location: , 'Thailand year: 2008 source: HSRI

title: Thai Diabetes Risk Score Applied to Cost-effectiveness Analysis of Diabetes Primary Prevention for Prediabetes in Thatpanom District, Nakhon Phanom Province

abstract: The objective of this quasi-experimental research was to apply the Thai diabetes
risk score for evaluating diabetes prevention outcome in order to conduct a cost-effectiveness
analysis of diabetes primary prevention for prediabetes. The study population
included 1,182 cases of prediabetes selected by verbal screening criteria and impaired
fasting glucose level (100 - 125 mg/dl); they were divided into two study groups for
comparison. The experimental group consisted of 400 prediabetes cases who agreed to
participate in a prediabetic day camp; the control group comprised 410 prediabetes cases
receiving ordinary health-care services. The instruments used for collecting the data were
questionnaires, Thai diabetes risk score, customer and provider cost data recording profiles,
practice guidelines for a diabetes prevention program in a day camp. Data were
analyzed statistically, using frequency, percentage, mean, standard deviation, and ratio;
they were comparatively analyzed by t-test and paired t-test at the 0.05 level of statistical
significance.
The results of this study were as follows: (1) prediabetic day camp activities effected
a reduction in the cumulative incidence of developing diabetes by a factor of 7.49 times in
the experimental group (relative risk = 7.49) compaired with the control group; it also
statistically significantly decreased the average diabetes risk score and the probability
level of the sample in the day camp compared with those in the control group. Furthermore,
the risk factors for diabetes reduced from lifestyle modification caused a statistical
decrease that was significant (p < 0.05) on both average BMI and BP level, except for
waist circumference; (2) the effectiveness of diabetes primary prevention for prediabetes
justified by summation of the individual differences in diabetes risk probability before
and after intervention was 0.0198; otherwise the cumulative incidence of lower diabetes
risk score for prediabetes in the experimental group revealed a score of 0.2375; (3) the
economic cost of diabetes primary prevention for prediabetes in the prediabetic day camp
was 357,100 Baht, with the opportunity cost being 20.31 percent compared with the total
cost; (4) the cost-effectiveness ratio of diabetes primary prevention for prediabetes in the
day camp was 18,035,353 Baht per effective diabetes risk probability prevented and/or
1,503,578.9 Baht per effective cumulative incidence prevented.
It was recommended that (1) the research findings should provide important information
for policy decisions to apply the Thai diabetes risk score for evaluating diabetes
prevention outcome; (2) comparative cost-effectiveness analysis of diabetes primary prevention
for prediabetes should also be studied by other health-care teams on a long-term
basis.


location: , 'Thailand year: 2023 source: HSRI

title: Evaluation of Social Impact and Problems related to Treatment Process for Patients with End-Stage Renal Disease receiving Continuous Ambulatory Peritoneal Dialysis (CAPD), Automated Peritoneal Dialysis (APD), and Icodextrin

abstract: Background: In addition to the economic evaluation and budget impact information of dialysis in patients with end-stage renal disease (ESRD) obtained from sub-project 1, social impact and problems related to dialysis would be very useful information which can be applied as evidences for policy decision making. Objective: To study the social impact and problems related to dialysis in patients with ESRD using (1) continuous ambulatory peritoneal dialysis (CAPD) (2) CAPD using icodextrin one cycle per day of icodextrin plus glucose (CAPD+ICO) and (3) automated peritoneal dialysis (APD) methods as well as in all stakeholders providing care for ESRD patients. Methods: This study applied a mixed method which quantitative data of all patients participating in sub-project 1 were collected using a self-administrative questionnaire and qualitative data were obtained using in-depth interviews and focus group discussion among patients/relatives, healthcare personnel in service units related to dialysis services for ESRD patients. Results: According to the results of surveys using questionnaires, it was found that ESRD patients were relatively well equipped with reagent storage sites. In addition, CAPD patients undergoing peritoneal dialysis had more limitations in their daily lives than those receiving APD, however, there was no statistically significant difference. CAPD+ICO dialysis patients were reported to be statistically significantly more complicated than APD and CAPD dialysis. This may be due to a shorter pre-dialysis period for patients undergoing CAPD+ICO dialysis (51.9 months) than those undergoing CAPD (65.3 months). Most ESRD patients receiving APD reported that the absence of fluid during the day resulted in feeling better and more independent to the greatest degree. For patients undergoing CAPD+ICO, icodextrin was found to improve hyperhydration and decrease fatigue. Conclusions: APD is appropriate for pediatric patients, working adults, people who cannot perform dialysis during the day and old people who are unable to do dialysis on their own, but will have a caregiver to do it. However, if APD is included in the benefit package, the expansion of services with APD will require more healthcare personnel, especially peritoneal dialysis nurses and training. The system should be developed in conjunction with the service provider to provide an efficient service system for providing services to the patient.


location: , 'Thailand year: 2015 source: HSRI

title: Green Nursing Home Model Developed Based on Human Factors Engineering

abstract: Proper facilities for elderly is important for preparation for being an aging society of
Thailand in a near future. Number of elderly in elderly home care is increasing during the past
few years. This trend is expected to continue for decades.
This paper determines a priority of facilities for elderly in elderly home care in
Nakhon Ratchasima province namely Thamma Pakorn Poeklang. Three groups of information;
including capability of the facilities to prevent falling in elderly, frequency and violence of
falling in elderly, and level of self-care ability, are used for a determination of the priority of
facilities for elderly. This study shows that facilities relating to environmental arrangement and
balance of elderly are the most important depending on locations. For the wide court area,
facilities relating to environmental arrangement are this most important. While, facilities
relating to balance of elderly are the most important for limited space area. Results from this
study are based on elderly sampled from the studied area. For other areas, it is suggested to
determine the level of self-care ability of elderly in the interested area and re-determine the
priority of facilities for elderly in the same way presented in this paper.
This research explored basic information, physical characteristics, and strength of
elderly in Thammapakon Pho Klang nursing home, Nakhon Ratchasima. Fifty nine subjects, 41
males and 18 females, participated in this study. Average age of the subjects was 75.07 years
old. Average heights were 160.42 and 144.97 cm for males and females, respectively. Average
shoulder heights were 134.24 and 119.22 cm for males and females, respectively. Average
hand thickness were 4.00 and 2.90 cm for males and females, respectively. Average grip
breadths, inside diameter, were 3.55 and 2.89 cm for males and females, respectively.
Strength of males was greater than that of females. Data obtained from this research can be
used to design facilities for elderly. For example, handrail diameter should be 3-4 cm. and
handrail height should be 80 cm. These dimensions conform to stipulating accessibility in
buildings for disabled persons and elderly ministerial regulation B.E. 2548.
Design of buildings of Thammapakon Pho Klang nursing home, Nakhon Ratchasima
based on green building principles is a suggestion of design guidelines. These guidelines
include layout of project and buildings in Thammapakon Pho Klang nursing home which
conform to green building and energy saving principles and also efficiency increase. Moreover,
building utilization, water management, waste management, environment friendly material
selection, effect of buildings on health of building users and environment, construction, operations, maintenance, and high quality disposal are included. The researchers have made
3 dimensional animation in order to transfer knowledges and understanding of building design
for elderly based on green building and accessibility of people at all ages.


location: , 'Thailand year: 2009 source: HSRI

title: The Association between the concentration of air pollutions and the symptoms in population : Case study in Baan-Kaun-Hua-Chang, Chana District, Songkhla

abstract: Background and Rationale
There are association between the concentration of air pollutions and morbidities and
mortalities of cardio-pulmonary and vascular diseases from acute and chronic exposure. In Chana
district, Songkla. There are many constructions and many types of business such as the power
plants and the gas separation plants. From the factories’ reports, the concentration of air
continuous monitoring pollutions are below the standard limits but there is no survey to study the
association between the concentration of air pollutions and the symptoms in this population.
Objectives
To study the association between the concentration of air pollutions and the symptoms in
Baan-Kuan-Hua-Chang’s population
Methodology
Time series were performed in 319 subjects (everyone who stays in this region, age more
than 10 years old) in 9 July – 22 August 2009 for 44 days. Exposures are the concentrations of the
air pollutions, there are PM10, NO2, SO2, CO and O3, measuring by the mobile unit and the
concentrations were analyzed with standard methods. Outcomes are 18 symptoms in 5 systems,
there are skin, chest, cardio, neuro, opthamo systems, measuring by self administrative
questionnaires. The other confounders were included in the questionnaires such as smoking,
personal histories. This study also monitored and recorded the meteorological data such as humidity, temperature, wind speed. The Generalized Estimating Equation (GEE) were performed
using R 2.10.1 with Epicalc, NLME packages.
The results
319 subjects were analyzed, 114 male(45.14%). The average of age is 40.45 ± 18.12
years old. There are 10.03% of hypertension in the subjects and 9.4% of allergic disease. 54.55%
of the subjects is rubber tapping. 24.76% of the subjects still smoking (5.99+ 5.39 pack-year) and
54.23 % of the subjects are secondary smoker. There are some associations between the air
pollutions and symptoms after adjusting the meteorological data, personal data. Such as nausea
and vomiting and dizziness is positive association with NO2lag1, cough and rhinorhea is positive
association with O3lag5, eye irritation is positive association with O3lag6, headache is positive
association with O3lag7 , hoarseness is positive association with SO2lag4.
Conclusion
After adjusting the meteorological data, personal data, There are some associations
between the air pollutions and symptoms although the exposure are low concentration in this area.
Caution
This study did not aim to identify which is the source of the pollutions.


location: , 'Thailand year: 2008 source: HSRI

title: Referral of Unsuccessful Labor Cases from Khuandon Hospital, Satun Province

abstract: This report describes data on the referral by Khuandon Hospital in Satun Province
of patients experiencing unsuccessful labor in fiscal years 2005-2007. The objectives of
the study were to compile knowledge for planning in order to improve patient care and
referrals. The methodology of the study was to review the 122 cases of unsuccessful
delivery in the labor division of Khuandon Hospital, focusing on the rate of unsuccessful
labor, the characteristics of the patients experiencing unsuccessful labor and the patterns
of delivery after they were referred to a general hospital in the province. The findings
were as follows: the unsuccessful labor rate was 15.74 percent among the total study population
of 775 pregnant women. The patterns of delivery at Satun Hospital, to which the women had been referred, resulted in normal labor including breech-assisted cases
(41.80%), caesarean section (40.98%) (or 6.45% of the total of 775 pregnant women, which
was similar to the data of the Office of Health Service Development, Ministry of Public
Health (5.46 - 7.04%). The majority of patients experiencing unsuccessful labor were
primigravidae. The causes of referrals ranged respectively from pregnancy-induced hypertension
(PIH), cephalopelvic disproportion (CPD), prolonged stage, and fetal distress,
to premature labor and breech presentation. With regard to the patterns of delivery after
the referrals at the Satun General Hospital, PIH, fetal distress and premature labor cases
were successfully delivered in 66.67, 45.46 and 54.54 percent of the cases, respectively, but
the majority of CPD, prolonged stage and breech presentation necessitated caesarean section
(50.00, 45.46 and 90.91% respectively). The following recommendations were made
: the medical and nurse committees, obstetricians and pediatricians should join together
to develop guidelines for the care and referral of patients in labor and the hospitals should
link the data about the results of the care and health status of the mother and child after
referral.


location: , 'Thailand year: 2021 source: HSRI

title: Seroprevalence, Incidence and Immunological Responses to SARS-CoV-2 Infection among Frontline COVID-19 Healthcare Workers (HCWs) compare with Non-COVID-19 HCWs during the COVID-19 Pandemic at Siriraj Hospital, Bangkok

abstract: Background: Healthcare workers (HCWs) pose a higher risk of infection caused by SARS-CoV-2, leading to more frequent swab and testing with real-time PCR. Serology test to detect SARS-CoV-2 antibodies in the blood is easier and could be useful as part of surveillance. This study aims to determine the prevalence and incidence of infection caused by SARS-CoV-2 by serology testing in frontline HCWs. Methods: This study was prospectively conducted in 360 HCWs (240 frontline and 120 non-frontline HCWs) at Siriraj Hospital between June 2020 and April 2021. Blood samples taken at baseline, 4 weeks, 12 weeks and 48 weeks were tested for qualitative IgG using Pan-IgG [Elecsys Anti-SARS-CoV-2]) and quantitative IgG measured by anti-SARS-CoV-2 RBD IgG enzymes-linked immunoassay (ELISA). The cut-off of negative and positive control were 0.64 and 1.60, respectively. The samples positive by anti-SARS-CoV-2 RBD IgG were tested with micro-neutralizing assay (NT). Results: Among 360 HCWs, 82.2% were female and the median age was 32.5 years. One participant in non-frontline HCWs had positive rapid IgG test from baseline throughout 48 weeks but negative testing by anti-SARS-CoV-2 RBD IgG. With the cut-off determined in the study, two participants in frontline HCWs had positive anti-SARS-CoV-2 RBD IgG from baseline throughout 48 weeks and no participants had seroconversion afterward, given the prevalence of SARS-CoV-2 infection among frontline HCWs of 0.83% (2/240). One participant in non-frontline HCWs had seroconversion at 12 weeks, given the incidence of SARS-CoV-2 infection among non-frontline HCWs of 0.83% (1/120). Approximately 13-17 participants in frontline and 4-7 participants in non-frontline HCWs had borderline level of anti-SARS-CoV-2 RBD IgG. Testing with micro-NT for all samples with positive and borderline anti-SARS-CoV-2 RBD IgG showed negative result with the titers less than 1:10. Further study of the cross-reactivity with other human coronavirus is ongoing. Conclusions: The prevalence and incidence of HCWs was extremely low and no difference of infection was found between the frontline and non-frontline HCWs during the limited spread of transmission and well-control of COVID-19 outbreak. Serology testing with different methods may show the discordant result. Further study of the cross-reactivity with other human coronavirus is ongoing


location: , 'Thailand year: 2000 source: HSRI

title: Health care reform in Korea

abstract: Korea is one of OECD countries in Asia, which had high economic growth and could achieve universal coverage of health care shortly, only 12 years of development by setting limited benefit package in addition to low contribution rate. Rapid expansion of insurance coverage and benefit package was accordance with country’s high economic growth. In addition, political context is also crucial for the achievement, conflict between the North and South Korea and military regime tried to obtain legitimacy in the process of gaining political power, furthermore, integration of insurance schemes was succeeded during new popular political party become a government.	Legislation is the main mechanisms of reform in Korea in addition to strong political commitment.  Strategies of reform included expansion of insurance coverage and benefit package, redeployment of health resources, quality improvement, structural reform of insurance system, reform of payment mechanisms and separation of drug prescribing and dispensing role, and increase investment in health promotion.  Even Korea succeeded in achieving universal coverage some problems remained. For the recent reform, there is not enough evidence to show success and it’s still too early to evaluate. Success in reform is determined not only by appropriate designed of the reform but also political factors, especially, political factor in the health sector.


location: , 'Thailand year: 0 source: HSRI

title: Thai Health Literacy Survey (THL-S) of Thais aged 15 years and above, 2019

abstract: The Thai Health Literacy Survey (THL-S) of Thais aged 15 years and above has four objectives as follows: 1. to study the current situation of health literacy among Thais aged 15 years and above at the health regional and national level across health literacy competences and health domains. 2. to explore relationships between relevant factors and health literacy for identifying populations at risk. 3. to raise awareness among health professionals and relevant professionals on the impact of limited health literacy on national public health. 4. to produce evidence – based knowledge for better policy making, planning and implementation. The survey took place between March – August 2019. The Office of DoH 4.0 and Health Literacy led the project in collaborations with the 12 health promoting centers and Metropolitan Health and Wellness Institute. The project was financially supported by the Health System Research Institute. The valid sample size was 17,530 people. 38.67 percent were male and 61.33 percent were female. Key Recommendations Relevant organizations in health, educational, and social sectors should raise awareness and improve understanding among their personnel about the impact of limited health literacy on access to and utilization of their services. Effective health literacy related interventions should emphasize two approaches; one is to motivate and build individual capacity needed for finding, understanding, communicating and making health related decisions. The other one is to reduce the system demand and complexity and empower the people to become self-reliant so that the systems and services are health literacy friendly for all. Relevant educational organizations should build a strong literacy among students for finding, understanding, communicating about health information and making health related decisions. They might emphasize e-health literacy skills. The people in communities should be encouraged to take part in community based activities and assigned a role. All organizations should develop reliable and accessible channels for disseminating and searching for information. They also should announce and explain how to make use of the channels in appropriate manners. Curricula for health professionals, educators and social workers should address knowledge, skills, and technologies that can be used to facilitate and assist those who have limited health literacy.


location: , 'Thailand year: 2017 source: HSRI

title: Development of Slope Index of Inequalities in the Use of Public Health Services by Population in Health Regions

abstract: For an analysis of an inequality in health service use across areas, a recommended measure is
slope index of inequalities (SII). The SII captures area variations in users of health services as associated
with total population in the areas ranked by a descending order by health service use. In practice, a
binary outcome, such as use vs. no use, measured at an individual level needs to be aggregated at
the area level in terms of proportion of populations who were the users. To account for uncertainty
due to sampling, the SII could be estimated statistically using linear regression analysis. This paper
used the data in 12 health regions, excluding Bangkok from Health and Welfare Survey in 2015, the SII
revealed statistically significant inequalities in the use of health services from public facilities for both
outpatients and inpatients across 12 regions. The Universal Coverage Scheme population showed a
lower extent of inequalities in health service use than Civil Servant Medical Benefit Scheme.


location: , 'Thailand year: 2008 source: HSRI

title: Situational Review of Ethics in Research Involving Humans: A Study of Human Subject Protection in the Ministry of Public Health

abstract: The objective of the study was to assess the mechanism of human subject protection, focusing on the
ethics committee in the central part of the Ministry of Public Health. The methodologies included a literature
review, questionaire, and in-depth interview. The study revealed that most departments in the Ministry
had established ethics committees, i.e., Ministry of Public Health, Department for the Development of Thai Traditional and Alternative Medicine, Department of Medical Services, Department of Disease
Control, Department of Medical Science, Department of Mental Health, and the Health System Research
Institute. There are institutional ethics committees in the Department of Medical Services, e.g., the National
Neurological Institute and the Queen Sirikit National Institute of Child Health. Most members of
the committees are acquainted with international ethical principles and guidelines for research involving
humans. The composition of the committees is in line with international guidelines. Each committee has
its own guidelines and standard operating procedures. Only one committee has been surveyed, evaluated,
and recognized by the SIDCER/FERCAP Recognition Program, i.e., the Ethics Committee for Thai
Traditional and Alternative Medicine. Since research is not the first priority of the Ministry of Public
Health, there are some shortcomings that need to be considered for correction and improvement. Most
medical and health journals have no policy requiring the ethical clearance of studies submitted for publication.
Most ethics committees focus only on a preview of the protocol, with no proactive activities on
continuous review or site visits. Most committees review both scientific and ethical aspects; meanwhile,
most members of ethics committees have limited knowledge and experience in research on advanced and
complicated sciences. The support of most committees is inadequate. Information techno-logy is not fully
used by most committees. Some committees have problems in conducting timely reviews and there may
be doubts about their independence in some cases.


location: , 'Thailand year: 2008 source: HSRI

title: Relationship between the self-efficacy and the controlling practices of over-weight middle-aged in Bandung district, Udon Thani province

abstract: Many middle-aged women are facing problems with overweight, which is a risk
factor for cardiovascular disease, diabetes mellitus and hypertension. Key determinants
are physiological changes and food consumption and exercise. Controlling overweight
requires appropriate self-care. Self-efficacy would help middle-aged women to have confidence
that they are capable of appropriate practices. This study was aimed at identifying
the relationships between self-efficacy and practices to control the weight of women
aged 40-60 years. Three hundred and thirty-three middle-aged women who attended the
Golden Age Clinic of the Bandung Crown Prince Hospital in Udon Thani Province were
randomly recruited. Data were collected using a questionnaire on self efficacy and overweight
controlling practices for middle-aged women. The questionnaire was modified
from the questionnaire developed by Rawicha Hongrojchanpak, which used Cronbach
alpha coefficient for the self-efficacy part at 0.82.
The results indicated that the middle-aged women had high levels of overall selfefficacy.
The self-efficacy of food consumption and exercise were also at high levels. Most
of the middle-aged women (70.3%) had high to very high self-efficacy in eating fiber-rich
vegetables, walking instead of using vehicles for short distances (62.2%), not drinking
alcohol to relieve stress (60.7%) and drinking water rather than sweet soda (59.5%).
Their overall practices for controlling overweight were at a high level. They usually
and often did not eat fast food (72.1%), walked instead of using vehicles for short distances
(64.6%), avoided eating sweets (64.3%), did not drink alcohol (64.0%), avoided
eating carbohydrates (63.7%) and did exercises during their free time (61.3%).
The self-efficacy of these middle-aged women had a moderate relationship with
overall overweight practices with regard to food consumption behavior and exercise (r=
0.65, r=0.60 and r=0.58 respectively). However, most of the middle-aged women had
problems concerning self-efficacy and overweight controlling practices in avoiding highcalorie
foods, and seldom exercising, which resulted in their inability to control their
weight. It is essential to modify health promotion activities which emphasize self-efficacy
and continuity of appropriate overweight controlling practices among midldle-aged
women.


location: , 'Thailand year: 2008 source: HSRI

title: Retention Rate of Medical Graduates of Khon Kaen University in Northeastern Part

abstract: The survey research was aimed at determining the retention rate of medical graduates of Khon Kaen
University in Northeastern Part, after their compulsory three-year bonded period. The population under
study were physicians who graduated from Khon Kaen medical school during the period 1979-2000. The
list of alumni was colleted from the Alumni Association and Medical Education section. The list of alumni
and their workplaces was investigated from Provincial Health Offices and the GIS of the Ministry of
Public Health. The incomplete list of alumni and their workplaces was investigated by searching telephone
numbers and asking questions of the alumni deputy. The list of alumni was verified by teachers
who had to visit the alumni at their workplaces. The data were analyzed using percentages. The research
findings were as follows:
1. The medical graduates remaining in the Northeast (70%) was higher than the quota rate (60%) by
10 percent.
2. The distribution of alumni was as follows: in the Northeast 70 percent and in Bangkok 11.65 percent.
Compared with findings in 1992, the distribution in the Northeast decreased by 3 percent whereas in
Bangkok it increased by 1.85 percent.
3. The alumni were stationed in large hospital (51%) more than community hospitals (49%).
4. The alumni in the Northeast worked at community hospitals 26.88 percent, regional hospitals
25.48 percent and private hospital 3.46 percent.
5. The production of the Collaborative Project to increase the production of rural doctors (CPIRD)
was higher than the target by 29.66 percent for 1999 graduates and by 21.63 percent for 2000 graduates.
6. The retention rate in the Northeast (70%) was higher than the target (60%); 19 years out of 22 years
had higher than quota rate. The three highest retention rates were 1998 graduates (92.45%), 1994 graduates
(92.45%), and 1999 graduates (92.45%) respectively. The three lower rates were 1983 graduates (48.78%),
1982 graduates (51.16%), and 1979 graduates (54.55%) respectively.
Medical graduates from Khon Kaen University were retained in the community. The retention rate
was in line with the intention and philosophy of three medical curricula, which emphasize that medical
doctors should improve the public health of the community, have a positive attitude toward serving and
working with others in the health team. The research findings confirmed the objective of the Faculty of
Medicine, Khon Kaen University.


location: , 'Thailand year: 2021 source: HSRI

title: Success of Intermediate Care Implementation according to the Ministry of Public Health’s Policy

abstract: This qualitative study aimed to explore the implementation and key success factors of intermediate
care on patients with stroke, traumatic brain injury, and spinal cord injury according to the Ministry of Public Health’s policy. Seventeen hospitals providing intermediate care to older adults were multi-stage purposively sampled from the MOPH’s provider sampling frame of 897 hospitals covering 4 regions from the north, northeast, central and the south. Key participants comprised 30 executives at the ministry and provinces and 236 intermediate care providers of 17 hospitals. Data were collected by using in-depth interview, group discussion, field study, and were analyzed by content analysis. The findings revealed that: 1. Seventeen hospitals in 8 provinces were categorized based on service activities into 3 groups: 1) the intensive intermediate care provision (6 hospitals), 2) the moderate intermediate care provision (6 hospitals), and 3) the moderate intermediate care with limited evidence on provision (5 hospitals). Constraints were lack of staff’s understanding on policy and practice, specialist staff inadequacy, non-supportive reimbursement system, lack of logistics (budget, space, equipment, medicine and consumable), and inefficient referral and information system, and others. Key success factors of intermediate care were listed: 1) executives with visions, plan, clearly set goal and constant result monitoring, 2) service provider commitment with good teamwork, and 3) service system preparedness, and effective multidisciplinary network. 2. Policy recommendations include clear policy communications cascading with localized flexibility, seamless system integration with adequate health workforce fit with intermediate care demands (which should extend to cover more health problems), high-performance information platform facilitating referral of data among providers and payers, and appropriate and comprehensive payment systems.


location: , 'Thailand year: 2022 source: HSRI

title: Economic Evaluation of Programmatic Screening Strategies for Latent Tuberculosis Infection (LTBI) in TB Contacts

abstract: Introduction: Tuberculosis (TB) is a communicable disease caused by M. tuberculosis. Contacts of TB cases become clinically active TB or remain in the latent tuberculosis infection (LTBI), which is subsequent progression to tuberculosis disease. Currently, the available tests for LTBI diagnosis include tuberculin skin test (TST) and interferon-gamma release assay (IGRA). In Thailand, IGRA test is costly and has not been included in the benefit package. The results from this study can be used as an evidence informed policy whether IGRA test should be included in the benefit package and can be applied to support the strategies to eradicate TB. Objectives: To evaluate cost-utility analysis, budget impact analysis and feasibility analysis of LTBI diagnosis for contacts of TB patients using societal and government perspectives. Methodology: Cost-utility analysis using a decision tree and Markov model was performed to simulate the costs and utilities, and to estimate the budget impact of contacts with pulmonary TB patients. All parameters were obtained from published studies. Lifetime horizon was applied with both costs and outcomes discounted by 3%, as recommended by the guidelines of economic evaluation in Thailand. One way and probabilistic sensitivity analyses were conducted to examine the uncertainty of input parameters. This study considered three alternative diagnosis strategies as follows: 1) No screening, 2) TST alone to diagnose LTBI, if TST test was positive, treatment would be provided, and 3) IGRA alone to diagnose LTBI, if IGRA test was positive, treatment would be provided. Focus group discussion and literature reviews were applied for feasibility analysis. Results: The incremental cost-effectiveness ratios (ICER) of IGRA alone compared with TST alone was THB 1,220,287 per QALY gained. At the willingness to pay (WTP) THB 160,000 per QALY gained, IGRA would not be cost-effective. If the price of IGRA was decreased to THB 575 per test, the strategy of IGRA would be cost-effective. Five-year budget for TST and IGRA was estimated to be THB 148 million and THB 330 million, respectively. The barriers for IGRA implementation were lack of laboratory infrastructure and limited availability of laboratory personnel.


location: , 'Thailand year: 2018 source: HSRI

title: Evaluation of the Devolved Health Centers: Synthesis Lesson Learnt from 51 Health Centers and Policy Options

abstract: The devolution of health centers to Local Government Units (LGUs) in Thailand has been one of the many tools that the Ministry of Public Health (MOPH) used in its healthcare decentralization policy. Fifty-one out of 9,787 health centers have been devolved since 2007. This study aimed to (1) understand devolution process; (2) evaluate outcomes of the devolution; (3) analyze strengths, weaknesses, enabling factors, and threats of the devolution of health centers in Thailand and (4) make policy recommendations on the provision of primary health care that fits with the Thai context. The study employed qualitative and quantitative approaches consisting of literature review, data analyses of four selected quality indicators and self-administered questionnaires by health personnel at devolved health centers, in-depth interviews and focus-group discussions in four representative provinces.
The study showed that the rates of screening for diabetes mellitus, hypertension, and cervical cancer in devolved health centers were lower than those in non-devolved health centers (p-value = 0.0400, 0.0438, and 0.0000 respectively). The analysis found no statistically significant result for the rate of early access to antenatal care (p-value = 0.1974).
The findings from 41 questionnaires suggested that budgets, medical supplies and equipments, and facilities in devolved health centers were sufficient although some health centers still lacked adequate health personnel. Some devolved health centers could extend the range of their medical services. 75.61 percent of the respondents reported that quality of care and responsiveness were improved after the devolution. The short chain of command between LGUs and devolved health centers could contribute to less bureaucratic management but might also involve local politics. Although the relationship between devolved health centers and Public Health Organizations remained close after the devolution, only 19 devolved health centers reported to have routine audit by Public Health Organizations. Seven respondents indicated they would prefer to move back to MOPH. Lastly, it was reported that the devolution process lacked the participation from people and frontline health personnel.
Successful healthcare decentralization requires clearer devolution policy and supportive laws and regulations from the government. The MOPH should maintain its roles of supervision and regulation in all devolved health centers and collectively address any arising challenges with the LGUs. The devolution of health centers should maintain within the LGUs with sufficient capacities and people participation must be strongly promoted.


location: , 'Thailand year: 2016 source: HSRI

title: Situations of Using Thai Traditional Medicine Service in 2009, 2011, 2013

abstract: This study was an analysis of the situations and trends in the Thai Traditional Medicine (TTM)
services in Thailand, especially the illnesses and treatments with TTM, based on the data derived from the
2009, 2011, 2013 Health and Welfare surveys, conducted by the National Statistical Office, which interviewed
a sample of 28,000 households across the country each year. The trends in such services were
compared with those derived from other data sources during the same period.
The results showed that most Thai patients attended state health-care facilities, whereas a small
proportion of them sought medical care from Thai folk/traditional healers or masseurs at less than 2% of
all patients. Among all patients, the 25-59 age group sought TTM services, about the same proportions
ranging from 50.0% to 60.3% in 2009, 2011, 2013. Regarding their illnesses, the second most common
illness was chronic back and muscle pain, but their use rates were highest at 27.3%, 33.4%, and 31.1%,
respectively.
In conclusion, only a small proportion of the Thai population use TTM including herbal remedies,
but with a rising trend. Thai massage therapy is most popular in working-age people. Thus, such service
should be further developed and promoted through the integration with the use of herbal remedies and
other TTM services.


location: , 'Thailand year: 2002 source: HSRI

title: Civil society processing for public hospitals reform at district level

abstract: Civil Society Proceeding for Public Hospitals Reform at District Level	This study was conducted in collaboration  in the search of excellence community hospital for the whole community, strategic partnership was apppraached through all media channels and also direct marketing by sending 7,771 letters to all sectors at all levels for help proposing a delighted community hospital.  Voluntary basis of the hospitals was concerned.	Self-assessment report by executives (60 applied-hospital: 503 non applied) and core personnel (725: 1185), and external evaluation by district health officers (652:1078) and community leaders (225:334) were used in combination including  double teams sites at the end.  Eighty four out of 714 hospitals were proposed a champion, 60 hospitals joined, and 23 were defined as highly effective, 5 entered the third round, and were distinct performance.	The study results revealed that, community hospitals took care of 41 millon people and covered 90.26 percent of all districts with doctor per population 1:19,038; and 32.89% morbidity rate was found with average 2.67 visits per patient.  Increasing trend of inpatient admission and bed used were indentified.  Financial stability was assumed through revenue and expense ratio and current ratio. Most of critical success factors(CSFs) and key performance indicators(KPIs), showed higher mean scored rating by applied group than those non applied with statistical significant differences.  However, community problem-solving and involvement activities had low mean scores for both groups.  Effective coordination and good image were recognized by district health officers and community leaders except rating for participation in health service organization as low.  Those applied hospital were received higher mean scores than non applied significantly.	In conclusion, responses of civil society were fair as the existing circumstance, and high active response from health sector at all levels particularly community hospitals.  At least 23 hospitals showed strong leadership for pursuing development and act as role models.  Stage for sharing their visions, experiences, and success result should be available for continuous learning and deployment.  Community or comprehensive health care accreditation should also be institutional at national level.


location: , 'Thailand year: 2012 source: HSRI

title: Research and Systems Development for National Drug Account

abstract: This study was aimed to develop the annual report of national
drug account with the built-in information management system.
The system was designed to maximize benefits from data utilization
for every stakeholder. The 36-month study period (March 2009 to
February 2012) was divided into three phases: the configuration of
the core structure of the national drug account, the information management
system design and development, and finally, the system
testing.
Finding Summary
1. From paper-based report to electronics report
A major change resulted from this study was switching from
the traditional paper based to electronic submission of the annual report
of manufacturing and importing values by pharmaceutical companies.
With an intensive participatory research process from all crucial
stakeholders especially policy makers and key FDA officers, the
developed information management system was naturally integrated
into the routine work. All transcribed errors occurred from the paper-based system
were eliminated by this deliberate designed system. Other errors
were minimized through the standardization of all related variables.
This research had initiated a feedback report on market oriented information
to manufacturers and importers submitting data to FDA as
a recognition of mutual benefits.
2. 2010 National drug account
By the operation of this newly developed system, it was
found that for the year 2010, the value of the domestically manufactured
drugs (excluded repacking) was ฿ 46,895,753,521, the import
value was ฿ 99,663,791,612 and the export value was accounted for
฿ 12,077,467,549. The overall drug value of domestic consumption
(at consumer price) was ฿ 144,570,906,916. ANTIINFECTIVES FOR SYSTEMIC
USE, CARDIOVASCULAR SYSTEM, and ALIMENTARY TRACT AND
METABOLISM were the three ATC groups with the highest consumption
respectively. New input data, the proportion of drug distributed via main
distribution channels, has been added into the 2010 annual report.
However, the data received did not adequately represent the market
value, since these data were never formally required and the platform
of electronic data entry process was quite complicated, causing
pharmaceutical companies had difficulty to comply. The distribution
channel survey was then conducted requesting overall distribution
percentage via 4 major channels from manufacturers and importers.
The itemized analysis on drug distribution could not be achieved.
The consumer price factor, price difference between net sale
price and listed price, for each channel of distribution was calculated
and used to adjust the overall domestic drug consumption at listed
price to derive national drug consumption at consumer price.
Policy Recommendations
FDA should amend the regulation on the additional required
input data, specifically the proportion of drug distribution via
main distribution channels.
FDA should set up a task force to maintain and update data
standard appended to the developed system.
FDA should develop a coordination network to ensure the
consistency in using the standardized data sets across all
involved departments and stakeholders.
FDA should develop and adhere 3-digits statistic coding system for pharmaceuticals based on ATC system by WHO/
CC to the 8-digits Harmonized System code of tariff. This
would facilitate data collection and verification of the report
on importing and exporting values.
Future Studies Recommendations
Calculate national drug consumption 2012.
Develop a comprehensive list of drugstores and hospitals to
be built-in as a supporting system for drug distribution and
mark-up variables.
Elaborate industry feedback information for example, sets of
indices monitoring drug market and consumption patterns.


location: , 'Thailand year: 2017 source: HSRI

title: Recommendations for Health Research Management Reform in Thailand

abstract: Obtaining quality research that can benefit country development requires systematic management
of relevant agencies including research funding agencies. This study aimed to provide research funding
agencies recommendations regarding the management of health research in Thailand. The study was
carried out by reviewing literature and documents related to experience in health research management of both national and international government research funding agencies. Additionally, key informant
interviews and focus group discussions with experts involved in research systems were conducted.
The study analyzed and compared research management components of various countries with
those of the Thai research funding agencies under 9 different dimensions. The study showed that health
research management in Thailand still needed to be developed. In particular, health research management
needs to focus on the coordination of relevant agencies in national health research policy formulation,
reduction of budget support in unclear strategies, development and increase in the role of research
managers in order to support research utilization, and lastly, monitoring and evaluation using comprehensive
indicators to measure input, process, output and impact of research.


location: , 'Thailand year: 2012 source: HSRI

title: Universal Health Coverage: we believe and we commit

abstract: The Prince Mahidol Award Conference 2012 was held in Bangkok, Thailand during 24-28 January
2012 with the theme of “Moving towards universal health coverage: health financing matters”. The Conference
highlighted the importance of Universal Health Coverage (UHC) as one of the most effective
instruments that ensures human security and improves human development as well as fosters the concept
of all people’s rights to health care service. The Conference demonstrated that UHC was achievable
in many countries i.e., Japan, Thailand and others. It also highlighted equitable health systems financing
and other components of health system such as human resources, information system and other equally
important factors such as political commitment, government competency or civil society participation
that support the health system to achieve UHC. Last but not least, the Conference went successfully with
the hope to accelerate the movement towards UHC at the country level.


location: , 'Thailand year: 2008 source: HSRI

title: Comparison between CD4 Count and Viral Load Test in HIV Treatment: Viral load test as a tool for PHA active involvement addressing adherence in the ARV Clinic of Kuchinarai Crown Prince Hospital, Kalasin Province

abstract: The viral load (VL) test is not widely available in Thailand for HIV follow-up, which
relies mostly on CD4 count and clinical manifestations. Kuchinarai Crown Prince Hospital
(KCPH) has implemented the VL test in collaboration with MSF-Belgium. Coherent
PHA (N=128) for 2-7 years, including VL, CD4 count, clinical symptoms and Karnofsky
score 90-100, were used. The first arm reading involved 88 cases (68.75%) with undetectable
VL (<50 copies/ml), 84 (95.45%) having good CD4 count with no OI symptoms; that
of arm 2 involved 33 cases (25.78%) with VL between 50 and 1,000 copies/ml, with 30
cases (90.91%) having good CD4; that of the last arm involved 7 cases (5.47%) with VL >
1,000 copies/ml, of which 4 cases (57.14%) has good CD4.
Arm 2 received adherence counseling, followed by second and third VL follow-up
(3-month interval) resulting in undetectable VL after the second interval.
Arm 3 (last arm) showed no improvement in 4 cases (57.14%). They were put on
second line ART. At the end of the study, 124 cases (96.88%) out of 128 cases were undetectable
(VL < 50 copies/ml); while 4 cases (3.13%) with VL > 1000 copies/ml became
resistant to the first line ART and were switched to the second line ART.
The study shows that the systematic VL test should be included in HIV treatment to
detect treatment failure (i.e. virologic failure). The VL test is a tool for PHA active involvement
addressing adherence.
Viral load test should comprise a minimum package for HIV treatment in Thailand.
Our study shows that proper follow-up with systematic (client center) VL test reduces
the cost of second line treatment.


location: , 'Thailand year: 2006 source: HSRI

title: Extra funding for universal healthcare coverage

abstract: Thailand experienced a major healthcare reform in 2001 when the newly elected government launched the Universal Healthcare Coverage (UC) scheme, which is also known as the “30 Baht Healthcare Scheme.”  As the UC scheme is an entitlement program, the government has responsibility to provide such program and maintain the quality of the program to meet the standard.  Under the limited budget and commitment to many public programs, the government may have to find extra funding to finance the UC scheme.  There are at least two possible directions for the UC extra funding: reducing the cost of the program by transferring people who are eligible for the UC program (e.g. spouse and children of insured persons under the Social Security scheme) to a preferable healthcare program (e.g. Social Security scheme), and raising government revenues by increasing tax rates or healthcare co-payment.During the period of 2005-09, we estimate that there will be 50-52 million UC eligible people. In 2005, the capitation cost required to maintain the standard of healthcare services is Bt2,000.  When the capitation cost is indexed with the growth of public employee’s salary, the total cost of the UC scheme will be Bt100-136 billion in 2005-09.  Compared with past budget allocation (when capitation rates were much lower), the extra funding required to finance the UC scheme will be Bt31-46 billion.When transferring spouse and children of insured persons under the Social Security or SS scheme (who are currently under the UC scheme) and allowing retirees of the SS scheme and their spouses to be under the healthcare program of the SS scheme, the total cost of the UC scheme would reduce.  With the capitation cost of Bt2,000, the extra funding to finance the UC scheme would reduce to Bt17.6 billion in 2005 and Bt27.5 billion in 2009.The government can also raise extra revenues by increasing the commodity tax rates (e.g. taxes on alcoholic beverages and cigarette as recommended by many policy makers).  When the excise tax rate on alcoholic beverage increases by 40 percent in 2005, additional government revenue raised from excise taxes will be Bt25 billion in 2009.  In the same period, if the excise tax rate on fuel and gas increases by 30 percent, additional government revenue raised from excise taxes will be Bt45 billions.  An increase in the tobacco tax rate by 70 percent will raise additional government revenue on excise taxes by only Bt20 billion.  The additional tax rate on tobacco does not raise a large sum of government revenue because the price elasticity of consumption on taxed tobacco and cigarette is high.  About half of the cigarette consumption was untaxed.  In addition, an increase of value added tax (VAT) from 7 to 10 percent would raise Bt140-200 billions of VAT revenue during the period 2005-09.To raise tax revenues for the UC scheme, the government may choose to raise some combination of commodity tax rate just enough to cover the extra spending on the UC program.  However, this study has shown that, under the existing commodity tax structure, the government should increase tax rates on entertainment, fuel and gas, and clothing.  The marginal cost of public funds for alcoholic beverages and cigarette are high.  Raising their tax rates will further distort the prices and deteriorate efficiency of resource allocation.


location: , 'Thailand year: 2023 source: HSRI

title: Development of Essential Nursing Competencies for COVID-19 Pandemic: A Case Study of Songkhla Province

abstract: This emancipatory action research with action research aimed to develop essential nursing competencies for COVID-19 and nursing competency development models for primary, secondary, and tertiary health service units through the case study of Songkhla province where strong government management policy existed in collaboration with stakeholders. A total sample of 53 registered nurses (10 from primary, 31 secondary and 12 tertiary health service units) and 6 physicians were recruited. Research instruments consisted of 1) quantitative data collection tools including the questionnaire of essential nursing competencies for emerging infectious disease COVID-19 and the questionnaire of satisfaction on nursing competency development models for COVID-19. 2) Qualitative data collection tools included the behavioral-based interview, the in-depth interview, and the focus group discussion guidelines. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using content analysis. Research results revealed that 1) registered nurses had an overall higher mean score of essential nursing competencies for COVID-19 at each loop of research. Higher mean scores were found on both professional and technical competencies. 2) Nursing competency development model consisted of 3 components including practice guidelines, competency development method, and factors promoting competency development. Practice guidelines consisted of 5 main steps including 1) specification of essential performance competencies; 2) development of monitoring system, support, and empowerment; 3) specification of self-competency development guideline; 4) implementation of the competency development plan; and 5) summarization and report of development result. The competency development method consisted of 6 activities including 1) workshop, 2) on-the-job training, 3) learning from experts, 4) coaching, 5) self-study, and 6) knowledge sharing. Factors promoting competency development included the role of nursing leaders, explicit policy and practice guidelines, and a good attitude towards the profession. Conclusion: research findings could be used as guidelines for the competency development of nursing staff working in primary, secondary and tertiary health service units to have skill and nursing competency for patients with COVID-19 and emerging diseases in the future.


location: , 'Thailand year: 2020 source: HSRI

title: Policy Recommendation Synthesis for Improvement the role of the colleges under Praboromarajchanok Institute of Health Manpower Development Act to strengthen health personnel for Primary Care Cluster

abstract: The Ministry of Public Health’s constant formulation of primary health care policy and carry forward to Primary Care Act 2019 in order to develop Primary Care Cluster (PCC) system and primary care network in addressing healthcare access problem and medical care gap, supporting the primary health care workers are able to collaborate with Family Medicine in order to improve the services quality. Primary colleges under Praboromarajchanok Institute Act play an important role in strengthening personnel to support primary care cluster team and perform quality works. This mixed-method research aims to 1) examine the situation of public health personnel development to support Primary Care Cluster (PCC) team; 2) study public health personnel’s competencies in supporting Primary Care Cluster (PCC) team; 3) explore competencies of lecturers under Praboromarajchanok Institute in public health personnel development to support Primary Care Cluster (PCC) team; 4) analyze Praboromarajchanok Institute Act in light of strengthening of public health personnel to support Primary Care Cluster (PCC) team; and 5) synthesize policy proposals to develop the role of colleges under Praboromarajchanok Institute Act in strengthening health personnel to support primary care cluster team. The research method was used a mixed method design. Both qualitative and quantitative data are gathered in this study. The data were collected within 12 months between August 2010 and July 2020. The in-depth interviews and focus group were used to collect qualitative data. The key informant includes the Ministry of Public Health’s senior experts in charge of manpower and primary care service and network, primary care system division directors, provincial public health officers and heads of related sections in provincial public health offices, directors and deputy directors of colleges under Praboromarajchanok Institute, Ministry of Public Health, lecturers in charge of academic services or personnel development of Colleges of Nursing and College of Public Health under Praboromarajchanok Institute, Ministry of Public Health, primary operation personnel for supporting the policy on Primary Care Cluster (PCC) team and general residents and public as well as services recipient. The sample The quantitative and qualitative data are analyzed using descriptive statistics and content analysis, respectively. The following research resultsare found: 1. All colleges are prepared for operations according to the roles and missions of respective colleges and Professionals Council in the fulfillment of higher education standards of the Office of Higher Education Commission. Meanwhile, public health personnel development is executed according to Praboromarajchanok Institute’s policy or to the needs of local area or Area Health to support the service plan such as emergency practitioner nurse curriculum, critical care nursing curriculum and palliatives care curriculum. Also, the training program is arranged in response to the country’s demand such as “Thailand’s increasing number of elderly leads to the introduction of elderly-related curriculum” or to the expertise of lecturers in respective colleges e.g. family practice training program and cancer nursing curriculum. The training plans are in line with future needs of healthcare, while the colleges develop the lecturers’ expertise in each discipline in accordance with curriculum formulation as required by Area Health or with problems in local areas. Moreover, training programs that derive from university’s needs in uninterruptedly promoting expertise are also performed in collaboration with other agencies. 2. Staffs in Primary Care Cluster (PCC) team have a high level of overall picture of opinions towards all aspects of competency of public health personnel to support Primary Care Cluster (PCC) team. In particular, the ones with the highest and lowest mean scores are ‘good service’ (Mean=4.18, SD=.79) and ‘accumulated work expertise’, respectively.( Mean=3.83, SD=.97) 3. There is a high level of overall picture of competency of lecturers under Praboromarajchanok Institute in developing public health personnel to support the policy on Primary Care Cluster (PCC) team. When each competency is examined, most competencies are found at a high level, except the knowledge and understanding of Primary Care Cluster (PCC) principle, which is at a moderate level. (Mean=3.58, SD=.93) 4. Regarding the production and development of primary health care personnel by Colleges of Nursing under Praboromarajchanok Institute Act, the understandings and competencies of lecturers should be promoted in order to jointly introduce nursing curriculum for other agencies, which collaborate with health services or the Faculty of Nursing overseas. Besides, the primary health personnel development includes the introduction of specialized curriculum, extended from the curriculums of nursing practice and of family practice. The participation and learning in collaboration with the relevant communities is also created. 5. The research results indicate that the guidelines for development of roles of colleges under Praboromarajchanok Institute to support the primary care cluster team’s operations can be done as follows: 1) improvement of nursing curriculum or adjustment of instructional activities integrated with primary care systems to enhance the graduates’ post-graduation work ability; 2) survey of needs for development of public health personnel’s competencies in operating primary care cluster team and primary care system at both national and health canter level; 3) arrangement of training programs related to primary care covering all multidiscipline of Primary Care Cluster (PCC) team according to the local area’s needs; 4) formulation of long-term academic service plans and of colleges’ clear administration guidelines for public health personnel competency development; 5) development of an apparent plan for lecturer-related manpower development and of lecturers’ competencies in promoting knowledge and ability of nursing students to perform quality primary care services. This is to facilitate public health personnel competency development to support primary care cluster team’s operations; 6) building of network collaboration in developing a center of expertise or excellence that meets standards to support primary care cluster team’s operations; and 7) development of inclusive manpower information management system, especially lecturers under Praboromarajchanok Institute, for decision-making purpose in light of number, qualification, expertise and distribution according to Area Health.


location: , 'Thailand year: 2014 source: HSRI

title: Risk Management of Medicine Mixed up for Changes in Modern Pharmaceutical Manufacturing

abstract: The pharmaceutical manufacturing process must concern a quality requirement. There have been
chances of mixed-up of pharmaceutical products particularly when multiple drugs were produced by
using the same equipment. The mixed-up results in harmful effects on consumers and affects the image of
organizations. Therefore, the objective of this research was to improve risk management system, particularly
the problem associated with the mixed-up. The risk management system was conducted according
to the Notification of Ministry of Public Health. In this research, two unacceptable risks (risk score equal
25) caused by human errors was found from risk assessment. Those were the main causes of the mixedup.
A strict quality assurance guideline was applied in this study as a prevention measure of the mixed-up
in the process of product storage and line cleaning of filling. The result showed that the level of risk was
reduced to acceptable risks (risk score equal 5). Then, the prevention measure was established in all the
medicine production.


location: , 'Thailand year: 2009 source: HSRI

title: Health Effects Monitoring of People Living Nearby Mae-Mao Electric Power Plant, Lampang Province

abstract: Mae Moh Power Plant is the biggest coal-fired power plant in Thailand. Each year the power plant utilizes over 17 million tons of lignite coal from Mae Moh mine, an open-case mining located in the same area. Both the power plant and coal mine produce pollutants that can affect the environment and human health. However, at present, there is no surveillance system to monitor health effects, especially long-term effects, of people living nearby the power plant. This study aimed to review health impacts among people living nearby Mae Moh power plant, current surveillance system, and to suggest an appropriated health surveillance system. Information was gathered from a literature review, interviewing, and meeting with experts, related persons, and representatives from people living nearby Mae Moh power plant. Data were analyzed by content analysis.
From literature review, it was found that health impacts of  coal mining and  power plant were  1) increase prevalence of respiratory system diseases, especially chronic obstructive pulmonary disease, asthma 2) reduce pulmonary function 3) hearing loss 4) dermatitis, urticaria, and itchy rash  5) increase risk to get an accident 6) effect to child development 7) annoy due to odor and vibration. The result also found that there was no surveillance system for monitoring  health effects  of people living nearby Mae-Mao power plant.  The current surveillance system  was Ministry of Public Health’ surveillance system which showed size of problem and distribution of diseases. It could not provide details on risk exposure and cause of diseases.
It was found that the health indicators that should be monitored were: 1) emergency room visits, 2) hospital visit and service requested, 3) mortality monitoring, 4) pulmonary function of school children,   5) lung function of adults with respiratory problems, 6) chronic obstructive pulmonary disease cases, 7) pneumoconiosis among coal worker, and  8) stress and annoy due to environmental problems.
To implement this program, environmental law should be revised and the requirements for conducting health risk assessment added, in addition a health monitoring system should be set up. The regulatory system should also include grant and operation team  to support the surveillance system. The system should be operated by a committee consisted of all involved stakeholders, including Electricity Generating Authority of Thailand (EGAT)(Mae Moh), representatives from people living nearby Mae Moh power plant, staff from the government office and non-governmental organization, and specialists from an education institutions.


location: , 'Thailand year: 2002 source: HSRI

title: Community participation on addictive substances prevention and problem solving in Tambol Patan Khuntan district Chiang Rai province

abstract: The problem of substance addiction in communities is a serious increasing social problem at the present time. It has a great impact through families, communities, society and countrywide. The inefficient means on prevention and control of this problem will lead to a great number of social problems in communities very soon. Therefore, the participation of the community to fight with the epidemic of substance addiction is a very crucial mean. The objectives of this study were to explore the situation of addictive substance use and develop a model for prevention and problem solving by emphasizing on the community involvement. The participatory Action Research (PAR) was applied in this study. One hundred and fifty villagers who were community leaders, health volunteers, guardians,  and youths lived in village 5th, 9th, and 11th of Patan, Khuntan district, Chiang Rai province were participated in research activities. The researchers and the community groups analyzed problems and determined the solution means by using the AIC-technique and collected information by using the participatory observation method and focus group discussion technique. The study was conducted between October 2001 and February 2002. 	The result of the study revealed that there were 40 drug users in these villages. The source of substance distribution were found in all 3 villages. Community regulations for prevention and solving the addictive substances use were setup through the village meeting. After the regulations were implemented continuously, the situation of substance addiction was decreased dramatically in these 3 villages. The local organization in each communities played a very important role to solve these social problems. The community participation need to be strengthen and continue to sustain the success of substance control in these villages.


location: , 'Thailand year: 2012 source: HSRI

title: Knowledge on Policy Supporting Health Services for Chronic Disease and Hospital Pharmacist Participation at Primary Care Unit

abstract: Currently, primary care expands its role for patients with chronic care who have a controlled condition.
Drug therapy is the major method for treatment of chronic diseases. Therefore, pharmacists should
take their responsibility in drug therapy management in primary care unit. Understanding of policy supporting
health services is necessary for pharmacists to work efficiently with health care team. Since diabetes
mellitus (DM) and hypertension are the most common chronic diseases that hospitals refer patients to
receive further treatment at primary care unit (PCU), there are several health policies and financial mechanisms
by National Health Security Office and Ministry of Public Health as the way to support capacity
building and service system in PCU. For system monitoring, quality indicators focusing on processes and outcomes have been developed. The specified prescribing quality indicators for secondary prevention
included prescribing rate of aspirin in DM patients aged at least 40 years and prescribing rate of angiotensin
converting enzyme inhibitors or angiotensin receptor blockers in DM patients with
microalbuminuria. Pharmacists should ascertain that drug items in PCU are optimum for providing care
for patients with concomitant diseases. Drug service system should be improved and health care personnel
in PCU should be trained for basic drug therapy management. Pharmacists should work with the
disease manager nurses to develop referral system for medication history information between the contracting
unit and its’ PCUs. In addition, data collection and data processing system for specified quality
indicators should be developed.


location: , 'Thailand year: 2003 source: HSRI

title: The development of health polices and strategies on health manpower

abstract: The steering committee of health policies and strategies development for health manpower was appointed by the National Health System Reform Committee in May 2003. The committee secretarial tasks done by the Health System Research Institute and researcher team. The mission of the steering committee is to develop and present policies and strategies of health manpower under the changing situations of the Thai health care systems and its context. The secretarial team is carried out process were the documentary reviews and structured interviews, including various sub- committee meetings. The spotlight of the contextual changes in all aspects are described in the introductory chapter which focus on issues that needed carefully consideration. The main report describes results and recommendations with major principles for developing policies and strategies on health manpower. Three main topics have been discussed and concluded, these are:Components to be achieved on policies and strategies for health manpower;Initial plans for further action and;Short- term and long- term mechanisms for system development on health manpower should be based on concert efforts of various organisations. Such mechanisms are to be  functional units that linked with accumulated knowledge and national policy development. By summary, the future proposals for action should be pragmatic and relevant to the governmental policy toward the national policy on universal coverage. Under the contextual changes, health manpower policies and strategies should be grounded on the "demand driven" idea and responsive to basic and specific health needs of the entire population.


location: , 'Thailand year: 2015 source: HSRI

title: Dental Prosthesis Utilization among Thai Ageing Population, Comparing 2009 with 2013

abstract: This study is aimed at reviewing how elderly people in Thailand access to dental prosthesis service
comparing 2009 with 2013. Primary data was derived from two major household surveys conducted by
National Statistical Bureau in 2009 and 2013; health and welfare survey, and economic and social status
survey (n = 26,500 households in 2009 and 27,960 households in 2013). Extrapolation to total population
by weight was then calculated.
It was found that proportion of ageing population covered by health insurance in 2009 and 2013 was
97.3 and 97.9%, of which national health insurance scheme contributed 79.3% and 80.9% respectively.
Among them, dental health care utilization was low as 8.2-8.7%. Additionally, the percentage of accessing
to dental prosthesis services increased from 15.6% in 2009 to 15.8% in 2013. Most of the elderly (38.2-
40.3%) seeked dental prosthesis through private services. While a percentage of the omission of health
insurance scheme prevailed at 57.6 in 2009, reduced to 52.1 in 2013. On the other hand, utilization of
dental prosthesis among the elderly with high and low income in Bangkok and municipality areas in 2013
was found 2.8 times higher than the elderly with low income in rural areas. This viewed obviously the
inequity in access to dental prosthesis among elderly people in Thailand.


location: , 'Thailand year: 2011 source: HSRI

title: Why Tobacco Should be Excluded from Free Trade Agreements

abstract: Free trade agreements are intended to spread high-quality goods to all member countries without
any barriers so that the standard of living and the wealth of the member countries would be heightened.
Tobacco, however, is not a typical good. On the contrary, it is detrimental to human life. The more cigarettes
are smoked, the more harmis incurred by both the consumer and the people in the same environment.
Hence, the dissemination of tobacco products should be controlled. This paper considers statistical
data and relevant articles, and then presents the negative impacts of free trade agreements. After a tariff
reduction of 5 percentage points resulting from the ASEAN Free Trade Agreement (AFTA), the production
of domestic and foreign cigarettes rose. Likewise, the tobacco consumption rate among adolescences
expanded. Despite a wide-ranging campaign to reduce smoking, the decline in the tobacco consumption
rate in other age groups was not as remarkable as it should have been. Moreover, AFTA hindered the
development of tobacco-control regulations. The government was likely to soften the new regulations to
avoid infringing on the free trade agreement, whereas the tobacco industry worked to prevent such regulations
in the first place by threatening the government with the terms of the free trade agreement. This
paper, therefore, suggests that, in order to strengthen tobacco-control schemes, tobacco products should
be put on the exclusion list of free trade agreements.


location: , 'Thailand year: 2001 source: HSRI

title: Recommendation for reforming diseases prevention and control system in Thailand

abstract: Conceptual framework for reforming the system of diseases prevention and control in Thailand was developed in this study. Issues which were involved, were 1) situation and trend of epidemiology, society changes which had influence to the system 2) strength and weakness of the existing system 3) recommendation for reforming the system. The study results were summarised as following;situations and impact of diseases were considerably changing, globalisation was promoting severity of both communicable and non-communicable diseases,decentralisation was making necessity to reform the system,the existing system had two major problems; lack of coordination in responsible organisations resulting ineffectiveness of handling problems and much emphasis on project based administration in addition to academic development which was useful for coping new and complicated problems,all disease control organisations should be united into single organisation for developing,Health Research Institute should be established to develop body of knowledge similarly to the US National Health,the establishment of the institute and merging all responsible organisations into single organisation should be stated in the National Health System Reform Act,the disease prevention and control system in many countries were studied to be taken as inputs for reforming.


location: , 'Thailand year: 2008 source: HSRI

title: Relationship between Fasting Plasma Glucose and Hemoglobin A1c in Type 2 Diabetes Mellitus Patients Attending Ladlumkaew Hospital

abstract: The objective of this descriptive study was to determine the relationship between
fasting plasma glucose (FPG) levels, as well as a few other factors, with HbA1c in 100 patients with type 2 diabetes who were receving treatment at Ladlumkaew Hospital. The
data were collected during the period May-July 2007. The variables were sex, age, waist
circumference, body mass index, duration of illness, administration of metformin, and
fasting plasma glucose. The relationship between variables and HbA1c was assessed using
percentage, and odds ratio test.
The results of the study showed that patients who received treatment with metformin
had a mean level of FPG for three months equal to or less than 130 mg/dl related significantly
with an HbA1c level of less than 7 percent. When considering the results, 30 percent
of the patients had a mean level of FPG equal to or less than 130 mg/dl and 15
percent of the patients had FPG levels three times in three months that were equal to or
less than 130 mg/dl; these patients had HbA1c levels above 7 percent at 56.7 and 46.7
percent, respectively. Such findings denoted that the FPG level reflected the short period
of the preceding plasma glucose level; making an evaluation of hyperglycemic control by
FPG level would be misleading in the management of diabetes patients. The HbA1c level
was a better indicator for evaluating the achievement of glycemic control over the preceding
2-3 months. The HbA1c level could predict the complications of diabetes patients.
Therefore, for the goal of glycemic control, the HbA1c test shoud be employed in conjunction
with the FPG test.


location: , 'Thailand year: 2007 source: HSRI

title: Health Volunteers in the Context of Change : Potential and Developmental Strategies

abstract: Village Health Volunteers (VHV) were the hallmark of primary health care during the past three
decades. The volunteer exemplifies the concept of “community participation,” one of the most important
strategies for achieving the goal of “Health for All by the Year 2000”. As the health situation and political
landscape have changed, there was a need to re-conceptualize the roles and functions of the health volunteer
in health development. This study is aimed at assessing the roles and potentials of village health volunteers in the changing contexts of Thailand. Village health volunteers in Thailand, numbering almost
800,000, are an extremely valuable health resource. Although the recruitment of village health volunteers
has occasionally been questioned as being nepotistic or incentive-driven, village health volunteers are
those chosen by their communities for not only being public minded, generous, and willing to help those
in need, but also comparatively knowledgeable and concerned about health matters.
The study found that village health workforces were still very much active and have increasingly
become femininized. More than 35 percent of existing volunteers were recruited not more than five years
ago, while the number of female volunteers rose to almost 70 percent of the total. These volunteers performed
comparatively well on short-term tasks such as taking ad hoc health surveys, collecting periodic
data, or conducting disease prevention campaigns. They did not fare well, however, in the areas of work
that need long-term, continuous dedication, such as caring for chronically ill patients. Existing volunteer
workforces were found to be from a comparatively low educational and economic background. As health
issues have become more complicated, this finding poses the question of how could a volunteer workforce
with higher attributes and economic status more prepared for dedicated work be recruited. The changing
administrative system and decentralization has resulted in the village health volunteer being increasingly
implicated in local and national politics. Changing contexts and concerns call into question the relevance
of conventional model of VHVs. Case studies, however, suggest increasingly innovative roles and forms
of volunteers in health development, ranging from volunteers in hospital settings to disaster relief volunteers.
This strongly indicates that the idea of volunteering has been progressively more accepted and will
play an increasing role in Thai society in the future.


location: , 'Thailand year: 2020 source: HSRI

title: Lessons Learnt from Developing and Implementing the National Steps Challenge in Thailand

abstract: Thailand national steps challenge policy has been developed in 2019 by the physical activity policy development subcommittee according to Thailand Physical Activity Strategy 2018-2030. The policy has been implemented through Thailand Virtual Run Season 1 Fiscal Year 2020 by the Division of Physical Activity and Health, Department of Health, Ministry of Public Health. This article reviewed details of the policy formulation and implementation in order to get deeper understanding on the process of policy development, implementation gaps, and to make further recommendations. Lessons learnt led to deeper understanding on policy formulation at national level that required concurrent assembling of problem, policy, political streams with proper window of opportunity. Policy implementation needed context and situation adjustment for smooth management. Lastly, learning policy gaps from the past could shape better policy implementation in the next stage.


location: , 'Thailand year: 2016 source: HSRI

title: The use of F-18 florbetapir (F-18-AV-45) PET to assess brain amyloid deposition in Alzheimer’s disease, mild cognitive impairment and normal aging

abstract: Introduction The incidence of dementia in elderly population, aged 60 year or older, has been rapidly increasing. Dementia causes significant negative impacts on quality of lives, both in patients and families, constituting a huge socioeconomic burden and drawback in country’s development. Current diagnostic approach based on clinical symptoms and signs may not sufficient. Thus, early detection of amyloid deposition in the brain may play important role in accurate diagnosis, identifying patients at risk, planning for patient management and also leading to development the drug or procedure aimed for therapy or prevention of dementia.
Objectives To evaluate the use of F-18 amyloid PET scan in assessing brain amyloid deposition in Alzheimer’s disease, mild cognitive impairment and normal aging and the correlation between brain amyloid deposition in PET scan and results from neuropsychological test, MRI brain and F-18 FDG PET scan. We also aimed to evaluate the correlation between amyloid PET scan results and changes in neuropsychological test, MRI brain and F-18 FDG PET scan results.
Methods 1) Synthesis of F-18 flobetapir PET tracer 2) Initial clinical study in 43 eligible subjects including 22 normal elderly controls (HC), 12 MCI patients and 9 AD patients according to clinical diagnosis. All subjects were assessed by 1) clinical signs and symptoms and neuropsychological test, brain MRI, F-18 FDG PET and F-18 flobetapir PET scan of the brain within 6-week period. The images were then analyzed using visual and quantitative analyses.
Results The semi-automated synthesized F-18 flobetapir demonstrated equivalent characteristics to those of reported original compound; radiochemical  yield of approximately 20%, pH of 6, half-life of 115.66 minutes, radiochemical purity  > 95%, sterility and pyrogenicity were equivalent to drug for injection standard. Each synthesis could serve approximately 3 patients. Preliminary results of the clinical study in 17 of 43 eligible volunteers who had completed study protocol and test analysis found that F-18 flobetapir results in most of volunteers (n = 16 (94.12%) corresponded to the clinical diagnosis and neuropsychological test results, while MRI (Schelten’s rating scale) and F-18 FDG PET scan results corresponded with clinical diagnosis and neuropsychological test in 13 (76.47%) and 15 (88.24%) volunteers, respectively. The correlation of results between F-18 flobetapir and other tests showed that F-18 flobetapir tended to correlate with neuropsychological test in 16 (94.12%), MRI in 12 (70.59%) and F-18 FDG in 16 (94.12%) volunteers. So far, there was no detectable adverse effect in any subject.
Conclusion Our preliminary results found a very high correlation between amyloid PET scan using F-18 flobetapir and clinical diagnosis and neuropsychological test results, which was higher than in F-18 FDG PET and anatomical abnormality detected by MRI, respectively. However, correlation between amyloid PET scan results and changes in neuropsychological test, MRI brain and F-18 FDG PET scan results are still needed to be followed.


location: , 'Thailand year: 2009 source: HSRI

title: Breast Cancer Knowledge, Attitudes and Screening Behaviors - A Literature Review

abstract: Objective: To identify the factors, including knowledge, attitudes, beliefs, values, fears, and perceptions,
which influence breast cancer screening behavior among different groups of people.
Methods: A structured literature search was undertaken, using the United States National Library
of Medicine’s PubMed database. Thirty-one breast cancer-related studies were selected; these were summarized
by applying the Health Belief Model and Knowledge, Attitudes, and Behaviors Model to the
framework.
Results: Most of the studies had been conducted in North America, and the designs used were
mostly cross-sectional studies. The percentages of women who underwent mammography ranged from
5.3 to 82. Women who had performed BSE (breast self-examination) ranged from 6.4 to 83 percent, and
women who had undergone CBE (clinical breast examination) ranged from 26 to 61 percent. The review
found that not only did knowledge of breast cancer play an important role in people’s behavior regarding
breast cancer screening, but also regarding beliefs, attitudes, cultures, values, and perceptions.
Conclusion: This literature review addresses issues regarding the importance of knowledge, attitudes,
beliefs, values and cultural awareness when implementing prevention programs. Further research
needs to explore the threshold level of breast cancer knowledge in order to achieve a higher rate of the
breast cancer screening.


location: , 'Thailand year: 2023 source: HSRI

title: A Study of Duties and Powers of the Phitsanulok Provincial Administrative Organization on the Adopt of the Sub-District Health Promoting Hospital, a Case Study for Making Recommendations for Legal Reform and Amending the Relevant Provisions

abstract: The objective of this study was to determine the duties and powers of Phitsanulok Provincial Administrative Organization regarding jurisdiction of sub-district health stations. Attention was focused on rules and regulations relevant to the transfer of control over sub-district health stations in the province. Solutions were proposed on how to amend rules and subordinate legislations conducive to efficient transfer of operation of those health stations. Special attention was paid to promoting the healthcare system. The final outcomes were 27 recommendations for national and local policy and measures necessary for public health law reform, especially the operation of universal health coverage scheme. Analyses were carried out on duties and powers of a given provincial administrative organization in dealing with transferring of parts of its missions. Relevant laws, rules and regulations, and subordinate legislations required to achieve any transfer of its mission were also analyzed. Also included were announcements made by the Decentralization Committee, standard operating procedures in managing manpower, budgeting, materiel, and office space. Relevant management systems analyzed included information, drug and medical supplies, patient referral, cooperation and coordination of local and central administrative bodies, and collaboration among primary healthcare units in each province. In short, research findings included a lack of urgent measures to ensure implementation of relevant laws and guidelines provided by the Decentralization Committee. Consequently, problems and issues, and misunderstanding among relevant workers in the field, particularly in the public health sector and provincial administrative organization. Dealing with these issues in a timely manner could potentially lead to reform and improvement of the system by implementing recommendations from this study.


location: , 'Thailand year: 2010 source: HSRI

title: Decision-making on Patient Compensation Related to Adverse Events

abstract: Adverse events that occur in health service settings are resulting in more lawsuits than ever before.
The new patient compensation bill is expected to resolve patient-provider conflicts. It will be designed to
cover all groups of Thai people with acceptable claim process and amounts for compensations. This
communication reports the results of a study on the decision-making processes involved in compensating
injured patients under Article 41 of the National Health Security Act 2002.This was a descriptive study. The reasons used by committees in making decisions on whether to
“pay“ or “not pay“ the agrieved parties under the provisions of Article 41 were analyzed and compared
with the compensation criteria set out by the National Health Security Office. Altogether 1,276 claims
made during the period 2003 - 2008 were included in the study.
It was found that, of 1,276 claims, compensation was “paid out“ for 1,049 cases (82.2%) and 227 cases
(17.8%) were “not paid”. The main reason for paying compensation was that “it was an unavoidable
situation“ (76.5%). However, the reason above was not in accordance with the criteria for compensation.
Only 27.1 percent of the claims were made in accordance with the criteria, stating that the injuries were
related to medical errors or mistakes or substandard care. The main reason for not paying compensation
was that “the adverse events were the results of disease processes“ (61.6%). This was in accordance with
the criteria.
The conclusion was that inconsistency and unclear decision-making on patient compensations existed.
Of two cases with the same kind of injury, one might be paid and the other not. This type of
situation might motivate patients to bring cases to court.


location: , 'Thailand year: 2007 source: HSRI

title: Evaluation of Health Care System for Diabetic Patients of Contracting Units for Primary Care (CUP  Network under the Universal Care Coverage System

abstract: This study is part of the study to develop the monitoring system for primary
care at a macro level. This part shows the evaluation result of diabetic care
system of various contracting units for primary care in purposively sampled 18
CUPs, 4 regions. The components of the evaluation were diabetic care system
and process, clinical results, knowledge, practices and quality of life of diabetic
patients. The methodologies used were internal evaluation by questionnaires
and explore evaluation by observation, interview and documentary review. The
result showed that the quality of the systems among CUPs was much varied.
Most were passive, not proactive on risks and complications management. Primary
care showed fewer roles, only screening and follow up. Most of them were
not well supported by hospitals and CUPs. Health outcomes indicated that 38
percent of the total had good control of plasma glucose (HbA1c < 7 mg%); 10-19
percent high cholesterol, 21-43 percent high HDL, 2-12 percent high triglyceride
particularly among women than men; 31-50 percent micro-albuminurea (>30),
high creatinine 2-30 percent. These were different among areas and diabetes over
5 years had more complications than diabetes less than 5 years. The knowledge,
practice and quality of life of diabetes were varied among CUPs. Most had good
knowledge and practice on medication and general management, but has less
on diet, foot care and care for special events. Diabetes had quality of life on mental
aspect less than other aspects. Those with diabetes less than 5 years had
quality of life score on physical and dependency aspect better than those more
than 5 years, but the scores other aspects were not different. The diabetes in
areas that had better knowledge and practice also had higher score of quality of
life.
This study showed that the evaluation of diabetes care system can be one
tracer to monitor quality of primary care and contracting units of primary care.
The process and some outcome indicators in this study can be used to compare
conditions among areas.


location: , 'Thailand year: 1998 source: HSRI

title: Evaluation of strategy and technology for safer road project

abstract: Evaluation of strategy and technology for “Safer Road” projectThe study was to review knowledge and research results on various technologies used for reducing road accidents and increasing road safety to propose policy decision makers and operational offices for consideration. The 6 technologies were proposed, which were 1) red light camera for those violating traffic light and driving above speed limit, 2) motocycle lane, 3) road safety monitoring, 4) programs for relaxing bus and truck drivers, 5) annually effective vehicle check-up, 6) tax measures for promoting equipment which is used for road safety. However, the use of such technologies needs changes to existing policy and requires some preparation for example implementation of pilot projects and establishment of training programs.


location: , 'Thailand year: 2015 source: HSRI

title: Development of Strategic Map for Health Promotion and Prevention of Diabetes Mellitus Patients

abstract: The increasing trend of diabetes mellitus (DM) cases and weak coordination among groups who
take responsibility for taking care of these cases, brought about to the study of holistic care for DM patients
in Chiang Dao Subdistrict Municipality, Chiang Mai Province. Objectives: (1) To explore the problems
related with coordination among stakeholders who involve with health promotion and disease prevention
for DM patients (2) To develop strategic map for the implementation of health promotion and
prevention for DM patients. The study design is qualitative research approached by focus groups among stakeholders as a tool for collecting information. The sample consisted of four groups: subdistrict municipal
authorities, health volunteers, diabetes patients and health workers. Data were collected from 9 June
to 20 November 2014 through focus groups. Data reliability was tested by information contributors and
triangulation. The data were analyzed by using content analysis. Results: 1. Problems were identified in
four categories: (1) Management (2) Man (3) Materials for work (4) Money, 2. Strategic map for the implementation
of health promotion and prevention for DM patient of Chiang Dao Subdistrict Municipality,
Chiang Mai Province, was created comprising: (1) Learning and development perspective, (2) Internal
process perspective, (3) Efficiency perspective, and (4) Performance perspective.
Recommendations from this study are: (1) Development of information system for all groups involved
with DM care system is needed and should be easily accessible, (2) Development of network should
be continously used as a tool for coordinating, and for knowledge and resources sharing, (3) Provision of
knowledge on project planning and management including strategic management to achieve target result
with appropriate method should be in place.


location: , 'Thailand year: 2007 source: HSRI

title: Diabetes Mellitus and Its Risk Factors in the Thai Population : The Third National Health Examination Survey 2004

abstract: Diabetes mellitus and its associated complications are major health and economic burdens worldwide,
in Asia and the Pacific and in Thailand. This burden is expected to continue to rise. The aim of this
study was to determine the prevalence of diabetes and impaired fasting glucose (IFG), their association
with cardiovascular risk factors, and evaluate the management of blood glucose, blood pressure and cholesterol
in diabetes by geographical region of Thailand. We used a database of the National Health Examination
Survey 2004, a stratified multistage sampling design representing 37,138 individuals aged ≥ 15
years; the data were collected using questionnaires, physical examination and laboratory examination
The prevalence of diabetes mellitus and IFG weighted to the national 2004 population was 6.6 percent
(5.9% in men and 7.2% in women) and 12.6 percent (14.8% in men and 10.5% in women), respectively.
Diabetes was more prevalent in urban areas. In two-thirds of those diabetics who had not been previously
diagnosed, the prevalence of associated risk factors was high among diabetics as well as those with IFG.
Two-thirds of the diabetics with concomitant high blood pressure were not aware that they had high
blood pressure. Eighty percent of the diabetics with concomitant high cholesterol were not aware that
they had high cholesterol. The risk factors for diabetes and IFG were male sex, high blood pressure, high
cholesterol, central obesity and overweight. Most risk factors could be modified by lifestyle interventions.
Improvements in prevention, diagnosis and treatment of diabetes and associated risk factors are
required in order to decrease the expected burden.


location: , 'Thailand year: 2018 source: HSRI

title: Lessons Learned from Trans-Pacific Partnership Agreement: Implication on Tobacco Control in Thailand

abstract: The Trans-Pacific Partnership Agreement (TPP) is a comprehensive model of regional trade and investment agreement. As a complex and comprehensive new generation of trade agreement, tobacco industry or transnational tobacco companies would employ TPP to interfere with tobacco control policy and law of the State Parties. The State Party may not adopt the Investor-State Dispute Settlement (ISDS) with respect to claims challenging a tobacco control measure; however, such exception provision covers only the investment chapter. In sum, some of TPP’s provisions may have negative impact on tobacco control in Thailand and tobacco industry may not comply with the WHO Framework Convention on Tobacco Control (FCTC) or threaten the government by claiming the litigation or trade disputes in order to undermine tobacco control measures.