location: , 'Thailand year: 2010 source: HSRI

title: Global Warming and the Sex Ratios of the Newborn in Thailand

abstract: The impact of global warming on everything on Earth has been observed and reported by scientists
from every corner of the world for an extended time. Among those phenomena have been the correlation
of sex ratios at birth to increasing global temperatures. From known biological facts, sex determination
can be genotypic (GSD) or temperature-dependent (TSD). A number of previous studies have suggested
that TSD may be very common in many species of lower vertebrates, especially fish and reptiles, with
increasing temperatures generally affecting the sex ratio of a species (leading to many males and few
females). The most frequent citation is noted in a study directed by two Spanish researchers, Natalie
Ospina-Alvarez and Francese Piferrer, reported under the title “temperature-dependent sex determination
in fish revisited: prevalence, a single sex ratio response pattern, and possible effects in climate change,”
published in the July 30, 2008 edition of the scientific journal Public Library of Science (PLoS ONE). They
show that even small changes of just 1-2°C can significantly alter the sex ratio from 1:1 (males : females) to 3:1 in both freshwater and marine species. It is already known that high temperatures inhibit the synthesis
of estrogens, which are essential for female sex differentiation in fish and reptiles.
In mammals, under circumstances of ordinary temperature, male live births exceed those of females.
In humans, the ratio of male births to total births also favor the same trend. It has been hypothesized that
levels of steroid hormones (testosterone and estrogen) in both parents around the time of conception are
positively associated with the offspring sex ratio (proportion of males at birth) of mammals, including
humans. Some people, particularly women, in suboptimal health produce an excess of sons; thus, gonadal
hormones are responsible for adaptive variation.
While our findings of the comparative analysis on the secondary data obtained from the Thai Meteorological
Department and from the National Statistical Office in the 16-year period 1993-2009 show that
increasing temperatures result in an increased prevalence of newborn females over males. Details of
complex analytic patterns are elaborated in the text.


location: , 'Thailand year: 2014 source: HSRI

title: Prevention of Multidrug Resistant Organism Infections in Intensive Care Units

abstract: This research and developmental project aimed to develop appropriate and practical evidence-based practice guidelines for prevention of multidrug resistant organisms (MDRO) transmission and infections for intensive care units (ICUs) of secondary and tertiary care hospitals, to increase knowledge and promote correct practices among ICU personnel in prevention of MDRO infections from invasive medical device procedures, to create collaborative network among ICU personnel of hospitals and to promote knowledge sharing to improve quality of patient care, leading to reducing hospital associated infections (HAIs) in ICUs, costs of treatment and length of hospital stay including HAI related death.
This project applied collaborative quality improvement concept of the Institute for Healthcare Improvement (IHI), USA. Fifty hospitals participated in the project, including regional and general hospitals under Ministry of Public Health, hospitals under Ministry of Defence and a university hospital. The duration of the project was from November 2013 to November 2014. The project activities consisted of preparation of “draft” guidelines for prevention of MDRO infection, prevention of ventilator-associated pneumonia (VAP), prevention of catheter-related bloodstream infection (CRBSI), prevention of catheter-associated urinary tract infection (CAUTI), Two workshops were conducted for participating hospitals in order to educate ICU personel on collaborative quality improvement and practices in prevention of MDRO infections and HAI related to medical devices invasive procedures, and hand hygiene and providing information toward MDRO problems and trend, consequences of MDRO to patients, personnel and hospitals, reviewing HAI surveillance, advantages, utilization of surveillance information, and diagnosis criteria of frequent HAIs in ICUs. Brainstorming sessions for hospital personnel were conducted to determine the draft guidelines, exchange experiences and determine the appropriate and practical methods in solving HAIs in ICUs. Participating hospitals continuously improved their practices in prevention of HAIs using the outcomes of the project workshop. Researchers supported useful information. Hospital personnel presented their works in the project workshop in order to encourage hospitals to work continuously. The project intervention was assessed by using information from HAI surveillance.
Outcomes of the project included guideline for prevention of MDRO infections in ICUs, including guideline for prevention of MDRO transmission, guideline for prevention of VAP, guideline for prevention of CAUTI, guideline for prevention of CRBSI, guideline for environmental control and guideline for diagnosis of HAIs. Information from HAI surveillance of 79 ICUs of 40 participating hospitals which regularly sent the information from September 2013 to September 2014 indicated the highest infection rate was from VAP (7.8 per 1,000 ventilator-days), followed by CAUTI 4.6 per 1,000 catheter-days and CRBSI 2.5 per 1,000 catheter-days. Case fatality rate from VAP and CRBSI were 36.4% and case fatality rate from CAUTI was 24%. Cost of antibiotic treatment for VAP , CAUTI and CRBSI were 30,734,713 Baht, 8,317,268 and 2,545,381 Baht, respectively.
Prevention of MDRO infections in the ICUs need to be implemented continuously. Establishing evidence-based practice guidelines in prevention of important HAIs in ICUs can help improve up-to-date knowledge of ICU personnel and create more confident in practices among them. All guidelines developed from this project can be distributed to ICUs of other hospitals not participating in the project for patient care practices and educating their personnel.


location: , 'Thailand year: 2008 source: HSRI

title: Developing shan health communicators in Chiang Mai Province

abstract: The action research on “Developing Shan Health Communicators in Chiang Mai Province” is a project under the Popular Health Communication System Research and Development (HCS) program, which aims to develop health communication system for disadvantage minorities who have different language and culture from the Thai majority. The target beneficiaries of this research are the Shan migrant workers from Myanmar, working in manual labor sectors in Chiang Mai. Illegal status, hard works in exploitative conditions and the inability to communicate in Thai prevent these migrants to access health information and services. The research project has thus developed Shan health communicators to work on health communication by organizing trainings on concept of health communication, knowledge on health protection and treatment and communication techniques, and supporting health communicators to organize health communication activities namely hosting the health promotion program via the community radios, producing radio drama and organizing public forum in various places. The results from 10 month project implementation (March-December 2008)   are 1) Shan health communicators have increased their knowledge on health problems, prevention and treatment and communication skill. 2) Health networks are expanded among the health communicators themselves and between them and government officers, non-government workers, academics whose works relate to the Shan, their health and communication.  3) Health communication systems and mechanism to support health communication among worker migrants have been initially developed especially in setting up training curriculum and process for health communicators and increasing communication channels. To promote health communication among migrant workers, the project recommends that  1) health communicators to work with migrant workers should be increased in both quantity and quality by developing health communication training institute with relevant curriculum and training programs. 2) Education related agencies should increase non-formal education classes for migrant workers to study Thai language and culture. 3)  Local governments and religious organizations should play more active role in  promoting health among migrant workers. 4)  Health communication channels should be expanded and used more efficiently in health promotion. 5) The public campaign to reduce ethnic prejudice and promote the peaceful coexistence between people from different ethnic and religious background is needed to be done.


location: , 'Thailand year: 2020 source: HSRI

title: Synthesis Statement of Palliative Care System in an Urban Area of Chiang Mai Province, Thailand

abstract: Health care system in an urban community is complicated due to a variety of health care settings. This descriptive research aimed to analyze and synthesize policy recommendation regarding input, process, output, outcome and impact of palliative care system in Chiang Mai city of Chiang Mai province, Thailand. Subjects were patients with terminal illness and their family caregivers, health care team from university hospital, provincial hospital, a hospital of municipality, private hospitals and health promoting hospitals of Chiang Mai city, staff from Chiang Mai municipality and local administrative offices of Chiang Mai city, village health volunteers and key persons in the community of Chiang Mai city, Thailand. Methods of data collection compose of literature review, focus group discussion, in-depth interview, and group meeting. Guided questions for focus group discussion and in-depth interview were developed and tested for validity by experts. Data were summarized and categorized according to the objective the study. Results from analysis showed that: 1. Health workforce was insufficient for palliative care at the community, private, and local unit levels. Health workforce was limited in terms of capability of palliative care management. There was a lack of teamwork among health care personnel and other related personnel. There was no committee overseeing palliative care in private hospitals, sub-district health promoting hospitals, hospitals under local administrative organizations, and community hospitals. 2. There was a system for palliative care service in provincial and university hospitals. Nevertheless, there was no system or model of palliative care in hospitals under local administrative organizations and private hospitals, nor model for palliative care service at a community level. 3. COC link system was used for end-of-life patient referral from provincial hospitals to community hospitals and sub-district health promoting hospitals. However, university hospitals and private hospitals were not connected to such system. 4. Medical equipment and supplies, as well as health care technology were not sufficient for supporting end-of-life patients when living at home. 5. There were limitations in the allocation of budget for the management of end-of-life care after discharge due to the lack of personnel in private hospitals and hospitals under local administrative organizations, as well as the lack of budget for capacity development of palliative care team. 6. The university hospital had palliative care centers and wards operated under the committee. There were three nurses directly responsible for operation. The provincial hospital had committee, but palliative care nurses were also responsible for other routine tasks. There were no palliative care wards but there were beds set aside especially for end-of-life patients referred from other network hospitals. For private hospitals and the hospital under local administrative organizations, there were no systems for palliative care. As regards sub-district health promoting hospitals, there was no committee overseeing palliative care independent from long-term care committee. Moreover, the practice in community care was similar to other types of patient care, including chronic and bed-bound elderly care. 7. End-of-life patients under health care coverage for government employees could access palliative care at university and provincial hospitals. Palliative care patients under social security and universal health coverage could access palliative care at their registered university and provincial hospital. However, after discharge to urban community, the access to care and preparedness for palliative care were limited, particularly home care to allow end-of-life patients to spend the last moments of their lives as they wished. The lack of out-patient unit especially for end-of-life care caused these patients to receive care at the hospital based on their health coverage like other general patients, despite emergency. 8. End-of-life patients receiving services at university and provincial hospitals had relatively comprehensive and efficient services in terms of setting, equipment, personnel, and continuity of care from hospital to home. This was in contrast to those receiving care at private hospitals or hospitals under local administrative organizations where there was no policy for palliative care. Thus, these patients could not access such service, leading to inability to achieve end-of-life quality of life. The findings from analysis and literature review of palliative care in other countries have contributed to recommendations both in regard to the policies and service management, including the development of palliative care by establishing structure, health workforce planning, budget planning, pharmaceutical, equipment and supply support, building care capacity of personnel and networks, as well as improving service system for palliative care to respond to the needs of end-of-life patients and their caregivers in a concrete and a standardized manner.


location: , 'Thailand year: 2008 source: HSRI

title: Review of Decentralization in Public Health, 1999-2007

abstract: This is a report of a review of the situation of decentralization in health and to recommendations for
further steps that need to be taken. Documents, news and information from 1999 to 2007 were reviewed.
Key persons from the organization concerned were interviewed. The study revealed that the decentralization
process was operated slowly and that the infrastructure among the local administrative organizations
to support decentralization was not well prepared and well established. The analysis showed that
decentralization still has strengths and advantages because of the higher local administrators’ capability,
the increase in budget and a transfer of some public health personnel to the local level. Moreover, monitoring
and external audits could be easily conducted since the local authorities’ structures and functions
are less complex compared with that of the government structure. On the contrary, there are some weaknesses
in decentralization. These weaknesses include questions of transparency and lack of skill in public
health affairs among the existing staff. Also, the public health division has not yet been structured in most
sub-district administrative organizations. To consider opportunities, a health security system and health
promotion system from the Thai Health Promotion Foundation, as well as a health-care reform system
that could be possibly established, all would increase the opportunities of the public to participate in
health-care initiation at local levels. An internal audit of the system by the community and the general
public was also counted as an opportunity. Nevertheless, there can also be some obstacles. Currently, the
Thai government does not pay much attention to decentralization and does not really focus on decentralization
management. Therefore, it is possible that the “CEO Governor” system could be a system that
hinders and interferes with the local administration system. Moreover, there is a lack of cooperation
among government officers, and currently many public health personnel still have no confidence in decentralization.
A clear conceptual framework is therefore needed. Recommendations are: (1) Decision-making should
be done by the local administrative organizations; (2) the system needs to be efficient and autonomous; (4)
equity in health is needed; (4) good governance, transparency and accountability are very important; (5)
Public participation and responses to community needs should be focused; and (6) the relationship between
local authorities and the government need to be well established. Additionally, it is recommened
that the Ministry of Public Health be changed into a “standardization authority” with the roles and responsibilities
of monitoring, advising, and providing technical support to local administrative organizations.
At the same time, the local administrative organizations should be authorized with clear roles and
responsibilities to provide suitable public health services directly and specifically for the population in
their own areas. In addition, it is necessary to strengthen capacity-building among local administrative
organizations and capability development of public health personnel to support a good public health
system at the community level. Revision of laws and regulations also needs to be focused and carried out
together with the decentralization process among well-prepared local organizations. For monitoring the
outcomes, the ultimate goal of “health-care services with equity, good governance, efficiency, good quality,
and satisfactory standards” should be used as indicators for the evaluation.


location: , 'Thailand year: 2000 source: HSRI

title: Health systems reform in Taiwan

abstract: Health systems reform in TaiwanThis documentary study presented the developing process of health system in Taiwan. Strategies, tools, and other experiences those are applied to solve health problems in Taiwan will be learned Taiwan has succeedded in economics and industrial developments as well as impressive gains in the health of the general population. However new health problems accompany with the rapid rising cost of health expenditure and access to care problems are primary factors for formulating policy in health reform in Taiwan.These are:Setting of medical care Network: to balance their medical resources,Applying the National Health Insurance(NHI) Project in 1995Creating Computerized Patients and Health Information Network to improve health service facilities, andDeveloping Family Practice Tranning Programs for their personal. This universal coverage NHI program creates monopsony buying power and promotes administrative efficiency. Fee-for service and co-payment are used as financial strategies.Although the health system reform is able to distribute providers and facilities to remote areas and gives a chance for the poor to access health services, the cost of health expenditure in still rising. Many payment mechanisms such as capitation, case payment, or global budget and other administrative strategies are proposed by experts to solve this problem. Many differencess between Taiwan and Thailand should be concerned when some health reform strategies will be brought to apply in our country. Very contrast to Thailand, the strength of economic sector and government in Taiwan make at least 2 programs, NHI program and medical care network program, possible. Thus, these strategies should be careful if implement in Thai society. Many tools for health system reform from the Western countries, however, many have limitations for solving health problems in oriental developing countries as Thailand.


location: , 'Thailand year: 2010 source: HSRI

title: Efficiency of Resource Use in the Health Insurance Scheme

abstract: This study examined the efficiency of resource use in Thailand’s three health insurance schemes:
Universal Coverage (UC), Social Security Scheme (SSS), and Civil Servant Medical Benefit Scheme (CSMBS).
It analyzes the length of stay (LOS) in hospital and early readmission rate in diabetes mellitus (DM) patients,
using as a tracer for efficiency the use of resources and the quality of services, respectively. The
data came from the claims that hospitals servicing all three major health insurance schemes have to send
for reimbursement. The aim of the analysis was to compare the effects of the insurance schemes and other
factors on resource use, LOS as a proxy for resource use, and on quality as proxied by the readmission rate
within 30 days after discharge. The analysis compares three conditions of DM requiring hospital admission:
acute complications, chronic complications, and DM without complication, to prove that there were
no differences in the quality of service in patients’ condition, especially the acute complication condition.
The study found that CSMBS patients had longer LOS than UC and SSS patients. This implied the
efficient use of resources by patients of SSS and UC compared with those covered by CSMBS. However,
SSS patients showed no difference in early readmission within 30 days after discharge, while UC patients
had a higher rate of readmission in chronic DM and without the complication condition.


location: , 'Thailand year: 2008 source: HSRI

title: Ethical Considerations for Research in Routine Practices

abstract: The objective of the study is to review ethical considerations for research in routine practices. The main question is whether these researches need ethical review or not. The study concluded that, first, there is need to distinguish among practice, experiment and research. Any works that contain research element in part or whole should be submitted for review by Ethics Research Committee, if the researches involving human subjects, which included biomedical, behavioral and social sciences researches. The rationale is to ensure that  human subjects or research participants are appropriately protected in dignity, rights, safety and well-being according to international ethical principles in human research. However, the burden of ethical review should be appropriately managed. The researches should be categorized by their risks. The researches that contain minimal risks should be considered for expedited review.


location: , 'Thailand year: 2022 source: HSRI

title: Food Industry Interference in Public Health Policy in Thailand: A Focus on Interference through Government Organization

abstract: Food industry intentionally takes actions to protect its benefit through direct or indirect industrial interferences with the public policy makers. The interferences mediate via direct contact with relevant government staff. This study aimed to collect lessons learnt from the experiences of industrial interferences with the public policies from government staff, and to develop recommendations for appropriate interactions between government and the industry. This qualitative study applied 3 methods: 1) a review of the literature and related documents, 2) in-depth interviews with key informants, and 3) a Delphi survey. The present study found that Thai and multinational companies in food industry used same interference strategies, such as, written communication, direct contact with administrators and policy makers. However, multinational companies tended to more often refer to international trade regulations and rules as an important strategy that created arguments when the intervened health policy was implemented. Based on the corporate political activity (CPA), the strategies directly applied to government officials include 1) information and messaging, 2) constituency building, and 3) legal strategy. Recommendations from the present study are 1) transparency throughout the process of communication between government and industry, 2) citation of academic evidence, including the rules and regulations related to international trade in communication, 3) a clearly defined process of communication between government and industry.


location: , 'Thailand year: 2022 source: HSRI

title: Translating Evidence on Physical Activity to a Better Active City Policy: A Brief Literature Review

abstract: The United Nations Sustainable Development Goal 11 commits to inclusive, safe, resilient, and sustainable cities and human settlements. Rapid urbanization can result in increased non-communicable disease burdens attributed to physical inactivity among the urban population. The patterns of physical inactivity and interventions to promote physical activity in the urban setting in Thailand are largely unknown. This study reviewed evidence on physical activity epidemiology and interventions to promote physical activity in the urban setting from the international and national studies, and recommended policy interventions that promote physical activity in the urban setting. The results suggested that promoting active transport such as walking, cycling, and use of public transport, integrating transit-oriented development in city design and planning, and supporting recreational activities for all groups of people, were key leverage policies that addressed the sedentary problem in Thailand.


location: , 'Thailand year: 2022 source: HSRI

title: Effectiveness of convalescent plasma therapy in Covid-19 patients with moderate to severe pneumonia

abstract: Coronavirus disease 2019 (COVID-19) is a contagious disease which cause by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. COVID-19 epidemic first appeared in Wuhan, China in December 2019. The World Health Organization (WHO) declared a Public Health Emergency of International Concern and then on 11 March 2020 announced as a pandemic. Since there is no specific drug and treatment, the use of convalescent plasma (CP) may serve as an alternative treatment for patients with COVID-19. This study aims to determine the effectiveness of CP therapy in COVID-19 patients with moderate to severe pneumonia. In our trial, 186 patients were enrolled including 111: male and 75: female, age of 21-91 years, and 49 patients completed the trial. The primary outcome showed 95% (177 of 186 patients) of patients were discharged, whereas 5% died. Among the 49 patients, clinical assessment was evaluated using by Chest-X-Ray, COVID-19 antibody levels and laboratory parameters. the kinetics of anti-nucleocapsid, anti-spike and neutralizing antibody level of 49 patients were significantly increased in 3-, 7- and 14-days post-transfusions respectively. Moreover, IFN-β, IL-6, IL-10 and IFN-α have significant difference among the groups. These findings indicated that most patients with low SARS-CoV-2 antibody titers tended to higher recovery rate after receiving high antibody-titre convalescent plasma. Nevertheless, we could not conclude that outcomes were entirely due to only CP treatment.


location: , 'Thailand year: 2000 source: HSRI

title: Health Status and Quality of Life in Thai Working Population

abstract: In this study the working population was defined as Thai people aged 13-59 year old. The data showed that this population accounted for more than 50 percent of the total Thai population. The majority of them (51-56 percent) worked in agriculture. The remaining people worked in industrial sector (16 percent) or in service sector (12 percent). The study found that 85 percent of Thai working people felt they were healthy. Factors affecting health status included age, sex, behaviors, occupation, and environment. For example, health problems among elderly people were mainly degenerative diseases, such as, heart disease, hypertension, and diabetic mellitus. On the other hand, health problems among young prople were accidental injuries and AIDS.


location: , 'Thailand year: 2021 source: HSRI

title: Risk factor associated with malignant transformation of astrocytoma

abstract: Astrocytoma can be found to develop malignancy in 9-23 percent that is significantly associated with poor prognosis. From a literature review, lack of evidence mentioned about risk factors associated with malignant transformation. The study objectives were 1. to identify factors associated with malignant transformation 2. To identify the prognosis of astrocytoma that developed malignant transformation according to biomarkers. Method The present study was a retrospective cohort study and the study population was patients who were diagnosed with low-grade astrocytoma. The processes of the study comprised 4 processes as follows: 1. investigation of the candidate genes from fresh frozen tissue 2. Investigation of candidate gene mutations 3. survival analysis 4. nomogram development. Results Following whole-genome sequencing, IDH 1 and IDH 2 mutations were candidate genes. In 90 patients, IDH 1 and IDH 2 mutations were found in 12.2% and 10%, respectively. Malignant transformation was associated with a short survival time (log-rank test, p=0.006). Factors associated with malignant transformation were a supratentorial tumor, midline shift of more than 1 cm, the extent of resection, and IDH 1 mutations following multivariable analysis. Therefore, a nomogram was developed for predicting malignant transformation. Conclusion Malignant transformation was significantly associated with poor prognosis; therefore, a close follow-up strategy should be applied in high-risk patients.


location: , 'Thailand year: 2023 source: HSRI

title: A Platform Development of Health Management System for People with Long COVID-19, Disease Prevention and Management Health Risks Among People with 608 Groups to Improve Quality of Life in Community Levels by Integration Between Primary Care System and District Health Board (DHB) for Improving the Quality of Life and Enhance Health Security Through Medical Care

abstract: This research project is a research and development design. The objectives of this study were to 1) assess the outcomes of patient care through home isolation 2) develop a health management system platform for disease prevention and risk management in Long COVID-19 syndromes for a cohort of 608 people in the community and 3) assess Health management system platform for disease prevention and risk management in Long COVID syndromes for a cohort of 608 people in the community. The population and sample included: multidisciplinary professions which was consisting of physicians, registered nurses, pharmacists, medical technicians, physical therapist and 26 District Health Board and 30 patients in group 608. Data were collected between 1st November 2022 and 30th June 2023. The research method consisted of four steps: 1) the collection stage. Problems 2) model building stage, 3) model development stage, and 4) validation stage. Data were collected from in-depth interviews and analyzed by content analysis. Software development was tested by connoisseurship and tested the software system from the users among the staff of the subdistrict health promotion hospital, Village Health volunteer and group 608. The results found that: 1) Outcomes of patient care under home isolation were 1) factors that delayed work; management, materials, and misunderstandings in communication and lack of awareness 2) the key factors to success during the quarantine period; joining together and help each other from all sectors, teamwork and the use of technology to coordinate. 2) The prototype of this platform, named “608 Prompt@Home” or “608 Prompt@Home”; consisted of seven functions for staff of sub-district health promotion hospitals; consisting of 1) Viewing map data via Dashboard 2) Viewing patient information 3) Receiving notification upon patient request 4) Consultation recording 5) Coordinating village Health volunteers to provide 608 group care 6) Live chat and 7) Viewing summary reports. There were three functions for Village Health Volunteer groups: 1) Viewing 608 patient information 2) Assessing 608 according to the standard assessment form received from the staff of the sub-district health promotion hospital and 3) Live chat. There were 608 functions for the 608 group; four functions consisted of 1) viewing public relations information and selfcare 2) Self-assessment and assessment form from sub-district health promoting hospitals 3) Making an appointment to see a doctor and 4) Live chat. 3) The results of the evaluation of the use of the System Usability Scale (SUS) platform showed that the test results of 608 Prompt@Home received the average SUS Score from all three groups as follows: 1) received an average score of 73.75 points. 2) Village Health Volunteer Group received an average score of 80.62 points, and 3) group 608 received an average score of 55.00 points. The average from all three groups was 69.71 points. The development of this prototype 608 prompt@Home has received significant recognition from the user in community. In addition, the design and development of the system is in line with the needs of users. Furthermore, the platform needed to develop to be able to cope with other epidemics and emerging diseases in the future.


location: , 'Thailand year: 1999 source: HSRI

title: Populations' suffering from health care utilization

abstract: Populations’ Suffering from Health Care Utilisation	The Thais’ suffering as a consequence of health care utilization was studied in order to set up recommendations for improvement. Quantitative and qualitative study was used during August to October 1998. The sampled health care facilities were the university hospitals, both public and private hospitals, and health centers in totality of 1473 facilities. Their suffering and dissatisfaction were grouped in terms of cause natures as following: health providers, patients’ illness, environment of health facilities, medical equipment, facilities’ management and administration, patients’ profiles including their socio-economic status, services features and health insurance schemes. 	With regard to health providers, conflicts among health providers were often found possibly leading to poor quality of care while insufficient providers made long waiting lists. Lack of informing the patients and unavailability of patients’ consensus were also an important issue. Patients’ dissatisfaction led by either crowding or dirty OPD was linked to their uncertainty of how well the facilities did infectious control.  Those insured by the Public Health Assistance Scheme did not feel confident in care quality given. Most of the Thais subjectively related good quality of care to high technology based medical instruments, comfortable OPD space, warm welcome reception, and care provided by specialists. The study viewed that financial resource was not the sole answer to reduce the patients’ suffering.


location: , 'Thailand year: 2018 source: HSRI

title: Comparison of Muscular Pain during Smartphone Use among Three Age Groups: Elementary School Student, High School Student and Office Worker

abstract: Smartphone is used widely by children and adults. Previous studies have shown that using smartphone can lead to certain struggles, especially for university students. However, there has yet to be evaluated on the effect of muscular pain while using smartphone in other age groups. The evidence gathered from this current study could be useful in preventing adverse health problems caused by smartphone usage in all age groups. The purpose of the study was to examine pain at the neck, shoulder, upper back and arm areas after smartphone use for 20 minutes. Smartphone was used in 3 positions during the study (on the chest level, on the table, and on the lap). Seventy-five asymptomatic users aged 10-48 years old were recruited into this study. The participants were assigned to use smartphone in random orders of each position. Location and severity of pain were measured by using a body pain chart and visual analog scale (VAS), respectively. The results showed that 1) After smartphone use for 20 minutes, pain at the neck, shoulder and upper back areas increased significantly and the pain increased in all age groups (p-value<0.05). 2) Office workers had higher pain significantly in the neck and shoulder; higher than high school and elementary school students (p-value<0.05). 3) Neck pain was found 164 times in the overall 225 studies, followed by shoulder, upper back and arm pain. 4) Neck pain showed the highest severity in the lap position in high school students, whereas it showed the highest severity of pain in the chest position level in elementary school students and office worker groups. 5) Smartphone use on lap caused the highest number of participants (96-100%) reporting pain in various regions of the body. In addition, using the device on lap led to the highest intensity of pain in the marked region, and also the highest pain level, overall. In conclusion: smartphone use caused pain at neck, shoulder and upper back areas in 3 separate positions in all age groups.


location: , 'Thailand year: 2022 source: HSRI

title: Synthesis of evidence for policy recommendation in continuous renal replacement therapy benefit package for acute kidney injury in critically ill patients in Thailand

abstract: Background: Acute kidney injury occurs when the kidneys lose their function over hours or days. If a pharmaceutical intervention is not available, renal replacement therapy can play an essential role in increasing patients’ survival chances. Currently, there are four methods of renal replacement therapy, and the preferred method will depend on patients’ disease indications. One of the methods is known as a continuous renal replacement therapy (CRRT), which is already included in the universal healthcare benefits package under the Universal Coverage Scheme, covered by the National Health Security Office (NHSO). However, from the annual’ s stakeholder meetings held by NHSO, there were comments regarding access and reimbursement for CRRT. Objective: The objective of this study was to analyze the incidence, cost, and budget implications for critically ill patients with acute kidney injury requiring CRRT. Specifically, this study included a survey to examine the feasibility to provide CRRT services among hospitals in Thailand and a costing exercise to investigate the unit costs of such services in selected hospitals. Methods: This study included analyses of NHSO's e-Claim databases to inform the incidence of renal replacement therapy usage, and a budget impact analysis was performed from the perspective of the public health insurance system in a 5-year timeframe. Furthermore, The feasibility and service resources survey was conducted by sending surveys to more than 280 hospitals nationwide. Results: The results showed that there were between 3,540 - 6,049 acute kidney injury patients requiring CRRT annually in Thailand, and the cost of CRRT was between 57,502 and 116,890 baht per person. As for the five-year budget impact analysis, If we are referring to the number of patients who need CRRT services at 3,540 will be between 1,017 and 2,068 million baht. In the other case, if referring to the number of patients at 6,049, the budget impact will be between 1,739 and 3,535 million baht. From the stakeholder consultation meetings, there appears to be inadequate support for hospitals to provide CRRT. Moreover, the survey results showed that 88% of hospitals currently providing CRRT could treat more patients if the reimbursement rate for CRRT were to be adjusted to more appropriate level. Conclusion: Information from this study could support policymakers to update reimbursement rate and associated processes in order to improve accessibility to CRRT among critically ill patients with acute renal injury.


location: , 'Thailand year: 2022 source: HSRI

title: Willingness to Pay for Elderly Care in Nam Phong District, Khon Kaen Province

abstract: This study aimed to estimate the value of willingness-to-pay (WTP) for elderly care and study the
impact of factors on willingness-to-pay for the elderly care. A total of samples in this study were 420
people aged 18 years and older, living in Sa-Ad and Nongkung subdistricts, Namphong district, Khon Kaen
province. The study found that mean age of the samples was 57.6 years, 71.0% were females, 75.2%
had primary school education or lower, more than a half lived with a monthly household income of
<10,000 baht, more than a half reported having health problems, and 63.1% never provided care to
dependent elderly. The three major problems related daily activities reported were: 9.8% having difficulty
of physical movement, 8.3% feeling sick, and 6.9% having stress/depression. More than 90% of
respondents were willing to join and pay for the elderly care program. The mean value of willingness-to-pay
for the elderly care was 373.77 baht (SD=286.01). This study found that willingness-to-pay was significantly
associated with age, household income, smoking behavior, quality of life, selfcare problem, anxiety/
depression, willingness-to-join the care program and starting price (p < 0.05). The study also found
that WTP value was associated with household income, size of household, years of providing elderly
care, selfcare problem and starting price (p < 0.05). As willingness-to-pay for elderly care studies are still
limited in Thailand, findings of the present study could be good lessons for other areas or settings.


location: , 'Thailand year: 2023 source: HSRI

title: Database System Development to Support Rational Drug Use Indicators

abstract: The objective of the develop a database system project to support indicators of the rational use of drugs is to develop a database structure for answering various indicators related to the rational use of drugs at all levels. In this project, three parts were done: 1) development of a tool for calculating the indicators of rational use in hospitals; by relying on a database in the hospital information system. This is a new version of ThaiRDU with 3 platforms: a) HOSxP with MySQL database management b) HOSxP with PostgreSQL database management and c) Hospital OS can process 18 indicators for rational drug use in hospitals. All 3 platforms covered almost all the use of hospital information systems of the Ministry of Public Health. ThaiRDU tool was developed with the Delphi program and installed into the Windows operating system. The program was easy to use and no structural changes were made in the database of the hospital information system. It could be processed anytime online. A list of drugs used in hospitals could be set for calculating the indicators. Using hospital drug codes and not relying on 24-digit drug codes, the list of drugs that was imported into processing was accurate. In some indicators, the use of ThaiRDU might be a factor in obtaining indicator values that differed from those reported on the HDC website. 2) The results of the several indicators in three fiscal years obtained from the three data sources, i.e., the developed tools (ThaiRDU), the HDC website (HDC Service), and the Big Data on HDC (HDC Big Data) were similar. However, the results of some indicators were different which depends on many factors. One of those factors was transferring the correct information from the hospital into the HDC system in a timely manner. Using ThaiRDU has the advantage of being able to use primary sources directly. The relevant drug list can be defined without the need for a 24-digit drug code, and the drug list can be updated to be correct at any time. In the case that the hospital has already sent relatively accurate information to the system, the website provides a service plan processing service related to rational drug use that will process various indicators correctly. According to the policy, the hospital will have time to adjust the correctness to bring it into the processing at a certain time. Therefore, the reported values through this HDC website will not change. Researchers can use data from Big Data to process tasks of rational drug use, and 3) define a standard structure for rational drug use. Because the utilization of the accumulated information will be in the form of data analysis, the research team chose a design in terms of fact constellation, i.e., more than one fact table. In this research, two fact tables in two main modules were designed, i.e., the prescription_fact and literacy_fact were fact tables in a module of prescription which was used for analyzing drug use of patients, and a module of health literacy which was used for analyzing health literacy of people, respectively. In the rational use of a drug monitoring system, it can be seen that there is a need for a systematic database to process various indicators. The most systematic database that measures people's actual drug use is the HDC. It focused on drug use in hospitals in the Ministry of Health. This should be proposed to expand to all health services. It is important to measure health literacy. There is still a lack of a database that collects matters related to health literacy at the levels of health media, activities, and various questions used to measure health knowledge. The agencies responsible for such databases in the development of the database are therefore important parts of the further development of rational drug use at all levels.


location: , 'Thailand year: 2008 source: HSRI

title: Lead Levels in the Blood of Residents Living in the Vicinity of a Lead Smelter

abstract: This cross-sectional study was conducted to determine the lead levels in the blood
of people living within 1 kilometer of a lead smelter.  The subjects included were 134
residents aged 20 years and older, randomly selected, one each from the households.
Among them, 103 (77%) were female, 12.7 per cent had occupational exposure to lead,
83.6 per cent spent their time at home seven days a week, 57.5 percent had a primary
education, 54.5 percent lived within 500 meters of the smelter, and 71.6 per cent drank
water from sealed containers.  The average blood lead level was 12.7 micrograms/deciliter.  Factors which were statistically and significantly associated with blood lead levels
were education level, distance from the smelter and source of drinking water.  The results
of this study could be used to locate the hazardous zone surrounding the smelter, to
select safer sources of drinking water and to educate residents at risk in order to prevent
future health hazards


location: , 'Thailand year: 2023 source: HSRI

title: Prevalence of Diagnosed and Undiagnosed Obesity and Complications Found in Electronic Medical Record Database of a University Hospital

abstract: At present, it is apparent that the incidence of obesity keeps increasing. It has also been discovered that there is a strong positive correlation between body mass index and the prevalence of chronic diseases. However, there are still many undiagnosed obesity patients. Therefore, the present research aimed to determine the prevalence of obesity in terms of underdiagnosed cases and chronic diseases in all obese patients from the Prince of Songkla University Hospital information system. This study employed a cross-sectional descriptive approach. We gathered data of all outpatients older than 18 years, excluding pregnancy cases. Data collection was taken from the hospital information system between 1 January 2016 and 31 December 2020. From 327,300 patients, a total of 135,112 patients were included in the study and 35.6% of patients met the Asia Pacific criteria for obesity (BMI ≥ 25 km/m2), but only 15.9% of them were given a diagnosis of obesity using Asia. The prevalence of 3 chronic conditions in obese patients was 21.3% for hypertension, 12.3% for type 2 diabetes mellitus, and 32.4% for dyslipidemia. Moreover, 9.5% of patients met the World Health Organization criteria for obesity (BMI ≥ 30 kg/m2), but only 33.5% of them were given a diagnosis of obesity. The prevalence of 3 chronic conditions in obese patients was 16.3% for hypertension, 18.8% for type 2 diabetes mellitus, and 11.3% for dyslipidemia. This present study showed that despite having a BMI exceeding the threshold for obesity, many people are still not given a diagnosis of obesity. Moreover, the prevalence of hypertension, type 2 diabetes mellitus, and dyslipidemia found among obese patients were lower than research in western countries.


location: , 'Thailand year: 2008 source: HSRI

title: Analysis of the Quality and Efficiency of the Nursing Service System in the Outpatient Department, Srisungwan Hospital

abstract: This retrospective descriptive study was conducted to analyze the quality and the efficiency
of the Nursing Service System in the outpatient department in fiscal year 2007, using a
questionnaire comprising 10 key indicators for evaluation, as contained in the fifth section of the
standards for nursing services; the results were presented as percentages. The study showed that the
nursing practice fulfilled the criteria for eight of the indicators, failed one, and could not be
evaluated for the other.


location: , 'Thailand year: 2002 source: HSRI

title: The health impact assessment of highrises in Muang Chiang Mai

abstract: This research has been conducted in 4 dimensions of health namely, physical, mental, social and spiritual health in both positive and negative impacts.  The research design was a participatory action research with rapid appraisal and survey. Activities included two workshops one for academics and the other one for stakeholders to discuss and advise indicators to be used in the assessment. After the questionnaire was constructed, a survey was conducted in 2,744 samples comprising in-building, around-building, and general residents.The literature reviews showed that building constructions in the past in Muang Chiang Mai were not well planned and managed, specifically lack of city vision to guide the direction of development. Most of the times, they depended on the administrators’ policies without people participation resulting in Muang Chiang Mai’s vague direction of development. The results show that the around-building and general residents had more physical health impacts than the in-building. This might be the indirect effects of highrises. i.e., the urban heat island phenomenon that causes more air pollutants deteriorating the respiratory system. The hypertension and cardiovascular diseases might be the results of anxiety due to mental and social health problems. The assessment of other dimensions of health also showed that the around-building and general residents had more health impacts than the in-building. The older and longer-living tended to have more health effects than the others.It is suggestive that:The highrise construction permissions for those non-constructed should be cancelled.The height of highrises should be revised in accordance with the context of Chiang Mai not that of the Act, which enforces nationwide.The highrise constructions should be controlled more stringent, and buffer zone should be re-considered.The areas that are allowed for highrise constructions should not those that can potentially be threatened to ecology, urban heat island and historic conservation.The Ministerial Laws enforcing the town planning should be amended that land uses in each zone should take the vertical dimension into account and the percentage scheme of land use should be cancelled.


location: , 'Thailand year: 2011 source: HSRI

title: Learning and Sharing Together to Empower Society

abstract: Chiang Mai University applied the concept of social work volunteers
managing a workshop camp under the project of Learning and Sharing Together to
Empower Society.
This project’s aims were to support and instill moral integrity and ethics for students
and participants. In cooperation with other local sectors and organizations in Chiang
Mai, this workshop organized various activities that gave opportunities for the
disabled in local areas to experience self learning and development by sharing
experiences with others. Participants learned about the value of life, equality in
society and an awareness of the disabled, different life styles and social problems.


location: , 'Thailand year: 2001 source: HSRI

title: Possible models of health promotion and care for elderly under the condition of community participation and elderly's need : a case study in Songkhla province

abstract: This study aimed to explore the health status of older people, their health behaviors and needs of health care services. Also it explored the potential and readiness of community participation and investigated strategies for providing health services under the condition of community participation and meeting elderly’s needs. Data were collected from older people who lived in two rural villages in Songkhla province. Participants were 95 from older people, 59 from village A and 36 from village B. Questionnaires, interviews, audiotape focus group meeting and home visits were used to collect relevant data. Data were then analyzed using content analysis. The results showed that among the 95 older people, thirty-seven percents were males and sixty-three were females. Ages ranged from 60-84 years with the average age were 71 years. The average age for male older people were 67 and for female were 72. All participants were Thai ethnic and Buddhist. Most of the participants, had primary school educated and living with their spouses and children. They perceived having adequate incomes and perceived their health as “equal or at the same level of health” as compared to other older people in their age group. Sixty-one percents of the older people perceived that they had some health problems. The three most common health problems were a. knee joints/back pain (30%), b. hypertension (27%) and c. heart disease (16%). Health promotion behaviors of the participants were practicing followed the medical advice, exercise, and eating useful food. In their perception of needs of health care services, they reported that they wished to be healthy so that they still can be able to keep working and keep performing self-care. As they were healthy, they did not expect help from their children or from the community. However, when they were ill, they would like their children to help taking care of them or accompanying them to see doctors and paying the bills. They indicated their needs to meet other older people as a social group and having organized group activities such as exercise, health education, group relation, dinning together and offering medications when getting a minor illness such as catching a cold. In surveying of the readiness, potentiality and community participation needs, the data revealed that the studied communities had economic readiness as the people felt their children could find jobs and gain adequate incomes. There were group gathering of housewives and teenage representatives to performed activities. After discussed with key persons involved in caring for older people including elderly themselves, to identify a health promotion model that involved community participation and meeting the needs of older people. Firstly, the community agreed to enhance the local wisdom projects to treat the main health problems of elderly, for example, the use of herbal medicines and massage to treat the arthritis/ joint pain of the older people. Second, the community agreed to arrange a group gathering of older people to run the health promotive activities. The activities would function under the guidance of the health professionals in the design and conduct of various programs. An exercise program would be initiated and instituted by the health professionals. Funding support would have to come from the local government so that the programs can be perceived as governmental support and co-operation for local initiatives. Thirdly, the children and housewives group were agree to support and take care the older people when they get into late older and got sick. Two factors influenced the success of implementing the health promotion program for elderly were the leadership and the attitude and expectation of older people to the group gathering.


location: , 'Thailand year: 2004 source: HSRI

title: The Model of dental health care under universal health care coverage policy in Maung district, Buriram province

abstract: Nowadays, The government has concerned about the health system by using the policy of universal health care coverage as “ 30 Baht health care”, which emphasize on advance-service system and management of particular area. The problem seen in Amphur Muang Buriram is there are a lot of  workload in dental clinic,  Buriram Hospital. So dental staffs have to take time and partial budget for management, and dental services in community health center, especially the dental public health in school. Thus the management of dental public health in Amphoe Muang  Buriram, has to have an effective  management in human resources, time, and budget, through the co-operation of associated organizations for the appropriate service pattern in that area  and the most benefit for people.The purpose of this study is to develop the proper pattern of dental service in Amphur Muang Buriram, according to the health policy under the condition of resources limitation in this area. The methods are 1. Collecting the historical data of dental public heath projects in Amphur Muang Buriram, 2. Reviewing project patterns of other provinces, 3. Brainstorming for determining the proper model of process in clinic and community, and 4. Evaluating the indicators (i.e., dental services in clinic, waiting time for special treatment, the coverage of dental health in school, and the satisfaction of dental patient and staff) after implement  the developed  model  for 6 months.The results from brainstorming showing that there are the development of services:1.Expand the network of dental service subcontractor for people with UC card at  Buriram Provincial Public Health Office.2. Development of dental service system in Community Public Health Centers that have  dental nurse3.Begin  the mobile car of Buriram Hospital for dental services in school.4.Initiate system and format of oral health  report  in school, which developed by staff. 5. The results from change evaluation show that quantity of overall dental services is raised in every dental clinic, increased waiting time of some special treatments  (since there are movement and/or resign of dentists), and the satisfaction of patients  and staff is increased.In conclusion, the development of dental services by participating of staff can create the pattern of process accordance with the situation area. Moreover, the evaluation should be taken and continuously modified for suitable dental service according to variations of situation.


location: , 'Thailand year: 2023 source: HSRI

title: Immunogenicity of the Third Covid-19 Vaccines Booster Dose in Adults with Completed 2 Doses as Recommended by the Ministry of Public Health

abstract: Objectives: To report the safety and immunogenicity profile of a protein subunit vaccine (CovovaxTM) given as a third (booster) dose to individuals primed with different primary vaccine regimens. Methods: A third dose was administered to individuals with an interval range of 3-10 months after the second dose. The four groups were classified according to their primary vaccine regimens, including two-dose BBIBP-CorV, AZD1222, BNT162b2, and CoronaVac/AZD1222. Immunogenicity analysis was performed to determine binding antibodies, neutralizing activity, and the T-cell responses. Results: Overall, 210 individuals were enrolled and boosted with the CovovaxTM vaccine. The reactogenicity was mild to moderate. Most participants elicited a high level of binding and neutralizing antibody against Wild-type and Omicron variants after the booster dose. In participants who were anti nucleocapsid immunoglobulin G-negative from all groups, a booster dose could elicit neutralizing activity to Wild-type and Omicron variants by more than 95% and 70% inhibition at 28 days, respectively. The CovovaxTM vaccine could elicit a cell-mediated immune response. Conclusion: The protein subunit vaccine (CovovaxTM) can be proposed as a booster dose after two different priming dose regimens. It has strong immunogenicity and good safety profile


location: , 'Thailand year: 2017 source: HSRI

title: Utilization and Unmet Healthcare Need for Outpatient and Inpatient Services of Population Living in Bangkok Metropolitan in 2015

abstract: An achievement of the Universal Health Coverage since 2002 has increased an access in health care utilization of the Thai population. However, populations in Bangkok tend to have an access problem. Basic structure of health service system in Bangkok is different from other regions. This study aims to analyze healthcare utilization and unmet health need both in outpatient (OP) and inpatient (IP) services of population in Bangkok. This is a descriptive study. The 2015 Health and Welfare Survey provided a sample of 5,893 individual persons living in Bangkok for data analysis. Majority of population in Bangkok were covered by the Universal Coverage Scheme (UC) (47.9%) and Social Security Scheme (33.8%). 64.2% of population under UC were in age group 15-60 years, however, 35.8% of them did not work and 18.8% of them were in the poorest quintile. For the OP illnesses, 35.2% of the UC had self-care, mostly by purchasing medication from drug stores. When seeking care at the public hospitals, the UC poorest quintile paid out of pocket disproportionately higher (24%) than patients of other quintiles, with the median amount 1,500 baht higher than the richer quintiles. For IP services, majority of the UC (71.1%) admitted to public hospitals. 32.5% of the poorest quintile had to pay out of pocket for the service with median amount 2,000 baht. Among UC respondents, unmet health need for services was 7.4% for OP and 1.3% for IP, higher than other schemes. The main reasons of the unmet health need for IP services among the UC were unaffordability, inconvenience in travelling, and time barrier (34.6%, 22.3%, and 13.9%, respectively) In Bangkok Metropolitan Area, public hospitals should facilitate an easy access to health services for the UC beneficiaries who had relatively low socio-economic status. This would help mitigate the unmet health need caused by financial hardship due to health payments.


location: , 'Thailand year: 2001 source: HSRI

title: The reform in disease prevention and control

abstract: The Reform in Disease Prevention and Control	The authors present examples of damages and disasters caused by a panic of Plague in India, an epidemic of mad cow disease in Europe, an embargo on imports of seafood from epidemic-stricken countries. These damages are due to mistakes in using technical knowledge in the control and prevention of diseases. This report also points out that non-communicable diseases are important and require a lot of technical knowledge to tackle.	It is proposed that reform in disease prevention and control should be divided into two parts: intelligence and operational services.	Intelligence services an intelligence organization, namely Institutes for Heath Surveillance, should be set up to be independent of the Ministry of Public Health. It should be an autonomous body governed by a board chaired by the Minister of Public Health. The duties of the Institute are: to gather technical knowledge related to disease control and prevention, both domestic and international; to continuously develop the country database systems for monitoring communicable and non-communicable diseases; to cooperate with the international community; to conduct and support research projects on disease control, and to develop human resources. The institute must have proper strategies for management  that can coordinate resources among all domestic and international technical bodies. The institute must also be very efficient in mobilizing resources from all relevant sources. It is not necessary to have epidemiologists for all diseases, or regional branches or its own comprehensive laboratory. However, it should have budgets and the ability to make use of  academics in other institutions and to work with the network of laboratories in every part of the country efficiently.	Operational Services    The operation of disease prevention and control can be divided into two parts; firstly the clinical process such as immunization, screening, treatment and prevention of disease complications and secondly measures other than public health services, e.g. social and legal measures, improvement on safety and environment, regulation of industrial and agricultural products, etc.	The Ministry of Public Health should be responsible for disease prevention and control in the following areas: regulating rules, securing central budgets to support local needs, procuring supportive materials for local communities, providing special clinics for certain diseases, monitoring disease prevention and control activities.	Clinical control will largely be under the responsibility of the health services, whose quality is assured by hospital accreditation processes.  The Institutes for Health Surveillance would have to set standards for the quality of services related to preventive care, regardless of whether the service providers is private or under central or local governments control.


location: , 'Thailand year: 2008 source: HSRI

title: An Outbreak of Influenza A (H1N1) in Li District, Lamphun Province, November 2007

abstract: An outbreak of influenza A (H1N1) in Li district, Lamphun Province in November
2007 led to investigation and control of the event and an epidemiologic study to determine the characteristics of the outbreak, to define the cause and factors associated with
the outbreak, and to implement effective prevention and control measures. Methods included
descriptive epidemiology, environmental survey and laboratory study. A total of
80 cases were identified in this outbreak; 58.8 percent were students and 35 percent were
children aged 5-9 years. The causative virus, influenza A (H1N1), was identified by PCR
technique in 61 out of 77 cases (79.2%). The highest incidence rate of 38.31 per 1,000
population was evident in Village 5 of Srivichai subdistrict. The propagated source epidemic
probably started after introduction of influenza virus A by a student who contracted
it from the local market and then spread it at his school. The health team implemented
comprehensive control measures, including health education on disease etiology
and prevention for local residents both in the school and the community, screening and
isolation of new cases, giving prompt treatment, providing masks and promoting hand
washing among school children and teachers, temporary closure of schools to cut the
transmission chain, and active surveillance and early treatment in the community. A
field hospital was set-up in a temple to accommodate and provide treatment to overloaded
cases from Li Hospital. As a result of all intervention measures implemented by
public health agencies, community leaders and villagers, the outbreak was curtailed
quickly, with no further outbreak in nearby areas.


location: , 'Thailand year: 2018 source: HSRI

title: Knowledge, Perspective, and Reasons of Not-Calling Emergency Medical Services in Thailand

abstract: Emergency Medical Service (EMS) can help increase survival rates and reduce possible disability among emergency patients. However, the number of calls for EMS is relatively low in Thailand. This study aimed to inspect the knowledge, perspective, and reasons of calling and not-calling the EMS by patients or their relatives who visited the emergency room in 45 government and private hospitals from December 2015 to February 2016. The hospitals were scattered in 9 provinces with the sample of 2,028 patients, whereby 646 patients had called EMS and 1,368 came by themselves or otherwise. The key reasons for not-calling were: the convenience of personal transportation (76.0%), avoiding waiting time for an ambulance (31.0%), and anxiety on the emergency situation (28.9%). Most misconceptions on the EMS included: (1) Ambulances were used only for casualties from accidents, and (2) Ambulance services were not free. In terms of perspective, most patients or relatives had negative views towards the EMS, especially the idea that they had to help themselves until the condition was severe or medications or relief devices were unavailable. Another view was that the EMS was slower than getting to the hospital on own-self. These perspectives were from non-users more than users. In conclusion, the study indicated that the causes of non-user involved misunderstandings, poor perspectives, and lack of awareness as well as the absence of knowledge on threats related to particular emergency conditions. Hence, regional agencies, the National Institute of Emergency Medicine, and the Ministry of Public Health should discuss the solutions to raise public awareness and to improve the perspective towards the EMS, in order to promote more usage.


location: , 'Thailand year: 2008 source: HSRI

title: Management of health technology assessment in foreign countries

abstract: Title: Management of health technology assessment in foreign countries
Objective: The study aims to explore how the processes to assess the appropriateness of health technologies are managed and carried out in responsible organizations in other countries.
Methods: Literature search on MedLine, Google Scholar as well as institutes websites were employed in order to gather relevant information. The selection criteria were; (1) the institute must be the national representative and noncommercial institute (2) data must be able to retrieve via electronic database and (3) relevant information must be in English. Certain institutes with rich and
useful information were selected purposively. Content analysis of the documents was the major approach of this review.
Results: Health technology assessment institutes in 10 countries, namely England, Germany, the Netherlands, Sweden, Denmark, the USA, Canada,Australia, Republic of Korea, and South Africa are included in this study. The review suggests that the processes undertaken in these organizations can be divided into 4 main steps: (1) The selection of health interventions to the assessment: Website is a common channel for topic submission. Eligible stakeholders to propose particular technologies comprise different parties namely including healthcare professionals, government bodies, health technology users and the public. The magnitude of health problems expressed in term of ็burden
of disease้ is the most widely-employed criteria. (2) Assessment and consultation: Once the topics are selected, groups of researchers will be assigned to conduct the assessment according to their expertise. The research team generally consists of members of the institute,s advisory committee and scientists from universities, research institutes and representatives of government agencies. (3) Approval of the evaluation results: consultations are convened to obtain comments and suggestions concerning the assessment results. This stage involves experts in relevant fields, health minister, and other key stakeholders in order to ensure the reliability and acceptability of the findings and policy recommendations. (4) The appeal procedure: Concerned parties are allowed to make appeal over the disagreeable assessment results. This procedure is available in some institutes with appraisal or policy decision authority. With regard to the good governance, it is argued that such an idea should be
incorporate in the management of health technology assessment, since the results of the assessments and relating policy recommendations are undeniably affect a wide range of actors in the health sector. Concerning issues include the potential implications for the access to healthcare, government’s budget as well as business’s profits.


location: , 'Thailand year: 2008 source: HSRI

title: Effect of the Positive Self-talk Training Program in Patients with Generalized Anxiety Disorder

abstract: This quasi-experimental research study was aimed at assessing the effect of the positive
self-talk training program on anxiety in patients with generalized anxiety disorder.
All subjects were outpatients of the Takfa Hospital, Nakhon Sawan Province, seen during
the period October through December 2007. The study was one of a group of pre-post
tests conducted on 15 subjects obtained from random sampling. Research instruments
comprised (1) a demographic data form, (2) the translated version of State-trait Anxiety
Inventory of Spielberger, and (3) the Positive Self-talk Training Program based on the
concept of Nelson-Jones. Data were analyzed using descriptive statistics and paired ttest.
The findings were that the state-anxiety score of the patients decreased significantly
after they joined the Positive Self-talk Training Program (p < 0.05). The finding suggests
that the methodology could be taken as a guideline for ameliorating anxiety in patients
with generalized anxiety disorder.


location: , 'Thailand year: 2008 source: HSRI

title: A Synopsis of the Official Opening of an Art Therapy Demonstration Center and the Activities of the Third Art Therapy Specialist Seminar

abstract: After almost 20 years of effort, the Art Therapy Demonstration Center was established under the
Rajanukul Institute, a 48-year-old mental health hospital and academy of the Department of Mental Health,
Ministry of Public Health. The date was April 3, 2008 and the occasion was presided over by General
Wanchai Ruengtrakul, President of the Rajanukul Foundation, and Dr. Wachira Pengchan, Deputy Director
General of the Department of Mental Health, Ministry of Public Health. The co-chairpersons announced
the official opening of the “Art Therapy Demonstration Center.” The opening event was followed
by the Art Therapy Specialist Seminar on “Art Therapy Roadmap in Thailand”, which was attended
by 120 mental health personnel, some art therapists, professional artists and art educators, among
others.
The seminar comprised two sessions: “Art Therapy in Thailand” and “Art Therapy in the West.” The
first speaker, Dr. Udom Petchsangharn, the former director of the Institute, spoke of the value and status of art therapy in Thailand based on the concept of “adjunct therapy” or “essential adjunct therapy,” and
the role of “art” in human sociology, and its power in the treatment of the mind. The second speaker, Prof.
Punya Vijinthanasarn, an outstanding artist and Dean of the Faculty of Painting, Sculpture and Graphic
Arts of Silpakorn University, spoke on the historical development of fine art in association with innersubconscious
expression by using extensive examples of Western art works. Prof. Saman Supprasri, Dean
of the Faculty of Fine and Applied Arts, Burapha University, gave notes on the role of art education and
aesthetical values in relation to the therapeutic approach. Dr. Lertsiri Bovornkitti concluded the session
by addressing the role of art therapy and its value, and the characteristics and knowledge that art therapists
should formulate, i.e., the two types of art therapy in the West: “Art as Psychotherapy” and “Art as
Therapy,” and then summarized a roadmap for art therapy in Thailand.
He acted as moderator for two invited speakers, Mr. Jordan Potash from the United States and Ms.
Debra Kalmanowitzs from England, who spoke on “Art Therapy in the West.” An example of historical
practices associated with traditional and indigenous art therapy was Navajo sand-painting. They also
provided background knowledge of art therapy in the West based on the two concepts, art as therapy and
art psychotherapy, explicating the three knowledge roots of art therapy, i.e., art, psychology and therapy;
and theoretical notions on “witness/witnessing.” The presentation was followed by a question-and-answer
session related to the practice of art therapy. The presentations of the two international art therapists
provided support for the future development of art therapy in Thailand.
For further improvement of the knowledge of Thai art therapy, the authors suggest that a series of
art therapy workshops be organized by qualified international art therapists and educators for the Thai
art therapy practitioners and those who are interested in this newly developing field.


location: , 'Thailand year: 2003 source: HSRI

title: The health impact assessment of Map Ta Phud industrial development and its vicinity

abstract: The Health Impact Assessment of Map Ta Phud Industrial Development and Its Vicinity is a retrospective case study and successfully carried out with support of the Research and Development Program on Healthy Public Policy and Health Impact Assessment (HPP-HIA) under the Health Systems Research Institute. The study is also done in response to the Program’s approaches towards the health systems reform. Industrialization of Map Ta Phud has been carried out based on the policy to promote the Eastern Seaboard program since early 1980’s. Map Ta Phud is assigned to serve heavy industries of petrochemical, oil and gas refinement, iron and steel for the period of 50 years.  Industrialization here stemmed from hopes and dreams that economic propensities were being brought to the country, and that it would uplift Thailand to the status of a Newly Industrialized Country, in particular promising exploitation of natural gas.  Map Ta Phud was touted as the most modern industrial estate in the making. Public was promised that with its high standard of management and control, there would be no pollution problems. However, in the last two decades, accumulated pollution and environmental problems as well as mysterious diseases have begun to emerge as very much linked to each other, and hugely affected small people in the area. At present Map Ta Phud People suffer hard the air pollution especially the bad smell while Rayong province boasts the highest number of patients suffering from respiratory diseases. The province is also known as having one of the most highest numbers of AIDS infected people and AIDS-related deaths as well as a great number of mentally ill patients and commit suicide cases. Similarly, the number of industrial incidents and accidents on roads is dramatic due to rapidly increasing chemical use and  transports. Drastic changes in the exploitation and quality of natural resources and production of rural sector are obviously akin to the uprooting of the way of life of individuals, families and communities which directly affects to their livelihood.This study, therefore, put on exploring impacts at Map Ta Phud in various forms, in particular through the issue of “health” under a much broader definition than the conventional one. According to the essence of the drafted National Health Act, “health” is defined as the state of human integrated well-being in four aspects of physical, mental, social and spiritual health.  Consequently, the outcomes revealed in this paper are rather vogue and pioneering, as there has been none of such study on industrialization with this particular focus.  In addition, this paper also applies the WHO’s health and environment analytical  framework (or DPSEEA model) to  analyze the causes and effects of industrial development at Map Ta Phud. The framework divides the analytical process into five levels of Driving force, Pressure, State, Exposure, Effects and Actions. Based on the process, each specific development programs will be recognized as the driving force of the overall potential health impacts and risks. This driving force can lead to increasing in environmental and social pressures. Such pressures might cause drastic changes in the state of environmental and social quality,  after which it leads to  exposure to the industrial pollution and social problems and finally ends up with various forms of health effects. Apart from the WHO’s model, the conceptual framework of healthy public policy process is also partially applied in responding to some complicated aspects of the existing problems as well as to propose proactive approaches at different levels to improve those health effects.


location: , 'Thailand year: 2016 source: HSRI

title: Thailand Future Health System in 2033

abstract: Thai health system is currently affected by constantly changing environmental factors. Forecasting
the future of the country is essential for preparing the future health systems. Defining future preferable
health systems is an important first step of country’s future health system developments, which later
would deliver efficient resource allocation and maximize social utility. Literature review and expert consultation
meetings were conducted. There were 18 meetings held with a total of 121 experts or well-known
people to define what are the preferable health systems in 2033, compared with the status quo scenario.
The status quo scenario is the passive health systems, focusing on treatment, using human resources
and being centralized. While the preferable health systems would emphasize on health promotion, make
high use of information technology and promote community to be able to manage and cope with health
problems in own environment with high health literacy level.
In conclusion, the preferable health systems can guide future directions or priorities to support future
health research.


location: , 'Thailand year: 2008 source: HSRI

title: Unit Cost of Health Services in Mae Sariang Hospital, Fiscal Years 2003 and 2004

abstract: Unit cost analysis has often been used as a tool to determine the efficiency of a health-care facility.
Policy makers employ the unit cost of health services in order to make decisions on resource allocation
and for efficiency improvement. This descriptive study was aimed at calculating the unit cost for each cost
center in Mae Sariang District Hospital by collecting financial and accounting secondary data during
fiscal years (FY) 2003 and 2004. The study then evaluated a change in the unit costs of the health services
in each cost center for the two-year period. This study applied the principle of cost analysis and the manual
of unit cost analysis for district hospitals affiliated with the International Health Policy Program (IHPP).
Costs in the study were defined as accounting costs with a provider’s perspective.
The results showed the following proportion of labor costs, material costs, and capital costs in FY
2003 and 2004: 57.73; 27.59; 14.68 and 61.61; 31.61; 6.78, respectively. Average unit costs of all outpatient
departments were Baht 257.01 and 256.33 respectively. Those of all in-patient departments were 4,579.31
and 4,944.22 Baht per case admission, respectively, and the unit costs per adjusted relative weights were
6,575.79 and 7,177.76 Baht, respectively. Compared with the out-patient departments, the unit cost of
dental services was the highest (679.28 baht per visit) in FY 2003 and the counseling service department
had the highest cost (684.39 baht per visit) in FY 2004. Among in-patient wards, the intensive care unit
(ICU) had the highest cost in both years (14,327.40 and 12,338.29 baht respectively per case admission). A
comparison between both years revealed an increase in the number of ambulatory visits and in-patientdays
in most departments. Compared with unit costs in FY 2003, half of the out-patient service centers
had a higher unit cost, but most of the in-patient departments, except for the male ward, could operate at
a cheaper in-patient-day. The data collection methods and the unit cost calculations as described in the Manual of Unit Cost
Analysis for District Hospitals, which were used in the study, were practical and easy. The proportion of
the labor costs to total costs of Mae Sariang Hospital was similar to that of other district hospitals. The
average unit cost of out-patient services was not very different from that of other 90-bed hospitals, but the
average unit cost per in-patient case was higher. Specialists practicing in the hospital and the provision of
ICU services and preterm baby care may explain the more expensive unit cost for in-patient care. In terms
of cost efficiency, an increasing number of patients and the total expenditure in some service centers actually
resulted in an increase in the unit cost; thus, several service centers surprisingly turned out a cheaper
unit cost for visits as well as unit cost of in-patient-days. The findings may indicate greater efficiency of
resource utilization. However, the quality of health services and relative weight of diagnosis-related groups
should be taken into account.


location: , 'Thailand year: 1999 source: HSRI

title: Social organization and the development of Tambon Civil Society : a case study on Ubonrat District, Khon Kaen Province

abstract: Social organization and the development of tambol civil society:a case study on Ubonrat district , Khon kean provinceThis study is a comparative study of the development of civil society in two sub-districts, Tung Pong and Kong Sung in Ubonrat District Khon kane Thailand. Using an analytic research approach, data were gathered by key informant interviews, community leaders' group discussion and compact questionnaires.     It was found that civil society have been existed at village level and closely related to cultural and mythical belief. Civil action and linkge at the sub-district or "Tambon" level  were also existed through kinship and cultural beliefs. External factors which facilitate civil society at tambon level are the country's administrative reform of decentralization and the new constitution which recognize the community rights in resource management. Internal factors are undamentally endowed and related to matri-archal kinship system, indigenous knowledge, sufficient economy, people organization, good leader and interactive learning.  In both tambons, there were similar formal groups supported by the government. Tambon organization and a group of village health volunteers were foremost accepted by the people. The two groups appeared to have good communication network above village level. Both organizations were dependent on external funding and bureaucratically supervised. The change from agricultural to industrial based community as found in Tambon Kok Sung became an importance condition the weaken traditional civil society in the area.There are exists conflicts of land and water uses. This conflict has not been concertedly solved by existing people organizations including Tambon Administrative Organization. In contrary, Tambon Tung Pong has remained agricultural based without serious resource management problem  and socially knitted by kinship. Tambon civil society in this  case was strengthened by interactive learning process, people   participation and progressive leaders. Experiences learned from  working with the NGO in the community enable Tambon leaders to modify their way of communication through series of meeting planning and evaluation. Water management system which has been totlally run by villagers was a unique example of people civil society of this Tambon. As a result it was found that Tambon Tung Pong were more serene and self sufficient as compared to Tambon Kok Sung. Example drawn from this study suggested that existing culture and mythical belief as well as kinship were supporting civil society in the rural community under normal and agricultural condition but it was not enough to tackle emerging conflicts along the path of development. Existing people organization and interest groups need to develop interactive communication systems, good management and transparency and democratic decising making. All these can only come about when people realized that public issues are, in deed, individual concerns


location: , 'Thailand year: 2013 source: HSRI

title: Cardiovascular disease risk assessment

abstract: Ischemic heart disease and stroke are two major health problems in Thailand. This study aims to
review existing evidence of the screening for cardiovascular diseases at the population level from the
clinical practice guidelines used in selected countries, including Thailand. It is recommended that a global
risk score, known as the Rama-EGAT heart score, should be used for the general Thai population aged 35
years and above to screen for the development of coronary heart disease at 5 year intervals, with a plan to
monitor and evaluate the method at the population level. Further research is also needed for the development
of a global risk score for strokes in Thailand.


location: , 'Thailand year: 2022 source: HSRI

title: COVID-19 in Thai Society : Documenting Coronavirus Crisis and Epidemic Responses

abstract: This research aims to understand and uncover experiences, thoughts and practices of the 5 groups of people in dealing with COVID-19 includes (1) executives and policy makers (2) medical and public health officers (3) disease control workers (4) poor and disadvantaged people and (5) civil people and journalists. This study used both qualitative and quantitative research methodology. Conducting in-depth interviews with 148 people and use an online questionnaire to get the data from 555 samples. Information from social media and online documents are also collected. From March to November 2021 is the period of data collecting. This study uses anthropological perspectives to suggest that the COVID-1 9 crisis is syndemics that inseparably related to unequal society, economy, politics and human life. The 5 chapters of this research are: (1) recording important events of the COVID-1 9 outbreak in Thailand, which is divided into 5 periods. (2) a study of the experiences of 5 target groups. (3) lessons in the work of various organizations in the COVID-19 crisis. (4) an analysis of social science knowledge in an pandemic situation. (5) conclusions and policy recommendations. The four key findings are: (1) the Thai state uses medical, economic and governance knowledge that leads to a centralized command system and controls people in the same inflexible regulation. The Thai state does not understand the different changing socio-cultural contexts found in local areas and communities. Government solutions do not meet the needs of the people. Social science knowledge disappears from the Thai state policy-making that reproduces and expands structural violence in which the disadvantaged people are damaged. (2) failed coordination between government agencies, civil organizations and the private sectors can be found in every local communities. Government officials do not plan for effective work and change practices over time. This problem is the source of conflicts. Another important problem is that there are a poor welfare and caring for medical and public health workers. (3) people distrust in the government because of their inefficient work and error decision making. The Thai government fail to give public enough and clear information but give privileges to some people. This problem leads to the people protests and calling for the government resign. (4) there have been several unexpected consequences in government policy. Particularly, the lockdown and the close of various businesses that affects many people who work in the informal sector. Policy recommendations are outlined in the final chapter for government agencies to take account in solving the pandemic in the future.


location: , 'Thailand year: 2010 source: HSRI

title: Prevalence Rate and Related Factors of Musculoskeletal Disorders in Sugarcane Workers

abstract: This cross-sectional descriptive study was aimed at determining the prevalence rate and related
factors of musculoskeletal disorders in sugarcane workers of Baan Meng subdistrict, Nong Rua District,
Khon Kaen Province. The data were collected in the period from April to May 2009 by interviews; they
were modified using Worksheet “A” and Worksheet “B” MSI risk factor identification of the Workers’
Compensation Board of British Columbia, Nordic Musculoskeletal Questionnaire, and the musculoskeletal
disorders questionnaire devised by Somkiat Siriratanaphruek MD, PhD. All 219 sugarcane workers in
Baan Meng subdistrict were randomly selected. The prevalence rate of musculoskeletal disorders in the
sugarcane workers over the previous 12 months was 72.6 percent. Factors significantly related to musculoskeletal
disorders were maintenance work, extending arms away from the body for at least two hours
per day and working with repetitive movement for at least two hours per day. The authors recommend
that these practical surveillance guidelines be developed and provided to the governmental agencies concerned
in order to prevent such musculoskeletal disorders in sugarcane workers.


location: , 'Thailand year: 2004 source: HSRI

title: Manual on qualitative research for health professionals

abstract: The report is a result of an ongoing process of developing manual on qualitative
research for health professionals. The process of drafting the manual was a participatory
developmental process involving researchers as well as health professionals which are
targeted as the end users of the manual. Beginning with a manuscript developed by a group
of researchers at the Society and Health Institute, the draft manuscript was used as a manual
for an experimental training workshop for a group of health professionals. Participants of the
workshop were asked to reflect and suggest ways to improve the manual. Suggestions were
used to rewrite the manual and it will be tested by further trainings before final version could
be made available. The current report is therefore in its initial stage and needs further
refinement.
The purpose of this manuscript is to serve as an introductory manual for qualitative
research. It aims at providing health personnel with basic understanding of research work
and exercise for increasing necessary research skill. The manuscript is divided into four
chapters. The first chapter provides philosophical foundation for understanding how
knowledge is created in different modes of research work. It also explains the fundamental
principles and the differences between qualitative and quantitative research. The second
chapter discusses how to relate problems in everyday working situation of health workers to
research work. The third chapter discusses the methodological aspects of qualitative
research, starting with how research questions are formulated. Methods for data collection
are extensively elaborated with examples. Research tools and exercises are also included.
The final chapter discusses how qualitative data is analyzed and interpreted. Techniques on
report writing, presentation and how to make use of qualitative research results are also
incorporated in this chapter. Useful bibliographies on research design and methodology are
provided for further study. Techniques on proposal development and how to write a good
research proposal are also provided in the annex.


location: , 'Thailand year: 2022 source: HSRI

title: Research Program under Inclusive Society Research Excellence Centre (ISREC)

abstract: This research aims to develop the knowledge about problem situations, causes and guidelines for driving social change. at the goal of creating a supportive society do not abandon each other through a series of research on target groups, areas or issues by creating quality academic work can bring the results into action to solve the problems of vulnerable groups and develop an effective health system that responds to all people and to develop the potential of researchers and people working in complex and difficult-to-reach marginalized populations through the development of methodological knowledge A new kind of training focused on real-world operations. and connection Seek cooperation between partners, networks, both from higher education institutions in the country. and abroad Public organizations, government agencies, NGOs Driving social change by developing a management system for the Center of Excellence to be the center of academic work for vulnerable groups and is a center for disseminating various information by creating a public communication space to drive policy and research strategies for vulnerable groups that can be put into action. aiming to create a society that does not leave each other at various levels, both at the policy level and the area The results showed that Reviewing family knowledge for a database Knowledge and understanding of family conditions in the context of Thai society that are facing It is such a study that will lead to seeing the "family" in the dimensions and surrounding context. To support the drive to solve the problem of social vulnerability situation. and understanding technology issues in the future world There will be a connection with human beings in terms of rights. The fairness that will occur is different for many levels of people. While the study of access to health systems among vulnerable populations both children and adults It is a study of both the body of knowledge about the complexity of the problem of social inequality and related dimensions in economic, social and political aspects. It has been found that inaccessibility of public health services is an important factor that must be addressed in the mechanism of both in the system and outside the system The research hence contains summary and policy proposals, 1) Work should be developed in the dimension of knowledge development concerning the complexity of social inequality problems. both in terms of situations Causative factors and contextual conditions in various dimensions and levels, and solutions at both the operational level and the structural or policy level. 2) Developing the potential of workers is important Because it is a solution that leads to the development of people in the mechanism of work both in the system and outside. Ready to drive work that is difficult and complex effectively 3) Should create a prototype area to perform specific problems. Based on the knowledge developed and networking at all levels from policy to community which will lead to driving for change in the future.