis B immunity is low among transgender people. Regarding mental health, there is a trend of higher depression and anxiety scores but improved gender dysphoria, attention deficit, and internet gaming disorder scale. The assessment of the current Thai transgender health systems demonstrated several barriers and challenges from providers' and patients’ perspectives. The main issues include unsupported laws involving the fundamental right, discrimination, access to medical care, health care insurance regarding gender-affirming treatment, funding for developing transgender clinics, education for medical providers, mental health care, health data gathering, lack of support for the transgender community and transgender law. Summary: Transgender people have specific physical and mental changes with gender affirming hormone treatment. Most are consistent with international data, apart from the minimal decrease in depressive and anxiety scores, which should be monitored closely. The medical professional should recognize the changes along the treatment process. Several barriers in transgender care are present from providers' and patients’ perspectives. Therefore, a strategy supporting the development of transgender clinics should be designed to ensure that transgender people receive high-quality care without discrimination.


location: , 'Thailand year: 2017 source: HSRI

title: Development of health management model for Thai-Melayu elderly with hypertension based on community participation in Southern Thai culture

abstract: This research and development aims to study current situations and associated factors of health
management and needs for model development in health management among the Thai-Melayu elderly
living in the South of Thailand. The participation action research (PAR) was conducted using qualitative
and quantitative research. The sample of 149 participants recruited into the study were 33 elderly people
being diagnosed with hypertension, 33 care givers of those elderly, and those who involved in the care
for those elderly including 2 health public officers taking care of the patients with hypertension, 3 health
public offices working for the Sub-district Administration Organization (SAO), 3 political members of SAO,
20 religious leaders, 10 village leaders, and 45 village health volunteers. The interviews and focus groups
were used for collecting. The content analysis was used to analyze the qualitative data.
Finding revealed that the needs and community participation in health management in Thai-
Melayu elderly with hypertension included; 1) religious leaders providing health education for the elderly
people, 2) visiting home by the religious leaders to encourage the elderly patients, 3) health education
for the community to reduce sweet, salty, and fatty foods 4) providing the place for exercise, 5) setting-up
the home visit system by village health volunteers , and 6) having a village leader to carry-on the
activities for elderly in the community.
Based on the qualitative data, the researchers developed the guideline to promote health
management among the elderly having hypertension and found that post intervention, the average score
of health management, at higher level, (X = 4.30 S.D = 1.08) was higher than that of pre-intervention
(X = 3.87 S.D = 1.21), at the same higher level. However, it also discovered that the lowest average scores
were found in the following dimensions: reducing high fat diet, and deep-fried foods or stir-fried meals
X= 2.4 S.D= 1.29, X= 3.26 S.D = 1.46, respectively.
The results showed that after receiving health management the systolic blood pressure (SBP) and
diastolic blood pressure (DBP) were also significant lower than pre-receiving the health management at
the level of P< 0.001 and P< 0.05 respectively but there was no significant difference in body weight,
waistline, and body mass index (BMI).


location: , 'Thailand year: 1999 source: HSRI

title: Development of Indicators for the Achievement of consumer protection on health products according to the Eighth National Socio-economic Development Plan

abstract: Development of indicators for the achievement of consumer protection on health products according to the eight National Socio-economic Development planThe objectives of this research were to develop reliable and valid set of indicators measuring the effectiveness and fairness of the health consumer protection activities as well      as to develop tools to evaluate the practicality and of the designed indicators prior to their application. This activity is in accordance with the Eighth National Socio-economic      Development Plan (1997-2001) on the Consumer Protection on Health Products. Sets of indicators were developed and subject to test of their validity and reliability in the field. Thus, the working group set the guideline of theoretical indicators. Suggestions from the chief of health consumer protection and pharmacy all aver the country of 76 provincial health offices regarding the indicators via questionnaire were made, after that brainstorming the stakeholders in health consumer protection and carried out empirical indicator. Then setting the questionnaire to test validity and reliability by health officers and health volunteer groups in twelve districts, of four regions and retest by consumer groups in Anything province. Effectiveness and fairness were the two areas of the seven sets of indicators which had been found. The reliability was between 0.6784 and 0.9754. The effectiveness indicators had four sets; skill to know how to consume (11 items), known how to develop themselves (8items), quality of products (8 items) and proper distribution of products (10 items). The fairness indicators had three sets; fair price (8 items), equality (10 items) and product liability (3 items). Tools for measuring were questionnaires, survey and data  collection from.


location: , 'Thailand year: 2023 source: HSRI

title: New Normal Emergency Stroke Care System in Public and Private Hospitals during COVID-19 Pandemic

abstract: Background and Rationale: This research and development aimed to review, develop, and evaluate the new normal emergency stroke care system in public and private hospitals during the COVID-19 pandemic. Methodology: A research and development methodology was employed using system implementation form and semi-structured interviews for evaluation. Participants included 40 individuals, comprising 10 acute stroke patients exhibiting symptoms outside the hospital, 2 heads of accident and emergency departments, 4 emergency department physicians, 20 emergency department nurses, and 4 emergency medical workers. Results: The developed system unfolded in three phases. (1) Pre-hospital care phase integrated telemedicine for on-scene patient care, addressing the imperative of preventing COVID-19 infection, and transportation to the hospital systems. (2) Care phase in the emergency department with rigorous COVID-19 infection screening protocols and diligent patient care. (3) Patient in-hospital transfer phase needed a heightened focus on infection prevention and patient isolation during the transfer process. The new normal emergency stroke care system diverged significantly, emphasizing patient isolation, mandatory mask-wearing for patients, utilization of personal protective equipment by healthcare teams, a cautious approach to administering the blood thinner rt-PA (recombinant tissue plasminogen activator) to COVID-19 patients displaying severe symptoms, and enhanced monitoring of patients receiving rt-PA, with the potential inclusion of telemedicine to mitigate exposure risks. Summary: Ninety-nine percent of the samples agreed on the suitability and practicality of the new system’s content and procedures. The new normal model would serve as a robust safeguard for patients and healthcare staff alike, but with an increasing time-to-treatment. Suggestions: To maintain the quality of care, all healthcare staff involved in stroke care must receive comprehensive training on the new system.


location: , 'Thailand year: 2011 source: HSRI

title: Diabetic Disease Management Comparison among Community Hospitals in Ubonratchathani

abstract: Background: Evaluation of the diabetic management programs among community hospitals is not
comparable. Therefore, it is recommended to use data analysis from EMRs in evaluating diabetic care in order to drive the quality of diabetic care at the community hospital level. Objective: To compare and evaluate the process and clinical outcomes of diabetic care. Method: EMRs from the period 2006-2009 were
retrieved from 18 community hospital database systems to evaluate the process and clinical outcomes of
diabetic care. The process of care was measured as having received at least one clinical lab test each year.
Data were encoded for patient confidentiality. Results: Process of Care Quality of the diabetic care process
increased from 2006 to 2009. The proportion of patients who received at least one HbA1c lab test, CHO,
TG, HDL, LDL, UA and Scr were determined in 3.95%, 37.85%, 39.80%, 29.40%, 34.14%, 17.61%, and 65.98%
of patients in 2006, respectively. These numbers increased to 26.55%, 56.09%, 59.30%, 52.07%, 57.52%,
32.15%, and 66.52% in 2009, correspondingly. Outcomes of care: Compared with 2006, the proportion of
patients who had LDL<100 mg%, TG <150 mg%, HDL ≥40 mg% were 39.53%, 32.88%, and 19.30% in 2009
respectively. In 2009, however, the proportion of patients whose HbA1c<7%, FBS 90-130 mg%, BP ≤130/
80 mmHg decreased to 25.63%, 11.55% and 12.01%, compared with 31.40%, 11.86% and 20.47% in 2006,
correspondingly. Conclusion: Although the process and some clinical outcomes of diabetic care improved
from 2006 to 2009, other clinical outcomes decreased. Proactive diabetic management programs should be implemented to enhance diabetic control.