location: , 'Thailand year: 2011 source: HSRI

title: Policy Analysis for Response to and Preparedness for an Avian Influenza Pandemic and/or Influenza in Thailand

abstract: Since 2005, a national strategic plan aimed at controling and preventing a future avian influenza (AI)
pandemic and/or outbreak of influenza in Thailand was established as a policy measure to tackle these
public health threats. The objective of this paper is to study the formulation process of two policy measures
for AI: vaccination of poultry and stockpiling of antiviral drugs for humans.
We used a qualitative approach with in-depth interviews of 38 key stakeholders from many organizations.
In addition, a literature review was carried out along with the interviews. After collecting data
from the literature and the in-depth interviews, we analyzed the emerging themes relevant to the policy
formulation process in Thailand.
We found that policy formulation concerning poultry vaccination is a very complex and politically
driven process since many stakeholders are involved with different special interests and powerful influences.
Small-scale poultry producers representing rural people are the ones who would rather use vaccine,
because non-vaccine measures, such as culling or using bio-security buildins and measures, are against
their rural culture. However, the majority of key stakeholders were against the use of poultry vaccine.
There are four major reasons: (a) evidence of vaccine effectiveness is not convincing and thus a public
health threat remains possible; (b) the government has confidence in the infrastructure needed to fight AI
outbreaks with non-vaccine measures; (c) the management system of vaccination (acquisition of goodquality
vaccine, finance, logistics, monitoring and exit program) is not fully effective; and (d) the government
implicitly wants to protect the poultry export industry. Thus, the government decided not to use
poultry vaccine.
Contrary to the poultry vaccine policy, building stockpiles of antiviral drugs for use in humans is
determined primarily by experts at the Ministry of Public Health, following World Health Organization
guidelines, but under budget constraints. Other factors relevant to policy analysis are: government leadership,
budget constraints, animal and human health co-ordination, scientific evidence and risk communication
for the public.


location: , 'Thailand year: 2001 source: HSRI

title: Informal working conditions and health problem : a case study of industrial home-based work

abstract: Informal Working Conditions and Health Problem:A Case Study of Industrial Home-Based Work At present, most of informal jobs employed in Thailand are mainly in the group of manufacturing industries.  The majority of these informal jobs are putting-out system, i.e., the subcontraction some parts of the manufacturing work to private homes.  As a consequence, the health of the workers in these home-based industrial work is at risk.  The case study of these informal jobs are bronze work, seed-making, fishing-net, hand-weaving, garment and gem-cutting	The result of studies found that the manufacturing process of these industrial works cause the health hazard to the workers and their family members as well as some environmental damage of their communities.  The level of health risk ranging from the highest are the following: bronze work, seed-making, fishing-net, hand-weaving, garment and gem-cutting.  In regard to the health problem, most of the workers’ illness are believed to be due to the working condition.  Most significantly, the result from the diagnosis of some doctors reveals that these industrial work are dangerous to the workers’ health and are the main cause of the illness of their family workers.	Aside from the health problem, another interesting point is that these home-based industrial workers have to invest on their own capital expenditure but earn lower wage than the minimum wage rate.  They have to face the health problem without the responsibility of their employers.  Therefore, the best solution in to set up a health insurance system for these informal home workers.  The system which is run by the community organization.  Their employers and the government have to share the responsibility.


location: , 'Thailand year: 2023 source: HSRI

title: Emergency Medical Service: A Case Study of the Local Government Administration Ban Tad Subdistrict, Mueang District, Udon Thani Province

abstract: This action research aimed to develop and evaluate the emergency medical service (EMS) in the local government administration Ban Tad subdistrict, Udon Thani province. The research was conducted during December 2021 - June 2022. Three target groups included: 1) 34 participants in academic group; 2) 23 participants of the local government administration; and 3) 388 people of Ban Tad subdistrict municipality. Three research processes were conducted: 1) exploration of the EMS problems; 2) development process; and 3) evaluation by using qualitative in-depth interview and focus group discussion. Data were analyzed descriptively by percentage, average, standard deviation, and by inferential independent t-test. It was found that the development of emergency medical service improved people’s knowledge on the EMS call center (before and after implementation p-value = 0.001). The EMS workforce’s time performance improved significantly after development (p-value < 0.05). The preparedness of resources for EMS operations improved from 96.4% to 99.4% after development. In conclusion, the Ban Tad local government EMS development success required indispensable cooperation from all parties.


location: , 'Thailand year: 2017 source: HSRI

title: กรณีศึกษา แนวปฏิบัติที่ดีในการดำเนินการตามกุญแจ PLEASE สู่การเป็น RDU Hospital

abstract: The objectives of Research Project in Development of Rational Drug Use (RDU) Hospital include: (1) to support the hospitals which join the RDU Hospital Project to achieve its goal by having a plan for concrete and effective actions based on the key advice P-L-E-A-S-E, (2) to strengthen the network of hospitals within the same geographical area, and (3) to support central tools in the implementation process of the hospital and network. The participatory action research (PAR) has been used to emphasize participation and action of local personnel and administrative team in 6 networks in the northern, northeastern-upper and lower, southern, central-eastern areas and the University Hospital Network (UHosNet). The suitable approaches are analyzed through the
 self-assessment of the hospital, network, and the performance indicators at the end of the project. Good practice and advice will be shared with the collaborators, stakeholders and hospitals continuing the RDU Hospital Development along with the central supporting tools. The key findings of the projects conducted within the two-year period (10/2015 to 9/2017) can be summarized as follows: (1) In cooperation with the hospitals and networks, several good actions were recognized in each aspect of the key advice P-L-E-A-S-E, which enable us to collect, recommend and distribute the report as a KM book; (2) Results of the performance indicators revealed improvement of the RDU Hospital processes and outputs in most hospitals, even if the targets are not reached in some metrics, thus imply the project success; (3) The key success factors are identified as the support of the executive team, multidisciplinary joint collaboration and the clear national policy. These also include the importance of networking of which results
 showed that more members of well-established network submitted the key performance results at the end of the project; and (4) Collaboration at multiple levels were established to develop a single and unique patient information drug leaflet in the country, that will be linked to Mobile Application ‘RDU รู้เรื่องยา’ to improve the nation's health literacy in medication for Thai people. Major impacts of the research project are (1) its utilization as the development for the 15th Ministry of Public Health Service Plan started in the budget year 2017, (2) its acceptance as one of the tools being used for the healthcare accreditation process (the subjects of pharmaceutical and therapeutic committee and medication safety), (3) its support for the RDU Core Curriculum for healthcare undergraduates, and (4) its involvement to promote the adoption of 2016 Ethical Criteria for Medicinal Drug Promotion Thailand.


location: , 'Thailand year: 2015 source: HSRI

title: Reviewing Anesthesia Service Rate of Government Hospital for Reimbursement in Civil Servant Medical Benefit Scheme

abstract: The rate of payment or reimbursement for health care services has been used by The Comptroller
General’s Department (CGD), Ministry of Finance of Thailand in Civil Servant Medical Benefit Scheme
since 2006. This rate does not comply with the cost of medical care services and the advancement in
medical technology. The Executive Committee of the Civil Servant Medical Benefit Scheme has resolved
to improve that public health service rate. Thus, the Health Insurance Research Office (HISRO) has been
assigned the responsibility to reviewing the reimbursement rate for health services. This review will bring
about several recommendations and modifications that are aimed to reduce the financial burden of the
reimbursements on revenues and control the costs of the drugs used. The existing reimburse rate that is
inconsistent with the operating costs.
Qualitative and quantitative analysis were used to discuss on the current data of anesthesiology
category. The first step was to conduct a focus group discussion with experts from 10 hospitals (Hospitals
under Ministry of Public Health, Ministry of Defence and Hospital Medical School) and The Royal College
of Anesthesiologists of Thailand. The second step was to consider the related items and then collected
and analyzed cost structures consist of labor cost, material cost and capital cost.
The results indicated increasing units of two services, anesthesia services and equipment usage,
from the period of 2006 to 2014. In anesthesia service, there were 8 items in 2006 and it had increased to 13
items in 2014. Meanwhile, the equipment usages cost was increased by 10 items from 6 items in 2006 to 16
items in 2014. In terms of structure cost, there are three highlighted findings. First, the total direct cost
structure equals to the sum of labor cost, material costs and capital costs. Second, the administrative cost
is accounted for 25 per cent from total direct cost. The updated price is derived from the full cost (total
direct cost structure plus 25 percent overhead). Third, the future development cost composed of the sum
of full cost and 5 percent of full cost.
The evidence suggested important findings in terms of Anaesthetic time records, at average of 1,342
hours. The average labor cost for an anesthesiologist was 11.68 baht per minute and 6.34 baht per minute
for a nurse anesthetist. In terms of material cost, the combination of anesthesia care and the basic material
used in the opening line, cost started from 1,053 baht. The equipment costs started from 490 baht per total
Anaesthetic time per 5 years. The ratio of direct cost, labor cost: material cost: capital cost by General
Anesthesia (GA), is estimated at 37:43:20, meanwhile the General Anesthesia for Complicated patient
(GA (C)) ratio is estimated at 49:35:16. Regional Anesthesia (RA) first-hours service in sequence is estimated
at 52:21:27 and Local Anesthesia with Monitored Anesthetic Care (LA with MAC) in the first-hours
service is estimated at 62:5:33.
In conclusion, this above mentioned figure of the cost structure reflects the actual cost in present
year, 2014. Labor cost recorded as the highest expenditure. However, additional cost can be requested
when necessary. It is suggested, the expensive equipment has to be separated from basic instruments and
form into new item. In addition to that, it is important and necessary to build comprehensive data for
hospital cost to improve the public health service rate. Lastly, the study recommends that the systematic
data collection and real-time data record have to be made.


location: , 'Thailand year: 2007 source: HSRI

title: Vegetables and Fruit Consumption Patterns among Thai Population across Four Regions and the Metropolitan Thailand National Health Examination Survey III

abstract: The objective was to examine vegetables and fruit consumption patterns
among Thai population across four regions and Bangkok.  This study was a part
of the National Health Examination Survey III in Thailand conducting between
2003 and 2004.  A total of 39,290 individuals aged ≥ 15 years were interviewed by
using a set of questionnaire including information on sociodemographic and
vegetables and fruit consumption.  Employing descriptive statistics, Wilcoxon
rank-sum test and Kruskal-Willis test at 0.05 level of confidence.  The findings
demonstrated that overall, an individual had average frequencies of vegetables
and fruit consumptions equal to 5.97 and 4.56 day per week, respectively.  Individuals living in the Central and Northeastern regions had the highest number of
days per week for vegetables consumption, while those living in Bangkok had
the highest number of days for fruit consumption.  On average, numbers of
servings of vegetables, fruit, and both vegetables and fruit consumed a day were
1.78 (median = 1.14), 1.46 (median = 1.00), 3.24 (median = 2.86), respectively.
People in Bangkok ate more vegetables, fruit, and both vegetables and fruit than
those in other regions.  There were significantly differences in median number of
days per week and the amount of servings per day for vegetables and fruit consumed across four regions and the metropolitan (p< 0.05). Proportion of individuals who met the recommendation for vegetables, fruit, and both vegetables
and fruit consumptions were 26.9 percent, 35.4 percent, and 26.6 percent, respectively.  In conclusion, frequencies and amount of vegetables and fruit consumptions in Thai people varied by regions of residence. Majority of Thais had an
inadequate daily amount of vegetables and fruit consumption.


location: , 'Thailand year: 2019 source: HSRI

title: Health Promotion Activity in Hospitals – A Systematic Review of Systematic Review

abstract: Reorienting health services to be more engaged in health promotion is a key health promotion
strategy that is widely accepted. The strategy has been implemented in Thailand. However, the scope
of health promotion work by Thai hospitals and its related functions were hardly known.
This research project explored health promotion activities in the hospital settings. It identified systematic
reviews of health promotion using PubMed database.
There were 10 systematic reviews that met the inclusion criteria. The reviews of health promotion
activities included body mass index monitoring during clinical consultation, individual exercise encouragement,
diet control, quit smoking and drinking, program to help release carers’ stress, and risk reduction
interventions among mental health patients.
This systematic review of systematic review can be beneficial for health promotion management
at each organization. The information can help expand work and research on health promotion activity
in hospitals in the future.


location: , 'Thailand year: 2013 source: HSRI

title: Rapid Assessment of National Civil Registration and Vital Statistics Systems: A case study of Thailand

abstract: Vital statistics provide essential information for monitoring the progress towards achieving the United Nations
Millennium Development Goals (MDGs). Well-functioning and reliable civil registration and vital statistics systems (CRVS
systems) are not only needed for national development, monitoring and evaluation systems, but also for organizations
to plan and manage their operation and programs. Well-functioning civil registration systems are the best data source
for reliable vital statistics. However, more than half of the countries around the world do not have CRVS systems or, if
they do, they do not function well. The United Nations (UN) and the World Health Organization (WHO) recognize and
are aware of this issue and are facilitating member countries to evaluate and improve their CRVS systems.
In 2011, WHO and the University of Queensland, Australia, developed a standard tool called, “Strengthening practice
and systems in civil registration and vital statistics: A Resource Kit ”, in order to strengthen CRVS systems. WHO and
many UN organizations, such as the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP),
encourage and assist member countries to use this tool.
CRVS systems have existed in Thailand for many decades, but have not been systematically evaluated. Therefore,
an assessment was a key step to understanding the status of the current system and identifying areas that need
improvement. The Thai Health Information Standards Development Center (THIS) and other key stakeholders, such as
the Ministry of Public Health, National Statistics Office, and Ministry of Interior, came together to evaluate the CRVS
system using the WHO Rapid Assessment of National Civil Registration and Vital Statistics Systems tool.
This report outlines the methodology and findings from this rapid assessment. It contains three main sections: chapter
one describes the background and history of Thailand’s CRVS system; chapter two describes the assessment objectives,
the tool and evaluation process; and the final chapter provides an analysis of results and recommendations.
It is hoped that the assessment will be informed Thai policy makers, administrators and others involved in CRVS of the
system’s strengths and weaknesses and hope to gain their support for further improvment system.


location: , 'Thailand year: 2007 source: HSRI

title: Screening Service for Diabetics and Persons at Risk of Diabetes in Bangmunnak District, Phichit Province

abstract: The practice of the Bangmunnak-Dongcharoen Health Network in carrying out the
policy of preventive control of diabetes mellitus had been by screening patients and high
risk groups using capillary blood glucose levels greater than 110 mg/dl.  Such persons would
be sent to the hospital for conventional diagnosis.  However, this process created considerable inconvenience as a result of overcrowding with attendees; satisfaction dropped and
attendees missed the opportunity to obtain important knowledge about nutrition and exercise.  The author thus created a model for the screening of diabetics and persons at risk and
for providing knowledge by a multidisciplinary team at the health center.  The model could
be used for evaluating the satisfaction of the attendees, comparing mean scores on their
knowledge about nutrition and exercise before and after education and demonstration, and
evaluating the satisfaction of the health officials with such a model.
The study was carried out at seven health centers in Bangmunnak district, Phichit
Province.  The target population included persons 40 years old and older who had a fasting
plasma glucose level higher than 110 mg/dl.  The sample group was tested for knowledge
about nutrition and exercise (pre-test).  Then education and a demonstration was given by a
doctor, nutritionist and physiotherapist. Post-testing was done, and the satisfaction of the
sample group and health officials was evaluated. The results of the study showed that 77
persons were included in this study: 29 cases were diagnosed as diabetics, and 48 cases were
in the impaired fasting glucose group. Most of the cases studied were in the age group 41-50
years and 51-60 years.  The ratio of females to males was 3.8:1.  Average body weight was
63.56 kg, average height was 154.98 cm; the average was 28.74 kg/m2
and 37 cases (48.05%)
had a BMI of 25 kg/m2
.  The sample group was satisfied with the education and demonstration.  Overall satisfaction was 100 percent and most of the studied group was satisfied with
every step.  The cost of travel was reduced by 7.5 times compared with travel to the hospital.
The mean score of the pre-test for knowledge about nutrition was 7.74/10.  After education,
the mean score increased to 8.94.  The mean score of the pre-test for knowledge about exercise was 7.34/10.  After education, it increased to 8.44.  A significant difference (tested by
paired t-test) in knowledge about nutrition and exercise of the sample group before and
after the education program (p < 0.05) was observed.  The result regarding the satisfaction of
the health officials showed that all the health officials were satisfied with the model (100%).
The results of the study showed that screening, coupled with education about nutrition and
exercise by a multidisciplinary team, can make the attendees more comfortable, economically safe, satisfied with less crowding and able to achieve significantly higher scores on
knowledge about nutrition and exercise.  The officials concerned were satisfied about the
education and demonstration aspects.


location: , 'Thailand year: 2011 source: HSRI

title: High-risk Medication use in Thai Elderly Patients: Case Study in Wangtaku Subdistrict, Nakhon Pathom

abstract: The high-risk medications used in the elderly is a pressing problem that is a concern in many countries
around the world. However, in Thailand there is still lack of studies related to this issue. Therefore,this study was aimed at surveying the high-risk medications used in the elderly at Wang Taku Subdistrict,
Nakhon Pathom based on the criteria for high-risk medications used in the elderly of Winit-Watjana W. et
al. The data of this cross-sectional study were collected by surveying and interviewing the elderly. Of 118
elderly, 72.9 % were female. Average age was 72.63 ± 5.25 years. Most medical problems found were
hypertension, (76.3%). Of 421 drug items, 92 items were high risk medication use or 0.78 item per patient.
The findings revealed 79 drug items with potentials to cause adverse reactions; 11 drug items with drugdisease
interactions and 2 drug items with drug-drug interaction. After analyzing each subgroup, angiotensin
converting enzyme inhibitors (out of 34 drug items) was mostly found in causing adverse reaction
and non-steroidal anti-inflammatory drugs (16 drug items) were subsequently found. In drug-disease
interaction subgroup, hypertension/heart disease (9 items) were found to be the most, and the other 2
items were gout-hydrochlorothiazide (HCTZ) and asthma/ COPD-benzodiazepine. The last subgroup,
drug-drug interaction, aspirin with NSAIDs and digoxin with HCTZ were found. Results of this study
can be used to develop a guideline for advising and monitoring high-risk drug use.


location: , 'Thailand year: 2015 source: HSRI

title: Performance Assessment of District Health System in Tak Province

abstract: Performance Assessment of District Health System in Tak Province.The aims of this study were
to assess of the provincial and district committee level,in 9 district of Tak province. ), which will assess
the compliance of the project in the context ,input, process, output and outcome .Using the model CIPP
Model of Stoughton Waffle Beam. (Stufflebeam's CIPP Model ) Data were collected and analyzed by
quantitative method with descriptive statistics.
The results showed that the context of each area with the integration of technical development in
areas already include self-assessment. The district health system Using a model planned community with
quality development, including the development of quality guidelines HA PCA standard and are used for
process-driven application development, network management services, process know-how. The
knowledge from routine to research. The input policy, budget, personnel, equipment showed that.
Commented that there is a consistent level. The process Issue Rating Is the process of implementation
Tracking supervision and evaluation The samples of the opinion that there is consistency in the level of
output of the sample is of the opinion that there is a consistent level of results, the sample is of the opinion
that there is a consistent level. The development of district health network. The collaboration at the district
level were moderate consensus. Providing essential health The samples of the opinion that there is a
consistent level. The sharing and development groups. Commented that there is a consistent level. The
involvement of community groups. Commented that there is a consistent level. And the value of work
Sample Commented that there is a consistent level.


location: , 'Thailand year: 2018 source: HSRI

title: Prediction of pre-eclampsia in advanced age pregnant women by using uterine artery Doppler  combination with maternal serum fms-like tyrosine kinase (sflt-1) , placental growth factor ( PlGF)  and pregnancy- associated  plasma protein-A (PAPP-A)

abstract: Objective To study the prediction of pre-eclampsia in advanced age pregnant women by using  of uterine artery Doppler combined with serum sflt-1,PlGF and PAPP-A. Method The prospective collective data study was conducted at antenatal care clinic Thammasat University Hospital. The pregnant women with age above 35 years old with  gestational age between 18-24 weeks were recruited. The clinical risk factors were recorded. Uterine artery Doppler was performed at the same time with measurement of  serum markers. The occurrence of pre-eclampsia and obstetrics outcomes were followed and recorded. All data was analyzed. Results The total enrolled pregnant women were 296. Only 276 pregnant women have  complete  information to analyze.  5.43 percent (15 pregnant women) had pre-eclampsia while 94.57 percent (261 pregnant women) had no pre-eclamptic symptoms. The baseline characteristics of both groups including age, body weight, body mass index, parity and history risk of pre-eclampsia were not statistically significant different. In pre-eclamptic group has higher percentage of  abnormal uterine artery Doppler compared to non pre-eclamptic group (26.67%, 4/15 vs 16.48%, 46/261) but no significant different (p= 0.31). The ratio of sflt-1/PlGF in pre-eclamptic group were higher than non pre-eclamptic group ( 8.60 +4.79 vs 8.09 + 5.24) but no statistically significant different (p= 0.71). MoM( Median of mean )  of PAPP-A in pre-eclamptic group was  less than  non pre-eclamptic group but there is also no statistically significant. The logistic model was generated to predict  the risk ratio of pre-eclampsia. The abnormal uterine artery Doppler has risk ratio (RR) 1.78, while the ratio of sflt-1/PlGF above 14 has RR  2.54. The MoM of PAPP-A less than 0.5 has RR  2.5 , respectively. Combination of these factors has prediction value for prediction 64.62%. Conclusion The combination of these factors could not be used  to predict the occurrence of preelcampsia in advance age pregnant women . However, the  incidence of preeclampsia in our study was lower than expectation , the larger sample size might be needed to verify this benefit.


location: , 'Thailand year: 2012 source: HSRI

title: Determination of 2010 Reimbursed Drug Price and Its Budget Impact in Public Hospitals in Thailand

abstract: Total drug expenditure for Civil Servant Medical Benefit Scheme (CSMBS) has rapidly increased.
Reference pricing (RP, or maximum reimbursable limit) for drugs is proposed as a means to control drug
expenditure. The objectives of this study were to determine the RP of five high expenditure drug groups
and estimate the budget impact of RP implementation. Prescription records of 29 public hospitals in 2010
were collected. Drug utilization and several RP’s of each drug product were determined. Then, overall
budget impact was determined for RP under three different scenarios.
Results showed that there were 1.7 million prescriptions, accounted for 2.5 billion baht. By drug
group, total number of prescriptions were 39.96%, 26.25%, 16.57%, 13.68% and 3.55% while total expenditures
were 44.65%, 20.43%, 20.59%, 4.47% and 9.85% for statins, Proton Pump Inhibitors (PPI), Angiotensin
Receptor Blockers (ARB), Angiotensin-Converting Enzyme Inhibitors (ACEI), and Bisphosphonates
(BIS) respectively. Brand name drugs accounted for 94.8% of expenditures but 50.6% of prescriptions. If
RP was implemented, the highest savings (50.39% of expenditure) would be from pharmacological substitution
(eg. price of Atorvastatin is equal to median price of generic Simvastatin). Generic substitution
(median price of generic for brand Simvastatin) would result in 20.56% savings while 15.91%-17.26%
savings would be achieved if brand drugs were reimbursed at cost plus 50 or 30 baht dispensing fee per
item respectively.
Use of high price, brand drugs has burdened the overall drug expenditure of government hospitals.
Reference pricing would encourage generic drug use and thus, help not only to control overall expenditure,
but also strengthen the local manufacturing drug industry.


location: , 'Thailand year: 2010 source: HSRI

title: A Flower in the Storm: A Case Study of a Woman Who Faced Repeated Family Violence

abstract: The purpose of this qualitative research study was to explore the incidence of repeated violence and
patterns of resistance. The main data were collected from in-depth interviews, participatory observation
and a document review. The research questions were: (a) what is the context of the cultural and power
relationships in which the repeated violence exists, and (b) how is the meaning of the experience and the
suffering of the abused the fault of the community?
It was found that the process of repetitious violence in the family caused resistance to social norms,
but it was the only way that the individual could have reacted in view of the power structure.
The findings reveal the patterns of resistance that occurred under the terms of the context of violence
that went against the social norms; it might be the only way that the individual could have reacted under
such conditions.


location: , 'Thailand year: 2019 source: HSRI

title: Immediate effects of foot massage and foot exercise on renal blood flow and heart rate variability in the elderly

abstract: Currently, the number of patients with chronic kidney disease is increasing. The main problem in chronic kidney disease patients is the reduction of blood flow to the kidneys, causes the insufficient blood supply to the kidneys. As a result, the accumulation of waste in the body due to the renal function excreted less waste from the body. It leads to a gradual decline in kidney function. In the elderly, it is found that blood flow to the kidneys decreased. The purpose of this study was to compare the effects of renal blood flow and heart rate variability before bed rest, after bed rest, and after the trial in the elderly. The 41 healthy elderly volunteers were divided into three groups: foot massage group (14 persons), foot exercise group (14 persons), and control group (13 persons). All of them were received bed rest for 15 minutes, then got a foot massage or foot exercise or bed rest for 15 minutes. Volunteers were measured for renal blood flow and heart rate variability for 3 times and 24-hours urine analysis was measured before and after the trial. The results found that renal blood flow and 24-hours urine analysis were not significantly different from the pre-treatment and no difference between groups. In massage group found that the standard deviation of the normal-to-normal intervals (SDNN), the square root of the mean squared differences of successive normal R-R intervals (RMSSD), and low frequency (LF) were significantly increased (p<.05). In foot exercise group found that SDNN and RMSSD were significantly increased (p<.05). And the control group found that only RMSSD was significantly increased (p<.05). However, there was no difference between groups comparison. Conclusion, the foot massage, the foot exercises, and bed rest could increase the heart rate variability by increasing the activity of the parasympathetic nervous system. But it does not affect the renal blood flow.


location: , 'Thailand year: 2009 source: HSRI

title: Global Warming and Malaria

abstract: The global temperature has increased by 0.74 ± 0.18 °C (1.33 ± 0.32 °F ) during the past century. The
same period has seen an increase in natural disasters and disease outbreaks. Reviews of the evidence of
links between climate change and human health suggest that a warmer climate could result in increases in
mosquito-borne diseases like malaria due to increased reporting of malaria cases in temperate climates
and malaria epidemics in upland areas. Within the range of survivable temperatures, warmer temperatures
reduce the duration of the extrinsic cycle of malaria parasites in mosquito vectors. Therefore, higher
temperatures should result in higher rates of malaria transmission. Mathematical-model estimations suggest
that more deaths will be attributable from malaria. However, during the past decade, the number of
malaria cases has not changed markedly, with 300-500 million cases per annum and > 1-3 million deaths.The complex natural history of malaria transmission involves interactions between humans, anopheline
vectors, and malaria parasites. Many different factors influence these three primary components, including
climatic, ecological, environmental, socio-economic and human behavioral factors. Thus, malaria transmission
may not simply be affected only by global warming; the relative importance of all the factors
involved should be considered jointly. Measures to control malaria–developing new preventive methods,
improving diagnosis, more effective treatment should all be encouraged and supported. An analysis of
the impact of global warming on malaria has implications for the effects of global warming on other
disease outbreaks, i.e., that they may not occur, or if they do, they may not be as serious as some predict.
However, disease surveillance systems must be closely monitored by epidemiologists if global warming
persists. There is an urgent need for ongoing public debate regarding what, if any, action should be taken
to reduce future global warming, and the development of more holistic information about the epidemiology
of disease in this context.


location: , 'Thailand year: 2022 source: HSRI

title: Developing a Model of a Primary Care System for Provincial Administrative Organizations (PAOs) and an Action Plan for Inter-Agency Collaboration and Citizen Engagement: Cases of Suphanburi Provincial Administrative Organization and Prachinburi Provincial Administrative Organization

abstract: In Thailand, the devolution of subdistrict health promoting hospitals to provincial administrative organizations (PAOs) depends on the readiness and willingness of each PAO. In Fiscal Year 2022, six PAOs took full responsibility of all the subdistrict health promoting hospitals in their provincial areas: Khon Kaen PAO, Nongbua Lumphu PAO, Mukdahan PAO, Prachinburi PAO, Roi-et PAO, and Suphanburi PAO. This study sought to develop a model of primary care for the PAOs that possess limited revenue streams and have agreed to take charge of all the subdistrict health promoting hospitals. A strategic framework for citizen engagement and intersectoral collaboration in primary care was also formulated for these PAOs. The research instruments used in this study included focus group discussions, in-depth interviews with primary care experts and local government scholars, workshops, and a survey of subdistrict health promoting hospital personnel and health volunteers in Prachinburi and Suphanburi provinces. Based on the research findings, Prachinburi province has more administrative capacity and social capital than Suphanburi province. Administrative capacity and social capital enabled the Prachinburi PAO to manage the transition period much more effectively. The Prachinburi PAO executives and leaders in the provincial health system followed the “shared leadership” style, while their counterparts in the Suphanburi province used the “paralleled leadership” style. Also, the PAO and provincial health authority in Prachinburi had a more robust working relationship prior to the devolution of subdistrict health promoting hospitals. When we used the “six building blocks” concept and the “ten building blocks of a high-performing primary care” concept to assess the two PAOs’ readiness to run their primary care systems, we found that the Prachinburi PAO performed better than the Suphanburi PAO in terms of service plans, personnel, medicine, information system, financial resources, and leadership and governance. In the end, we developed a model of primary care, which consists of the primary care management unit within the PAO Public Health Department, as well as three alternative models of primary care operations at the sub-provincial level. In addition, policy recommendations for other PAOs, the Ministry of Public Health, the Decentralization Commission, and the Department of Local Administration Promotion were offered.


location: , 'Thailand year: 2013 source: HSRI

title: Population-based Screening for Tuberculosis in Thailand

abstract: Tuberculosis is a serious contagious disease in Thailand due to high prevalence and incidence. Population-
based screening guideline has not been well established although chest x-ray figures in an annual
checkup program for the Civil Servant Medical Benefit Scheme (CSMBS) without evidence for effectiveness
or cost-effectiveness. The purpose of this article is to review and provide recommendations for population-
based screening for tuberculosis in Thailand through a systematic review and stakeholder discussion.
Analysis of clinical practice guidelines and experts’ opinion found no value for screening in the
general population. Disease detection was 0.05-0.7 case per 1,000 films and the cost per case-detection was
$8,000. Moreover, 30% of extra-pulmonary tuberculosis had normal chest x-rays. The screening should be
conducted only in high risk groups or symptomatic patients, whereas the general population should be
educated on the disease in risk reduction.


location: , 'Thailand year: 2007 source: HSRI

title: Chronic Renal Failure in Patients under the Universal Coverage Scheme : From Database for Fiscal Year 2005

abstract: The objective of this study was to assess the situation of in-patient care for chronic renal failure
patients under the Universal Coverage Scheme. The in-patient claim database for fiscal year 2005, compiled
by the Central Office for Health-care Information, was used for the analysis. All admissions with ICD-10 codes compatible with chronic renal failure were included.
There were 45,326 chronic renal failure patients who accounted for 83,734 admissions (1.84 admissions
per patient) in 929 hospitals. The average length of stay was 5.4 days. Fifty-six percent of patients
were female, with the average age being 63.9 years. One-third of the patients had multiple admissions and
95 percent had multiple morbidities. The most common diagnoses were related to hypervolemic problems
or infections. Blood transfusions were the most common treatment procedure . Hemodialysis and
peritoneal dialysis were performed on a number of the admissions even though they were not covered by
the benefit package. Total hospital charges were 917 million baht (median 4,845 baht per admission).
Approximately 82 percent of the patients were discharged with clinical improvement; the fatality rate was
9.84 percent (4,462 deaths). The validity of data was the major limitation regarding diagnostic and procedural
coding, hospital charges, and discharge status. The patient demographic information was quite
valid.


location: , 'Thailand year: 2004 source: HSRI

title: A review of measures and policies on gender and AIDS in Thailand

abstract: The study aims to a review of measures and policies on gender and AIDS in Thailand The author would like to propose that from the beginning, the management of the spread of HIV/AIDS and interest around AIDS issues has been characterized by social bias towards marginalized groups, such as gays, prisoners, drafted soldiers, drug users, women in prostitution, laborers who are considered by society as lower class, and women, who, in patriarchal society, are considered the inferior sex.  The role of middle class men, especially white men, as husbands and partners in the spread of HIV/AIDS is typically overlooked (whether intentionally or through the prejudice inherent in the structure of patriarchy).  A great number of men engage in promiscuous sexual behavior and fail to protect themselves, and may in fact be considered a large group with high-risk behavior. Although twenty years have passed, the state still hasn’t made a serious effort to address issues involving this group.  This is despite the fact that data shows that more than half of the people infected with HIV/AIDS are women who have had a sexual relationship with only one man their entire lives, which should be a good indicator of where the problem lies.  	Education around and/or responses to the HIV/AIDS pandemic must include consideration of the importance of sexuality and related issues. because the biological conditions of women make them more susceptible to infection.  It’s because the socially constructed context of gender disempowers women socially, culturally, economically, and politically and makes infection from men easy and with severe impacts.  Social constructs of gender have led hundreds of thousands of women to become infected and hundreds of thousands more to take on the burden of caring for both male and female family members who are infected.The unequal power relations between developed and developing nations places science and technology under the control of Western scientists who adhere to mainstream patriarchal ideology.  Smaller states tend to reproduce these patriarchal structures and accept the world economic order in the era of globalization.  This makes trans-national corporations able to control access to the medicine and vaccines necessary to prevent and treat AIDS. Under developed or developing countries are not able to handle the problem alone due to its magnitude and the economic power and capacity required to access knowledge and information.  The lack of clarity around the origins of AIDS leads to further problems.  Scientists outside the mainstream both in and outside the West come up against barriers in transmitting information and research findings in wider circles.  There is little or no space for natural or alternative methods of treatment and prevention within the larger global media. Knowledge and information concerning women, AIDS, and gender on individual, family, and community levels, as well as among NGOs, groups of people living with AIDS, government, and inter-government agencies, is still quite lacking.  It is necessary to work together at every level to conduct wider research and create discourse on the body of knowledge to be used as a conceptual basis to advocate for the equal rights, creativity, and sustainable development necessary to ensure the human security of both men and women.


location: , 'Thailand year: 2008 source: HSRI

title: Treatment of HIV-infected and AIDs patients with antiretroviral drugs at Somdetpraboromrachineenart hospital, Nathawee district, Songkhla province

abstract: Combination antiretroviral therapy has proved to effect lower morbidity and mortality
rates among HIV/AIDS patients. However, the effectiveness of continuing patient care is also important. Therefore, evaluation of treatment to improve the management
system is needed. This study was aimed at evaluating the effectiveness of triple therapy
with antiretroviral drugs by comparing CD4 cell counts, opportunistic infection rates during
treatment, side effect and adherence to treatment.
The patients’ data were retrospectively obtained from patient records. The patients
were those who came for treatment at Somdetpraboromrachineenart Hospital, Nathawee
district, Songkhla Province from January 2003 and April 2008. None of the patients received
treatment previously. CD4 cell count, body weight before and after treatment
were compared and analyzed by Wilcoxon signed-rank test.
There were 46 patients who met the criteria for treatment, but complete data were
available from 42 patients, 23 were male and 19 were female, 17 had AIDS, and there were
16 symptomatic and 9 asymptomatic HIV-infected patients. The results of treatment revealed
that CD4 counts after six months in all groups were significantly increased compared
with those before treatment. Side effects occurred in 10 patients, 8 with rash, 1 with
lipoatrophy and 1 with increased SGPT level. None of the patients developed opportunistic
infection after six months of treatment until now. Almost all (39 patients) showed
good adherence to treatment.
The study concluded that triple therapy with GPO-VIR in a middle-sized community
hospital gave good results. An effective management system that helps patients to
adhere to treatment and continuing evaluation is an important factor.


location: , 'Thailand year: 2009 source: HSRI

title: Monitoring of Physical Deterioration of Drug Products In Government Hospitals

abstract: The Bureau of Drugs and Narcotics, Department of Medical Sciences, conducted a five-year longitudinal
study that monitored the physical deterioration of drug products in 829 hospitals nationwide,
supervized or owned by the Ministry of Public Health, as well as some other hospitals in Bangkok,
between 2003 and 2008. The study encouraged healthcare professionals to voluntarily observe and report
defects or physical deterioration problems found in marketed drug products, available in government
hospitals. A total of 2,407 reports were gradually received. The results revealed the major problems: 37.1
percent of the total reports were related to container and packaging defects, 14.5 percent of which were
chipped, cracked, or splitting tablets, followed by discoloration or abnormal odor (11.5 percent) and suspected
product contamination and/or labeling concerns (6.2 percent). In terms of dosage forms, 47.4
percent were tablets, whose major issue was incomplete/missing amounts in original packages. The
percentages for other forms, including injections, solutions, capsules and inhalers, were also included.
Finally, the information regarding the physical deterioration of drug products obtained from this study is
helpful for healthcare providers in making decisions on product selections and for the quality assurance
of drug schemes, as well as for use in identifying standards in pharmaceutical development.


location: , 'Thailand year: 2000 source: HSRI

title: Social organizations and developments of the community : a case study of the community of Tambon Nakha, Amphoe Vapipathum, Mahasarakham province

abstract: Social Organizations and Developments of the Community: a Case Study of the Community of Tambon Nakha, Amphoe Wapipathum, Mahasarakham Province	Three  major  purposes  of  this  study  were:  1) to  examine  developments  of  various  organizations  with  working  roles  in  community  characteristics,  2) to  investigate  factors  and  conditions  that  strengthened  different  organizations  in  the  community  and  had  being  community  characteristics,  and  3) to  examine  formations  and  developments  of  being  community.  The  study  was  conducted  according  to  the  conceptual  frameworks  which  were  factors  and  conditions  strengthening  different  social  organizations  or  having  being  community  characteristics.  These  included:  (1) opportunities  and  stages  which  were  placed  to  meet  and  exchange  learning  with  one  another  as  well  as  forming  groups,  (2) the  process  of  learning  and  decision – making  in  working  together  among  different  sectors, (3) leadership  styles  and  leadership  in  the  community,  (4) equipment  or  communication  techniques,  (5) feelings  and  thoughts  of  the  people,  especially  the  system  of  ideas  in  self - dependence  and  participation,  (6) activities  for  working  together  and  relationships  between  people  in  the  community  and  various  institutions  in  the  community,  and  (7) unity  and  cooperation  among  different  social  organizations  in  these  groups.	The  study  revealed  the  following.  Group  activities  that  occurred  before  1984,  as  promoted  and  urged  by  both  state  and  private  sectors,  were  in  these  aspects:  development  of  quality  of  life,  public  health,  social  welfare,  funds,  women,  youths,  careers,  community  shops,  and  rice  banks.  After  1984,  there  were  these  groups:  public  utilities,  welfare,  funds,  savings,  credit  unions,  community  rice  mills,  Bun  Khao  Chi  Merit – making  culture,  cattle  bank,  and  silk – cloth  weaving.  These  groups  were  established  by  state,  private  and  community  sectors.  Most  activity  characteristics  were  in  the  self – dependence  from  while  the  state  sector  support  partly.  However  some  groups  were  dependent  upon  the  state  sectors  such  as  village  funds.  The  private  sector  promoted  such  activities  as  cattle  banks  during  1998 – 1999  by  the  Thai  Farmers’  Foundation,  community  rice  mills,  silk – cloth  weaving  and  paper  sandalwood  flowers  groups,  and  centers  for  preschool  child  development  in  the  monastery  from  Wang  Chan  community  by  the  office  of  fund  for  community.  The  process  of  learning  and  decision -  making  included:  learning  together  within  the  group,  high  compromises,  kinship  interactions  among  persons  and  the  same  career,  and  being  dependent  on  one  another  in  the  village  and  the  community.  However,  in  width,  there  were  traditional  activities  of  Bun  Khao  Chi  merit – making  (by  offering  baked  glutinous  rice  to  monks)  and  social  funds  such  as  the  cattle  band  of  the  Lomkhom  Group  which  could  cover  all  the  tambon  (sub – district).  Youth  sports  between  these  groups  and  the  tambon  administrative  organization  could  be  found  in  the  Bun  Khao  Chi  activity.  It  appeared  that  the  tambon  administrative  organization  supported  groups  with  budgets.  In  local  politics,  it  was  in  the  kinship  type  as  a  whole  by  having  high  public  sense  together,  having  dividends  of  benefits  for  the  public  at  both  tambon  level,  i.e.  group  activities  and  the  Bun  Khao  Chi  merit – making,  and  at  the  community  group  level  which  included  saving  groups,  shops,  community  rice  mills  of  Wang  Chan  community  which  could  give  services  to  the  community,  villages  in  and  outside  the  tambon.


location: , 'Thailand year: 2023 source: HSRI

title: Safety and Immunogenicity Against Omicron of Intradermal and Intramuscular Booster COVID-19 Vaccination Following the 2-Dose Primary Series of ChAdOx1 (AstraZeneca) in Thai Older People

abstract: Background: The booster vaccination for Covid-19 prevention has been specifically recommended among high-risk populations such as older people. Previous studies have reported that intradermal (ID) vaccination could be as effective as intramuscular (IM) or subcutaneous (SC) vaccination In addition, ID vaccination causes less systemic adverse effects which are much concerned by older people giving rise to lower vaccination rate in this particular age group. Therefore, this study aims to compare the immunogenicity and adverse effects following ID and IM booster vaccination of mRNA vaccines against COVID-19 in older populations. Methods: This randomized, open-label study was conducted at a single center, Siriraj Hospital, Bangkok, Thailand, which was completed in July 2022. The eligible participants were individuals aged 65 years or older who already had received 2-dose IM primary series of ChAdOx1 vaccine within 12-24 weeks. Participant were randomly assigned to six vaccine groups: ID mRNA-1273 (20 mcg; 0.1 ml, n=35), IM mRNA-1273 (100 mcg; 0.5 ml, n=35), ID BNT162b2 (10 mcg; 0.1 ml, n=35 for each group of 65-79 and ≥ 80 years of age) and IM BNT162b2 (30 mcg; 0.3 ml, n=35 for each group of 65-79 and ≥ 80 years of age). Self-reported adverse events (AEs) were collected for 7 days consecutively following each vaccination using an electronic diary application. The immunogenicity was determined by the level of IgG antibodies against receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S1 subunit). The pseudotype-based neutralization assays (PVNT) were used to measure neutralizing antibodies against SARS-CoV-2 variants. The T-cell response was measured using S-peptide and NMO-peptide stimulation. Results: Of 210 participants, the majority (70.5%) were female, median age was 77.5 years old (Interquartile range (IQR): 71.0-84.0 years old). At 4 weeks after booster vaccination, the geometric mean concentration (GMC) of anti-RBD IgG increased in all groups by overall of 45.11 (95% CI: 38.82, 52.41) folds from baseline. The GMC among participants who received IM mRNA-1273 had gained the highest immunogenic responses and significantly higher than IM BNT162b2 (GMC of IM mRNA-1273: 3,837.12 BAU/mL, GMC of IM BNT162b2: 2,530.58 BAU/mL, p=0.021). ID vaccination had significantly lower GMC than IM of the same vaccine type. Across vaccine groups, the geometric mean titer against Omicron variant BA.1 was the highest among participants who received IM mRNA-1273 boosting (616.8), followed by ID mRNA-1273 (213.9), IM BNT162b2 (144.6), and ID BNT162b2 (82.1). The ID route had significantly more frequent local AEs than IM with the highest rate among ID mRNA-1273 and the lowest in ID BNT162b2 group. Conclusion: The IM mRNA-1273 group gained the highest immunogenic responses as well as experienced less systemic AEs than BNT162b2. Although ID route achieved lower level of antibody than IM route, the immunologic responses were highly enough to create vaccine efficacy and caused less systemic AEs. Therefore, the ID mRNA-1273 could be the alternative type of Covid-19 vaccination for older people.


location: , 'Thailand year: 2011 source: HSRI

title: Cholera and Climate Change

abstract: Climate change results mostly from the activities of humans whose numbers keep growing. One of
the negative impacts of climate change is global warming. Global warming has deleterious effects on the
environment, ecology, distribution of various diseases and their vectors; this will, in turn, negatively affect
humans. One of those diseases is cholera. The present article reviews the pathogen, its distribution,
epidemiology, and the effects of climate change over distribution of cholera via the following factors:
temperature, ENSO (El NiNo/Southern Oscillation), sea rise level and salinity level, eutrophication phenomenon,
and human activities related to shipping. The authors conclude with recommendations on
research to understand and mitigate the effects of climate change


location: , 'Thailand year: 2001 source: HSRI

title: Primary care service model for eastern region community

abstract: The purpose of this action research was to develop the primary care service model for eastern region community , Thailand .  The process of developing was following	Step  1	To survey health status and health care service’s needs of people from 4 diversity communities including sub-urban, fishery industrial and agricultural community.  The questionnaires were administered from 1583 people and the semi-structured interview as well as in-depth interview method were carried out to gather data from 17 health care providers and community leaders.	Step  2	To analyze the primary care service that provide at 22 health care service including district health care center , community hospital metropolitan health center provincial and regional hospital 	Step  3	To synthesize the primary care service model from view of health care providers , community leaders , clients and villagers.	Step  4	To reflect the created primary care service model by villagers , health care , experts , nurse , educators , local politician and community leaders.	Step  5	To establish the primary care service model for eastern region community.   The results concluded that the people in eastern region were found non appropriate health behavior (30-50 percent) and need to be empowered in self caring.  The characteristics of the primary care service model are.1.  To should be closed to people’s house and accessible 2.  Existing district health care center should be developed to be primary care center according to this model or set up a new one.3.  Participatory management in one of key strategies in managing primary care center.  Four parties should be considered to be the committee.  They are health care team , villagers , community organization and non government organization related to the community.4.  Financial support should come from both government and local community.5.  Primary care service should provided health care across lifespan with health promotion , prevention , cure and rehabilitation focusing on promoting health learning activities.6.  Monitoring of primary care service and quality control should be continually practice and developed.7.  Qualified alternative primary care service and health net working should be established for complementary and selected service.8.  Professional nurse should be main provider at the primary care center and play role as a family nurse.


location: , 'Thailand year: 2022 source: HSRI

title: A literature review of health state utility values in Thai cancer patients

abstract: Utility value is an important outcome for cost-utility analysis (CUA). The EQ-5D is used to elicit the utility values for economic analyses recommended by the Thai health technology assessment guideline. Therefore, this literature review was to establish the dataset of utility values for Thai patients with liver, lung, colorectal, breast, cervical, ovarian and hematologic cancers in various stages in Thailand.
This study reviewed all relevant studies by searching international databases such as PubMed and Scopus, and national databases including health intervention and technology assessment program (HITAP), health systems research institute (HSRI) and Thai LIS-Thailibrary integrated system (ThaiLIS) Study was included if 1) report utility values for Thai cancer patients and 2) identify the type of instruments used to elicit utility values. Moreover, quality scoring and assessment were performed for all included studies based on the adapted National Heart, Lung and Blood Institute guideline.
Of total 4,432 studies identified, 30 studies were included for literature review. Utility values were elicited from direct methods (Standard gamble; n=3 and mixed direct methods: Standard gamble, Time-trade off and Visual analog scale; n=1), indirect methods (n=14), mixed direct and indirect methods (n=3), mapping techniques (n=3), indirect method and retrieved from published papers (n=3) and unidentified methods (n=3). Within indirect methods, the EQ-5D questionnaire (n=17) was used in which the EQ-5D-3L (n=13) was the most frequently used. However, none of the included studies reported the psychometric performance of the instruments used to elicit the utility values.
This review establishes the dataset of utility values for Thai cancer patients with various stages. Both direct (SG, TTO and VAS) and indirect methods are used to elicit the utility values. The utility values decline in patients with metastatic stage (Stage IV) compared to the earlier-stage (Stage I-II). However, the utility values are mostly the result from chemotherapy or surgery for cancer treatment, so the utility values is directly uncomparable among the included studies. Therefore, further studies investigating the differences of utility values derived from direct and indirect methods among Thai patient cancers with various stages should be encouraged. Furthermore, the EQ-5D-5L with hybrid model should be used to elicit the utility values for economic analyses based on Thai health technology assessment guideline.


location: , 'Thailand year: 2004 source: HSRI

title: Diabetes Registry Project 2003

abstract: Diabetes is a common chronic disease world wide. Its long term complications both microvascular and macrovascular lead to increased medical expenses, hospitalization and death in diabetic patients. It is proven that intensive control of diabetes and its comorbidities prevent or delay its complications, and the standard of care for diabetes has been established and widely accepted. Therefore, it is important to document the current status of diabetic care and complications in Thailand. We conducted a multicenter registry in diabetic clinics of 11 tertiary centers in Bangkok and major provinces. The registry collected data from April-December 2003. There were total of 9419 diabetic patients. The majority of patients were older than 40 year-old (91.7 %) and 65.9% were female. With respect to socioeconomic status, more than half of the patients had only preliminary education or less and not currently working, nevertheless more than 70% had health care coverage. The registry comprised of type1, 4.5%, type2, 94.6% and others 0.9%. The data also showed that 38.9% of the patients had diabetes more than 10 years, and almost 80% were non-smoker. For glycemic control, more than half had inadequate control: 61.8% had fasting plasma glucose > 130 mg/dl and 69.34% had HbA1C > 7%. The analysis of lipids profile revealed that 63.3% had LDL > 100 mg/dl, interestingly only approximately 32.2% had levels of HDL and triglycerides out of the recommended ranges. With regard to complications, the data showed prevalence of retinopathy of various degrees in 23.3%, but 24.4% of the registry did not received evaluation. Almost half of the patients also had not been adequately assessed for nephropathy, for those who had evaluation, 34.9% had some degree of nephropathy. 5.9% of the patients reported a history of foot ulcers, and 1.6% had had amputation. The prevalence of coronary disease, stroke, hypertension and dyslipidemia were 8.2%, 4.4%, 63.6% and 73.3% respectively. Medication usage data showed that 29% of the patients use insulin. The most commonly prescribed regimen was a combination of sufonylurea and metformin (37%) for hypoglycemic agents, and ACE-I and diuretic (6.5%) for antihypertensive. Lipid lowering drugs were prescribed in 54% of the registry which would reflected that 74.5% of dyslipidemia patients received treatment. Non-prescribed herbal preparation was used at one time in at least 33% of the registered patients.Conclusion: The majority of the patients in this registry had unsatisfactory control ofdiabetes and other risk factors for development of long term complications. Screening for early retinopathy and nephropathy also was insufficient. There should be additional process or system to improve care for diabetes.


location: , 'Thailand year: 2017 source: HSRI

title: Food Consumption Behaviors among Different Groups of Thai Population: Do Demographic, Socio-Economic, and Health Status Matter?

abstract: An unhealthy diet is a major risk factor of obesity and non-communicable diseases (NCDs). The diet-related health problems are increasing continually in Thailand. This study aimed to assess the association between dietary patterns of Thai adults (15 years old and above) and their demographic, socio-economic and health status. In this study, the dietary patterns asked on daily consumption of sugar-sweetened beverages (SSBs), and adequate intake of fruits and vegetables (FVs) at least 4 ladles and above per day. The data, obtained from the 2015 National Health and Welfare Survey, were ana¬lyzed using descriptive data analysis and multiple logistic regression. The results show that Thai adults aged 15-24 years old were more likely to drink SSBs and to consume less than 4 ladles a day of FVs compared to other age groups. Government/state and private employees were more likely to drink SSBs every day than the business owners. Compared to the poorest, people with higher economic status were more likely to drink SSBs daily. The findings suggest that nutrition policy should focus in¬tensively on high risk groups including students, government/state and private employees and people with high ability to pay for SSBs. Potential interventions include a comprehensive nutrition promotion program in and around education institutions as well as in workplace. Pricing and taxation and social marketing campaign are also the promising strategies to promote the consumption of healthy diet among Thai population.


location: , 'Thailand year: 2011 source: HSRI

title: Potential saving from setting reimbursable rates of outpatient drugs for Civil Servant Medical Benefit Scheme in 2010

abstract: The medical expenditure for outpatients under the Civil Servant Medical Benefit Scheme’s direct
billing system continued to be very high in 2009-2010 due to the use of drugs outside the National Lists of
Essential Medicines. This study estimated potential cost-savings using the aggregate drug utilization data
from 28 large public hospitals under two scenarios of reimbursement: 1) the lowest price of generic in each
drug group, and 2) median price of each drug. If the reimbursement rate was set most restrictively based
on the minimum price of the essential drug with an equivalent Anatomical, Therapeutic, and Chemical
(ATC) code 1-3 (eg. the lowest price of simvastatin for antilipids), the expenditure for antilipids,
antiosteoarthritis (non-steroidal anti-inflammatory drug (NSAID), cyclo-oxygenase (COX-2) inhibitor, and
symptomatic slow-acting drugs for osteoarthritis (SYSADOA)), and antisecretory/antiulcers (histamine-
2 receptor antagonist (H-2RA) and proton pump inhibitor (PPI)) in 2010 would be reduced by 72.8, 85.7,
and 86.5%, respectively. If each individual hospital was allowed the drug reimbursement as is but no
higher than a ceiling determined as the median of price per prescription for the drug with the equivalent
ATC 1-5, the expenditure for antilipids and antiosteoarthritis would be reduced by 13.4 and 13.3%, respectively.
For 20 drug groups with relatively high expenditure, the reimbursement ceiling could reduce the
expenditure by 14.0%. The least restrictive reimbursement condition using a fixed rate referent to the
median price of drugs with equivalent ATC 1-5 from all hospitals could reduce the expenditure for the 20
drug groups by 2.9%. Therefore, to contain expenditure using a fixed rate of reference price based on
drugs with an equivalent ATC 1-5 would be the least restrictive policy option.


location: , 'Thailand year: 2023 source: HSRI

title: Screening of SARS-CoV-2 Infection in Factory Workers by Antigen Screening from Saliva

abstract: The 2019 coronavirus outbreak has forced many industrial plants to shut down, then negatively affecting to the industrial sector and the economy of Thailand. Serial testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proposed as a measure for safe factory reopening. This study examines the efficacy of detecting the pathogenic SARS-CoV-2 infection by detecting antigens in saliva samples. It compares the results obtained from the automated machine with the results of the manual antigen detection. The samples used in the study were saliva samples obtained from industrial workers in Bangkok and Nonthaburi provinces between March 2022 and May 2022. A total of 4,364 participants attended the study, of which 85 were confirmed to be infected with SARS-CoV-2. An automated antigen detection using Lumipulse G1200 SARS-CoV-2 Ag detection and manual antigen test kit were compared with RT-PCR. The test results showed that The Lumipulse G1200 SARS-CoV-2 Ag is effective in detecting SARS-CoV-2 infection and results were comparable to confirmation method by RT-PCR with the sensitivity and specificity of SARS-CoV-2 as 87.0% (95% CI 78.0%–93.4%) and 99.0% (95% CI 96.6%–99.9%) respectively. In conclusion, the Lumipulse G1200 SARS-CoV-2 Ag is a capable tool for screening pathogens for SARS-CoV-2 and provide accurate test results when ccompare to the standard test method. The instrument is therefore suitable for use in epidemic situations where large volumes of samples are required to be tested, such as factory or school samples.


location: , 'Thailand year: 2022 source: HSRI

title: The Development of a Participatory Healthy Public Policy in Prevention of Corona Virus Disease 2019 (COVID-19) in Muang District, Trang Province

abstract: This participatory action research (PAR) aimed to 1) develop a participatory public policy for the prevention of coronavirus disease 2019 (COVID-19) in Muang District, Trang Province, and 2) monitor and evaluate the implementation of public policy. The target groups for collecting data were divided into 2 groups: qualitative data, consisting of 1) a group of scholars or people working in a government agency, 2) a group of executives of a local government organization, and 3) a group of 94 people or civil society groups, and quantitative data consisting of 384 people in the targeted areas. The research was divided into 3 phases, namely 1) the study of the situation of the problem, 2) the policy development and the policy trial, and 3) the public policy assessment together with the development of public policy driving processes for health. In this phase, there were 5 steps as follows: 1) Formation of policy issues, 2) Public policy formation, 3) Public policy decision making, 4) Implementation of public policy, and 5) Monitoring and public policy evaluation. The research was conducted between April 2021 – May 2022. The research instruments consisted of a group discussion guideline, in-depth interviews, questionnaires, observations, and learning exchange forums (lesson learned). The results showed that the first step was the formation of policy issues caused by the problem of disease outbreaks in the community with preventive actions control of outbreaks under a committee based on the incident command system and the Public Health Emergency Operation Center (PHEOC) together with community participation. The proposal from a group of scholars included an accelerated measure that covers the active case finding, treating infected people, vaccination, campaigning for people to follow universal prevention measures, as well as healing infected people’s minds. The local government organizations support public relations information, equipment, and utilities that were necessary for home and community quarantine. Measures done by the people's groups or civil society, were to create a safe area from COVID-1 9 (COVID Free Setting), focusing on important places, including restaurants, schools, hospitals, factories, hotels, and markets. Once the public policy has been formulated, then policy decisions have been made. The policy has been implemented in the communities. There was the monitoring and evaluation of the policy implementation. It was found that people have followed the measures at a high level (M=2.62, SD=0.28). They were satisfied with the public policy at a high level (M=8.30, SD=1.69), and their participation was at a high level (M=8.45, SD=1.57). The findings suggest that the development of participatory public policy in the prevention of coronavirus disease 2019 (COVID-19) in Muang District, Trang Province arose under the participation of government personnel, the private sector, and the people in communities. They have driven the public policy concretely.


location: , 'Thailand year: 2001 source: HSRI

title: Forms and systems of quality child care services in Thailand: an indepth case study

abstract: Forms and Systems of Quality Child Care Services in Thailand:An Indepth Case Study	Today most Thai families rely on child-care providers to help raise their children, often beginning at a critical stage of their brain development, particularly children under 6 year of age. But most of the settings where Thai children receive care fall short of the quality standards. The primary focus of this qualitative study is to investigate child care forms, systems and factors related to  quality child care services in Thailand. The second objective is to analyses the criteria and standards of quality child-care in both private and government setting, and compare with foreign standards in order to set (minimum) standards of care under Thai context.	Data was collected from administrators/owners and childcare providers/caregivers of the childcare settings, including children aged 0-6 years and their parents of 20 selected sample child-care centers/schools operated by government and private own in Bangkok and other provinces throughout Thailand. Both Structured and unstructured questionnaires for interviews, including observation and videotaping techniques were used to collect data.	The results showed that the forms of child-care services in Thailand were varied depending on the purpose of services (affiliated with school or not) the age group of children to be care (infants, toddlers or preschools) and t the need of children (normal or special disadvantaged children). About the system of good quality child care services, it was found that mostly composed of a better and more efficient managements in terms of accountability of financial system, low staff turnover and higher job responsibility and satisfaction; staff(s) with more formal education and specialized early childhood training in addition, a more developmentally appropriate environment with age-appropriate and child-centered activities to promote learning and foster all aspects of their development; higher standard of health, nutrition and safety provisions; including better relations with parents/and communities were evident.	For the quality improvement of all government units in Thailand, the focus was actually on standards and indicators of inputs and process of child-care services/centers more than outcome on child development. A good quality child-care center in Thai context should include some standards from foreign countries such as a clear philosophy and goals between child care staffs and parents to promote their complementary roles and to parents participation; the interactions between children and staff, the interactions between staff themselves; and also the respect of protecting child abuse. Therefore it will be worthwhile to specify that minimum acceptable standards regarding such factors in order to guarantee good quality child-care services for young children.


location: , 'Thailand year: 0 source: HSRI

title: The relationship of disease of respiratory system, disease of the skin and subcutaneous tissue and air pollution from the industries in Maptaphud Industrial Estate

abstract: The relationship of disease of respiratory system, disease of the skin and subcutaneous tissue and air pollution from the industries in Maptaphud Industrial estate conducted by comparing morbidity rate in Maptaphud Municipality to rate in Ban Chang and Wang Chan areas. The comparison revealed that the rate of disease of respiratory system in Maptaphud Municipality was higher 2.8 time and 1.2 time than the rate in Ban Chang and Wang Chan areas respectively. As well, the rate of disease of the skin and subcutaneous tissue in Maptaphud Municipality was 3.1 time higher than in Ban Chang and 1.2 time higher than in Wang Chan areas. And the study in Maptaphud Municipality found that the communities with higher estimated pollutants (NOx, SO2, TSP) had higher rate of disease than the communities with lower estimated pollutants. And the time series analysis also concluded that the rate of disease of disease of respiratory system was related to 3 previous days estimated SO2 (p<0.05) and 3 previous days estimated TSP    (p<0.05). While the rate of the skin and subcutaneous tissue was related to 4 previous days estimated SO2 (p<0.05).


location: , 'Thailand year: 2017 source: HSRI

title: Factors Related with Oral Health Behavior Regarding PRECEDE Framework among Students in Grade Nine, Maesai District, Chiang Rai Province

abstract: Caries and gingivitis are major and chronic problems in dental public health especially among adolescence. In particular junior high school students, they lack continuous oral health care. The present study adopts PRECEDE model as a study’s framework to determine association of predisposing, reinforcing, and enabling factors with oral health promotion behavior in ninth graders. The study was a cross-sectional analytical design. The population was ninth graders who lived in Maesai district, Chiang Rai province during academic year of 2015. Sample size was estimated by proportion of factor. Three hundred and seventy-five students were simple randomly selected from 13 schools in Maesai district. The study instrument was a questionnaire asking general information, enabling factors, predisposing factors, reinforcing factors, and oral health behavior. Data analyses were performed using descriptive statistics, chi-square, Pearson’s correlation for univariate, and multivariate ordinal logistic regressions were used to analyze adjusted effects of independent factors. Data were presented using Pearson’s correlation coefficient, adjusted odds ratio and 95% confidence interval. The results revealed that parent’s education had significant association with oral health behaviors. Correlation analyses found that knowledge had a significant inverse correlation with oral behavior (r=-0.164, p=0.001). While attitude, values, and enabling factors had significant positive correlations with oral health behavior (r=0.119, p=0.021; r=0.152, p=0.003; and r=0.392, p<0.001 respectively). By multivariate analysis, fac¬tors that positively affected on oral health behavior were the opportunity expansion school with the highest education of grade 9 (adj. OR 1.70; 95%CI 1.12-2.57, p=0.012), parent with graduate degree compared to those with no/primary school education (adj. OR 2.58; 95%CI 1.19-5.59, p=0.016), value of food consumption (adj. OR1.32; 95%CI 1.04-1.68), and enabling factors (adj. OR 1.60; 95%CI 1.25- 2.05). But knowledge negatively affected on behavior (adj. OR 0.60; 95%CI 0.43-0.82). These findings will facilitate planning and guidance for dentistry personnel in changing oral health behaviors among grade 9 students.


location: , 'Thailand year: 2001 source: HSRI

title: Vision and direction toward health system reform : views of civil ageing society

abstract: Vision and Direction toward Health System Reform:views of civil aging societyThe participatory research aimed to understand the following aspects which are related to aging issues in Thailand: a) the existence and situation of network of community based agecare organizations; b) roles, capacities and strategies of community based agecare organizations; c)  vision and mission toward improvement of quality of life of older people in Thailand.  The information fed by the participants, most of whom were older people from rural poor areas throughout the country, through participatory discussion that included A.I.C, focus groups techniques.  There were 127 participants from non-governmental age related organizations, indigenous group of older people. 	Comparison of the image of Thai older people in future compare to current situation (2000), it is revealed that about half of the participants (55%) indicated that the living condition of the older people would be better than present because aging issues is being campaigned and well-recognized by public increasingly.  The participants of all four regions stated that the aims of organizing activities are similar in terms of achieving the objectives of the establishment of the elders' clubs which aim to encourage older people to live with their families in communities as long as possible.  However, the types of activities are different in accordance to the needs and preference of the older people and the conditions of the areas.  The recommendations presented by the participants are similar which can be concluded as followed:All cares and services provided by the government sectors need to be reviewed, particularly actively provisions, instead of passively ones.  Such provisions should be accessible by all older people and equally.Health promotion measures should be sustainable and should emphasis on health information for community and self health care. Prevention and control of diseases measures should go along and make sure that it can be brought to practice effectively.


location: , 'Thailand year: 2000 source: HSRI

title: A situation on environment and health in Thailand

abstract: A Situation on Environement and Health  in Thailand	The population of Thailand has increased from 26 million to 62 million in the past 40 years. The increase had led to tremendous activities in economic and social development such as the development of land, agriculture and farming, fishery, energy, industries, transportation and tourism. These developments resulted in climatic change and environmental problems including physical chemical biological and social environment. Unplanned industrialization and urbanization, and the influx of rural population into cities had created environmental pollution and social stress in those area. Bangkok, the capital city with an estimated population of 10 million, and provinces in vicinity are facing problems of air, water, land, and noise pollution, hazardous substances and waste, food hygiene, unsafe housing and workplace. These environmental pollutants may enter human body either by eating, breathing, or skin contact. Health impact may vary from annoyance to discomfort, mild symptoms, severe illnesses, injury, disability, or death, depending on several factors such as type and amount of pollutants, exposure time and route of entry. 	Mortality statistics of Thai population during B.E. 2534 – 2541 indicated that hearth disease was the highest cause of death throughout the period, followed by cancers, accidents, poisoning-intoxication, blood hypertension and stroke, injury/suicide/murdered, pneumoconiosis and other lung diseases, liver and pancreas diseases, and kidney disease.	For infectious diseases, the highest illness was diarrhea, followed by pneumonia, hemorrhagic fever, food poisoning, malaria, salmonellosis-shigellosis, influenza, tuberculosis, sexually transmitted diseases, and measles.	Among these leading deaths and illnesses, there are several diseases that could be caused by exposure to either individual or multiple pollutants of physical, chemical, biological form and social factors. However, it is always difficult to pin point the exact causative environmental or social factors. This is due to the incomplete or unknown exposure history and the complexity of dose-response mechanisms of those factors on physiological change and etiologies of diseases, cancer, for example. Nevertheless, the results from animal studies could be cautiously extrapolated to human for the sake of prevention and control of adverse health effects and sustainable socio-economic development.


location: , 'Thailand year: 2019 source: HSRI

title: Development of working system and mobile application for report and alert the quality and safety of health care products

abstract: Development of working system and application for report and alert the quality and safety of health care products project was conducted to develop web application TaWai for Health version 1.0 (prototype) which have been used since 2016. This application was used in communities of health region 10 and 12 to report and alert in 3 topics including 1) adverse healthcare product reactions 2) unhealthy or illegal healthcare product and 3) illegal healthcare product advertising. The aim of this research was conducted to develop the efficacy and usability of the application by TaWai network and develop healthcare product problems database for consumers communication by 4 steps of development including 1) web application research and development 2) database development 3) TaWai network development and 4) communication method and media development for consumers and patients. After 1 year of research and development in 4 steps we could obtained 1) web application TaWai for Health version 2.0 which more satisfy the need of user. For 2nd step, TaWai for Health database could display the statistic and incidents of healthcare product problems in each area better than our previous database. For 3rd step, we could increase TaWai networks though our workshop in each area and provide practical healthcare product problems management guideline in community using web application TaWai for Health version 2.0 as management tool by 8 categories of users including reporter, pharmacist, admin in district level, admin in province level, admin in region level, user in region level, user in Country level and super admin. For final step, all problems that reported in web application TaWai for Health was summarized and created in to 6 videos and 6 infographics for communicate healthcare product problems to increase healthcare product literacy of consumers and patients. For future work, we would like to develop and apply our new application and management guidelines to be the alternative tool for customer protection in country level.


location: , 'Thailand year: 2018 source: HSRI

title: Urbanites’ Accessibility, Understanding, Evaluation and Application of Health Information for their Self Care in International Spreading of Emerging Infectious Disease

abstract: The research aims to explore and describe the Urbanites’ Accessibility, Understanding, Evaluation and Application of Health Information for their Self Care in Emerging Infectious Disease International Spreading. Mixed method was used in collecting data including in-depth interview of doctors, public health facilitators, village health volunteers (Or Sor Mor) and local press in the 4 provinces where immigration checkpoints are--Chiangrai, Nong Khai, Ubon Ratchathani and Songkhla—and administration of questionnaire for survey research on sample group living either Amphoe Mueang (a capital district of a province) or an Amphoe (districts) where immigration checkpoint or international airports is located. Those areas belong to the 7 provinces namely Bangkok, Chiangrai, Tak, Songkhla, Nong Khai, Ubon Ratchathani and Phuket.  The overall data was collected from 1,400 samples in total. The finding indicated that Thai Ministry of Public Health has a well-developed system and strong policy and control measures on the management of infectious diseases spread internationally as well as beneficial cooperation between Thailand and other countries. Measures on disease surveillance, control and prevention together with risk communication plan have been installed and are actively used.  The finding revealed the people become more aware when infectious diseases start to spread closer into the country and their hometown. The level of awareness fluctuates in accordance with the severity level of diseases. Usually, people’s awareness level rises high during the first period of news announcement about infectious diseases and gradually lowers as media ceases to report about diseases. On the other hand, when there is news report on the severity of infectious diseases, lack of treatment and mortality number of the infected combined with insufficient amount of information, the awareness level soars up and turns into panic. This can be alleviated by news informing people of government’s countering measures and procedures in screening, preventing and controlling contagious diseases. The health information about emerging infectious diseases spreading internationally are both news reports by the press and media created by Public Health facilities. Information sent are consisted of both arousing information of the severity of diseases warning them to change their behaviors and plain information of diseases aiming for understanding and procedures to follow for their safety. It is found that people access information about emerging infectious diseases spreading internationally through various media; mass media, personal media such as village health volunteers, neighbors, specialization media, local press and online media. The survey result shows that the overall frequency of people media exposure is medium. The most frequent media used is television. Radio, newspaper, friends, public health facilitators, village health volunteers, Facebook, LINE, news website, health care website, vinyl banners, pamphlets and broadcast towers have medium usage frequency. The accessibility level to the information of infectious diseases internationally spreading is medium. However, the number of channels accessed by the people and frequency of follow ups are low. The eagerness and content engagement are at medium level. Overall, the level of understanding is high. The most understanding of well-informed topic for the sample group are the chance of getting infected, the lack of treatment and the importance of following news trailed by following instructions. The survey result indicated that level of value and correctness of information evaluation is medium. Looking closely, sample group indicated that they mostly evaluate on the benefits of information in ensuring personal safety, however, they set up basic assumptions and check the validity of information, so these two topics are at medium level.  Application of information is found to be at high level. Sample group usually use the information learnt to protect themselves from infectious diseases, practice sanitary behaviors, self-observe for sickness and find further news and information. The result of a test on the hypothetic relationship reveals that the frequency of information access is positively correlate to understanding of content. Also, the mean of access to information varies positively correlate to evaluation of value and correctness of information. Both pairs have significant relationships shown statistically at .05 In addition, the information accessibility, understanding and evaluation of value and correctness of information all have significant positive relationship with application of information shown statistically at .05 It is found from comparative hypothesis testing that information accessibility, understanding, evaluation and application vary significantly between age groups and levels of education at .05 based on statistic.


location: , 'Thailand year: 0 source: HSRI

title: Development of the Health Literacy Model to Enhance Self-Management Behaviors and Health Outcomes among Older Adults with Type 2 Diabetes Mellitus and Hypertension in Primary Care Cluster, Saraburi Province

abstract: Development of a health literacy model to enhance self-management behaviors and health outcomes among older adults with coexisting type 2 diabetes mellitus and hypertension in primary care cluster Saraburi province was a research and development. The main purposes of this study were to develop health literacy model of older adults with coexisting type 2 diabetes mellitus and hypertension and to determine the effects of this model. A sample of 150 older adults with coexisting type 2 diabetes mellitus and hypertension visiting in primary care cluster Saraburi province was randomly entered into the experimental and control group, 75 participants for each group. The experimental group participated in the health literacy developmental activities for a period of 12 weeks, whereas the control group obtained regular care. The instruments employed in this research included 1) the health literacy developmental model and supporting documents and 2) the self-management behavior questionnaire. The percentage, mean, standard deviation, t-test, and content analysis were used to analyzed the data. The results showed that: 1. The health literacy developmental model to promote self-management behavior and health outcomes among older adults with coexisting type 2 diabetes mellitus and hypertension consisted of 5 stages as followed: 1) confidence to change, 2) access and understand our disease, 3) communicate and make decisions for health, 4) set the direction for self-change, and 5) continuously perform towards good health outcomes. 2. The effects of the health literacy developmental model to promote self-management behavior and health outcomes were found: 2.1 Post-test mean score of self-management behavior of the experimental group was significantly higher than the control group (p < 0.001). Post-test mean of HbA1c and systolic blood pressure of the experimental group were significantly lower than the control group (p <0.01 and p <0.001, respectively), whereas mean of diastolic blood pressure of the experimental groups were lower than the control group, but there was no statistical significance. 2.2 Post-test mean score of self-management behavior of the experimental group was significantly higher than pre-test (p <0.001), whereas mean HbA1c, systolic blood pressure, and diastolic blood pressure of post-test was significantly lower than pre-test (p <0.001). The results of this study can be employed to develop health literacy to promote self-management behaviors and control HbA1c, and blood pressure among older adults with coexisting type 2 diabetes mellitus and hypertension.


location: , 'Thailand year: 2015 source: HSRI

title: Health Promotion Model of Local Administrative Organization at Region 3 Health Provider

abstract: This research aimed to develop optimum health promotion model of local
administrative organizations. Development process consisted of four steps. The first
step, health promotion situation of local administrative organizations was analyzed and
evaluated. The second step, impossible health promotion model of local administrative
organizations was stipulated. The third step, health promotion model was practiced in
local administrative organizations. The forth step, practical result was assessed.
Research and development study with action research was used as research
methodology. Health promotion situation and problem in operating by local
administrative organizations was collected via document study and then people, officers
and stake holder were interviewed in pilot study. Health promotion model for local
administrative organizations, which was developed in previous step, was conducted in
focus group discussion comprised of scholars, experts and stake holders to find out
additional issues for drafting development. Health promotion model for local
administrative organizations was developed by implementation and then evaluation.
Result of document study revealed that health promotion model was belonged to
type 1, policy and key performance indicator - responded model, The model was
belonged to type 2, community’s health problem solving – responded model, The model
was belonged to type 3, both policy and community – responded model. In model
drafting development, data in previous step was conducted in focus group discussion
comprised of experts and model that integrated plan, policy and community problems
and participated with network would be an optimum model.
This research would lead the suggestion for Local Government Organizations’
potential development in health promotion. All public health organizations and related
organization should stipulate ways, model, operating procedure and supporting activities
for skill and knowledge training to Local Government Organizations’ committee which
would influenced their attitude and their concrete operation.


location: , 'Thailand year: 2023 source: HSRI

title: The Development of Telemedicine for Caring Patient undergoing Peritoneal Dialysis: Lesson Learned from the COVID-19 Pandemic

abstract: Background and rationale: Chronic kidney patients with renal replacement therapy were at risk of COVID-19. During COVID-19 pandemic with social distancing practices, hospitals postponed patient’s appointments. Methodology: The purpose of this mixed-method study was to develop and examine the effectiveness of telemedicine model in caring for peritoneal dialysis patients from lessons learned during the COVID-19 pandemic. The samples included 2 nephrologists, 6 pharmacists, 10 peritoneal dialysis nurses, and 80 peritoneal dialysis patients. Purposive sampling was used to select the participants. The study comprised 3 phases: phase 1 situation analysis; phase 2 design and development of a model of telemedicine service for peritoneal dialysis patients; and phase 3 result study of the telemedicine model by comparing the treatment time, cost and satisfaction. The research instruments covered a semi-structured interview guide, feasibility questionnaire of telemedicine model, cost record form, and satisfaction questionnaires for multidisciplinary team and peritoneal patients and caregivers. The quantitative data was analyzed using descriptive statistics, Wilcoxon signed-rank test, and paired t-test. Results: 1. During COVID-19 pandemic, patients and their caregivers have difficulty getting to the hospital as scheduled, the continuity of taking medication and the limitation of home visits. Patients and multidisciplinary teams suggested that during COVID-19, the methods of care should be adjusted, using telephone online platforms, such as Line application, to provide patients and caregivers the knowledge to promote self-care. The applications should be downloaded onto a mobile phone for immediate communication with the doctor and nurse when abnormal symptoms and problems were found. 2. According to patients and care providers, the feasibility of a telemedicine model in caring for peritoneal dialysis patients was moderate at the beginning. The model was rated highly by the multidisciplinary team, patients, and caregivers at the conclusion of the intervention. 3. Three patterns of patient journeys of peritoneal dialysis patients were identified based on clinical status of the patients: a well-controlled, a moderate control, and an uncontrolled symptom group. and 4. medication management of erythropoietin (EPO) and other medications for chronic kidney disease and co-morbidities were delivered through a nearby client hospital network. Discussion and conclusion: The cost of telemedicine model incurred higher capital costs at periphery. The higher number of services should lower the unit costs. Telemedicine was proved to be a feasible model of providing care among patients who had good disease progression control and reducing hospital visits. Therefore, the health service may develop and expand the results of this study to other chronic diseases. The provider should combine telemedicine with outpatient service.