location: , 'Thailand year: 2002 source: HSRI

title: The dental personel from health system reform in Thailand

abstract: The present study aims to reassess and synthesyze the framework of dental personnel development, focusing on dentist and dental nurse, through literature review and qualitative study.The results of the study showed that;  The influential  future streams of changes came from various directions and dimensions.  The main influence induced from the Health System Reform in Thailand  which reshuffled the legitimize structure of all sectors in the broadly defined “health system”, as well as extensively mobilized the current social paradigm and norms, particularly through the concepts of  health-oriented rather than disease-oriented and holistic health.  The health care services was remodeled mainly by financial and administrative measures and expanding the public sector service to include more private involvement.  The reform occurred concurrently with the amendment of the government service system, education system and the decentralization of authority over public enterprises to peripheral units.  In the other side, the expansions of capitalism, comsumerism, free  trade,  globalization, information technology, medical technology were also indicated for their influential  effects.  The change of Thai social structure as well as the current weak points of dental profession including insufficiency of self-dependency dental technology,  the imbalance of institutional knowledge /technology and the appropriate dental knowledge concerning the contexts of Thai society, as well as the limitation of some competence and attitude in graduated dental personnel, should also be taken into account. Apart from these, the reviewed of current dental public health situations and their trends showed that:  Dental caries rate of primary teeth in pre-school children was highly increased, notably in the rural area.  The rate of consuming cariogenic food also deeply increased during the past decade. Dental service utilization of the people was low, especially in elderly and rural people, mostly driven from acute symptom rather than from preventive approach.  The cases of dental profession code of ethics were in the increasing trend.    The future characteristics of dental personnel, apart from the basic professional knowledge and skill, should focus attention on:  the knowledge and skill of health promotion and social mobilization, thinking process, research and long life learning, team work coordination, communication skill, patient relationship and the extensive background of  non-professional knowledge to comprehend the situation and changes of the holistic world.  For the personality aspect, dental personnel should be raised in leadership, emotional literacy, human relationship and the mind of ethical integrity and responsibility to public. The role of dental personnel should be consequently adjusted, notably in the highly overlap role between dentist and dental nurse which partly reflect to the low team work performance affecting the efficiency of dental service outcomes. Dentists, especially in public sector, tended to provide too high proportion of simple services which were the majority of demand, resulting the under provision of the needy complex dental services.  While the interchangable of majority dental services by two types of dental personnel was increasingly be questioned by people under the health insurance system.  In the other hand, dental nurse faced the struggled of career ladder progress.  The direction of the solution, concerning the whole complication of each alternatives, should focus on the improvement of the ‘dental team’ or ‘oral health team’ which had to be systematically defined and organized.  The dentist, the team leader, should mainly responsible in taking care of holistic oral health care, planning and monitoring the overall oral care system, clinical diagnosis and holistic treatment plan, quality control and provide the complex dental services with the sufficiently assisting by dental auxiliaries including dental nurse.  This oral health team approach should be more relevant and flexible for the wide gap situation of dental manpower in the country than the legalized regulation limiting the curative role of dental nurse or to provide the license to dental nurse to work independently.  This approach allowed the oral health team to adjust the borderline roles of dental personnel within the team with the administrative means according to relevant place and time. The supporting training for increasing the oral health team approach should be started from the educational and training period.The recruitment of dental personnel, particularly in the government sector, should involve the community role in the enrollment process of dental student.  The involvement might be in selection process, educational expenditures support, field work training and employment in the local health care unit.The dental education direction have to be balanced between the aim to meet the advancement of dental institutional knowledge and technology and to rightly response to the oral health problems and needs within the belonging social circumstances. The educational process should be developed under the concepts of social or community based, patient-centered, active learning through research and thinking skill enhancement, comprehensive ethical motivation and the extensive evaluation and quality assurance of educational outcomes.This administration of the changing process in dental education should be implemented by adjusting the policy, improving educational manpower as well as providing the appropriate supporting environments such as:  connecting the education institutional dental service with the national or regional health service system, providing the relevant infrastructure and social environment, or developing the curriculum under local community participation.  The distribution of dental personnel in public sector by national monitoring through the compulsory contract of dental students was still considered as necessary. However, the pattern of distribution process tended to be directly indicated by the need or outcome estimation rather than by the current frame of the Civil Servant Office.  The concept of the mentioned  “oral health team” should be taken as the guideline for dental manpower distribution.  The increasing production of dental nurse was clearly indicated as well as the extension of dental public service involving private sector. The distribution management should be run concurrently with the recruitment of dental students and should include the motivational and supporting measures for the remote or the unmet need areas.The capacity building and quality control of manpower should be continuing implemented through the professional standard regulation involving the institutional quality assurance ie. Hospital Accreditation system and individualistic quality control (such as. professional licensing/ relicensing and continuing education).Licensing  by central examination from The dental council was questioned for its difficulty in developing  the complicate and professionally acceptable examination representing the overall achievement of dental education. It was suggested to be implemented only in case of the dental education of Thailand were generated by numerous and  various types of dental schools where the standard control through educational programme monitoring was inconceivable.Even though the relicencing was widely accepted for the necessity, it was scrutinized for the ability of measuring essential competence, as well as its cost-benefit and its concomitance to the quality from the consumer point of view.  It was suggested that relicensing should aim for consumer protection and utilize various evaluative methods rather than rely only on the examination or formal training.The professional control by the public was also the simultaneous measure of quality control. Several approaches were recommended such as the participation of people sectors in the policy board in many levels of the health system, the patient/ people satisfaction evaluation as a part of Hospital Accreditation, the involvement of consumer/people representatives in professional council and the board of dental educational institutions. The progression in professional career in the governmental sector should be separate to the administrative career.  All health professions should be promoted equitably among each other as well as in comparable to the administrators.  The promotion in the public health administrative line should be opened to any competence persons regardless of their professional backgrounds.The planning of the general practitioner and the specialist proportion should be closely supervised to meet the actual need estimation.  The dental specialty branches should be reduced to provide the more comprehensive dental specialists. The recognition and support for general practitioner should be improved such as establishing the system of on-the-job training to enhance the all-round dental skills and knowledge to the general practitioner, leading to the namely the specialist in general practice or family dentistry.  The mechanism of the overall policy making and planning regarding dental manpower should be established as an integrated part of the health manpower system in


location: , 'Thailand year: 2008 source: HSRI

title: Epidemiology and outcome of teenage pregnancy in Wiangsa district, Nan province

abstract: Teenage pregnancy is considered a high-risk situation that increases the likelihood
of adverse obstetric and perinatal outcomes, such as those associated with low birth weight,
anemia, hypertensive disorder in pregnancy and preterm delivery. The trend in teenage
pregnancy has increased. To effectively solve the problem of teenage pregnancy, currently
a global and nationwide problem (including in Wiangsa district as well), it is necessary
to study the real causes and results before implementing local, specific strategies.
The purposes of this study were to study the epidemiology of teenage pregnancy in
Wiangsa district and to compare the pregnancy outcome of teenage pregnancy with adult
pregnancy in Wiangsa Hospital. The research design for comparing the pregnancy outcome
was a retrospective cross-sectional study; that used for studying the epidemiology
was a descriptive study.
The study and the control groups (teenage and adult mothers respectively) each
consisting of 146 singleton primigravida females aged <20 and 20-29 years, respectively,
who were Wiangsa district citizens and who delivered at Wiangsa hospital between October
1, 2004 and September 30, 2007. The data were extracted from medical records and
analyzed for pregnancy outcomes. Then 43 teenage mothers who were still available in
the province were studied for epidemiology and interviewed in-depth (under informed
consent) to determine the factors causing them to become pregnant.
Results: In the study group 39.04 percent were 13-17 years of age. Antepartum period:
the study group had a significantly higher average gestational age at the first antenatal
care visit, a lower average number of antenatal visits, a lower average weight gain,
a higher rate of those who received inadequate antenatal care (<4 times), those who were
unsure about their last menstrual period, those who developed anemia and premature
membrane rupture. Intrapartum period: the study group had a significantly higher rate
of inadequate pelvis measarements (crudely evaluated by nurses during admission), caesarean
section, especially when indicated by cephalopelvic disproportion. Postpartum
period: the study group had a significantly higher rate of urinary tract infections. There
was no increase in significant complications commonly found in other studies, especially
preterm labor, and low birth weight. Epidemiology: the trend in the teenage pregnancy
rate in Wiangsa district increased, especially in younger teens. Weaker families and
society seem to be the major root causes of this problem.
Conclusions: Teenage pregnancy in Wiangsa district had poor outcomes, especially
antepartum and intrapartum. The trend of this situation is getting worse, mainly because
of weaker family and socialties.


location: , 'Thailand year: 2017 source: HSRI

title: A Systematic Review: Factors Related to Pre-Hospital Emergency Medical Service Utilization

abstract: Incidence of death and long-term disability of emergency patients could be reduced with prehospital
emergency medical service (EMS) utilization. Current reports indicated that emergency medical
services were used only 3.1 percent of cases in Thailand. This reflected that a review of causes related to
the use of pre-hospital EMS was urgently required. This research was then conducted to promote the EMS
utilization. After the review, 38 articles were found related to the topic, and the contents of 31 articles were
relatively relevant and credible with evidence-based data after verifying with rigorous methodology. Then all of the 31 articles were utilized in the process of content analysis. The findings indicated that
EMS utilization via 1669 hotline and others were related with various factors including population, socioeconomic
of the service users or relatives such as gender, age, education, marital status, income, and
vehicle ownership.
The important factors included attitude towards EMS, EMS past experience, social support, perception
on obstacles in using EMS, access to information, knowledge on urgent symptoms of EMS use, and
self-confidence on using pre-hospital EMS system. These findings may be used to develop further
research for promoting appropriate EMS utilization in Thailand.


location: , 'Thailand year: 2023 source: HSRI

title: Policy Proposals for the Monitoring and Evaluation of the Performance of the Sub-District Health Promoting Hospital Transferring to the Provincial Administrative Organization Case Study in Maha Sarakham Province

abstract: This research aimed to study the policy proposal for monitoring and evaluation of the Sub-district Health Promoting Hospital (SDHP) where have been transferred to Mahasarakham Provincial Administrative Organization (MPAO). The mixed methods research was conducted in 2 phases. Phase 1 was a survey in 500 samples and phase 2 was action research. The target samples were the stakeholders from 175 settings of Health Center in Honor of His Majesty the King’s 60th Birthday Nawamintrachini (HCN) and the SDHP. Data was collected by questionnaires, focus group discussion and commenting record. The results reveled factor affected the health service following the six building blocks of health system framework. The factors related the health services significantly were married status (p-value<0.001), work position (p-value=0.019), committee (p-value=0.023), and information sources (p-value=0.024). The factors affected the monitoring and evaluation of the HCN and the SDHP who transferred to the MPAO statistically significant were transferring (p-value=0.027), personal transferred status (p-value=0.006), gender (p-value=0.014), married status (p-value<0.001), education (p-value=0.0043), work position (p-value<0.001), work type (p-value<0.001), and training experiences (p-value=0.001). The comparing between a transferred group and a non-transferred group found the statistically significant difference (p-value<0.001) in the improved health, the responsiveness and the improved efficiency. The policy proposals will be implemented in 4 domains. First, the improved health domain should involve all stakeholders participate in the evaluation. The format depends on each district and should have a sharing forum. The first phase should evaluate the people impacts rather than outputs, according to the changes of health service system. Second, the responsiveness domain should select the indicators which can be performed under the situation of transferring to the MPAO. Third, the social and financial risk protection domain should monitor and evaluate the health impacts covering manpower, materials and network coordination. The facilities should be flexible for good health services. Lastly, the improved efficiency domain should increase the human resources for the effective coordination and performance. The assessors for the monitoring and evaluation should be the delegates of the health networks of the Ministry of Public Health, Provincial Administrative Organization, and stakeholders. The manual should be development for assessing guideline and improving performance.


location: , 'Thailand year: 2021 source: HSRI

title: Wastewater surveillance for SARS-CoV-2 in provinces that have confirmed COVID-19 cases

abstract: The project of wastewater surveillance for SAR-CoV-2 in provinces that have comfirmed COVID-19 cases was conducted by Division of Communicable Diseases, Department of Disease Control. The objectives of this project were to detect SARS-CoV-2 in wastewater and to characterize the relationship between the presences of SARS-CoV-2 genetic materials and the number of infected cases in the particular areas. The result could elucidate the correlation between degree of SARS-CoV-2 genetic materials and the number of COVID-19 patients in the community. Moreover, our result could be useful for disease surveillance and monitoring programs, conducive to setting appropriate measures and policies in controlling this kind of virus effectively in the future. From May to December 2021, a total of 248 of wastewater samples was collected from 11 places, including markets, apartments, universities, and prisons, located in the COVID-19 outbreak areas, Bangkok and Samut Sakhon. The real time RT-PCR technique was used for SARS-CoV-2 detection. The results showed that 118 samples were detected from 10 places, related to the number of infected cases. Moreover, variant of COVID-19 was also analyzed. Based on our results, we suggest that the detection of SARS-CoV-2 in wastewater can be used for COVID-19 monitoring and for integrating with other disease investigation practices in the community. Since individual detection of COVID-19 infection is limited, wastewater analysis could be considered one of the sensitive and cost-effective strategies. Routine implementation of this surveillance tool together with personal hygiene practices and social distancing would significantly improve our preparedness against new or re-occurring viral outbreaks.


location: , 'Thailand year: 2015 source: HSRI

title: Higher Direct Non-medical Costs Associated with Referrals from Community to Provincial Hospitals

abstract: Referring patients from community to provincial hospitals results in higher direct non-medical costs
(DNMc), which include the costs of transportation, food, accommodation, and informal caregivers. However, these costs have not yet been quantified.
This study estimates the increase in DNMc for referred ambulatory and hospitalized patients. To
approximate the DNMc of patients at community hospitals, a cross-sectional survey was conducted in
three community hospitals in Suratthani province during 16-26 February 2015. The DNMc of patients
who were referred to the Suratthani provincial hospital, were derived from previous studies which reported
the DNMc of patients at this hospital. Cost adjustment was performed using the consumer price
index, with base year 2015. T-tests were used to compare the differences between parameters, with a
significance level of 0.05.
The results showed that, for each day the patients were hospitalized at a provincial hospital, the
costs of informal caregivers were 632.90 Baht higher than those admitted to community hospitals. For
ambulatory care patients, the total DNMc of those referred to a provincial hospital were 513.40 Baht higher
than those receiving care at community hospitals.
Higher DNMc may prevent patients from accessing needed care when referred from community to
provincial hospitals. One way to mitigate this obstacle is to improve the capacity of community hospitals,
thereby reducing the need to refer patients to provincial hospitals without compromising quality of care.


location: , 'Thailand year: 2000 source: HSRI

title: Alternative Health

abstract: Alternative Health System Development in Thailand:Knowledge Synthesis on Health System Reform	Alternative health system development in Thailand were studied by reviewing international literature. The contents were synthesised to find appropriate development for alternative health system in Thailand to propose contexts which should be in National Health Bill. The study recommended development of alternative health system be integrated into mainstream of health system in order to achieve comprehensive and holistic health which correspond to Thai culture. Health alliance was considered as a major mechanism for reforming. To develop alternative health system, the Committee for Alternative Health System should be set up under the National Health Council to determine policy, direction and its system structure,the Alternative Health Institute should be an entity developing knowledge, supporting its network and being the secretary for the Committee,the Sub-committee for the Committee for Alternative Health System should be responsible for consideration based on determined principles, the Sub-committee would propose contexts for amendment to either regulations or laws to insure alternative health care,alternative health should be supported to be other professional-liked organisations and be supported for research development,representatives for consumer group should be positioned in the Committee


location: , 'Thailand year: 2007 source: HSRI

title: Looking at Health Promotion and Disease Prevention Services for Children 0-5 Years Old in the Periods before and after the Introduction of the Universal Health Coverage System

abstract: Children under five years old normally grow and develop rapidly; during that process they are at
risk of failing to reach the vital goal. Therefore, health promotion and disease prevention comprise potential
means for taking care of such children. This study was aimed at studying a profile of the health promotion
and disease prevention (HP-DP) services for them, regarding the utilization of the Universal Health
Coverage System, and the attendants’ behavior. Descriptive design with in-depth interview was employed
for data collection in the period from April 2003 to March 2004. The materials and the subjects
studied included documents, 1,000 selected children and their parents who attended HP-DP clinics, 12
health-care providers, and experts. Questionnaires and interview guidelines were used for collecting
information. The findings revealed the following:
1. All university hospitals, regional and community hospitals, as well as community primary care
units were providing HP-DP services in those settings both before and after the implementation of the
Universal Health Coverage policy, apparently without establishing institutional policies and practice guidelines,
manpower allocation, staff development or resource planning. Services were also extended to the
community despite the limitations of personnel and time constraints. The majority of health-care providers
did not understand much about the newly introduced benefit package for children under five years
old. In addition, limitations remained on practices in the assessment of childhood development, in
developmental stimulation or promotion, the arrangement of the developmental promotion corner and
counselling on child-rearing. Thalassemia screening for children whose parents showed traits or were
diseased, and thyroid hormone testing for children with indications were seldom practiced.
2. The old and new benefit packages of health promotion and disease prevention in children under
five years old did not differ much. Although the known services in the United Kingdom and the United
States were included, the practices of recording family history, genetic history, vision and hearing tests,
mother-child interaction, parental advice regarding food, oral care, accident prevention, and child development
promotion and empowering parents in child care were covered.
3. General information on children and their parents’ behavior on attending the HP-DP service noted
that the mothers were mostly the persons who brought their children to the well baby clinic. Most of
them were workers, housewives and civil servants. They preferred the hospital’s HP-DP service as it
was the place where their child was delivered and was in the vicinity of their residence. However, the
services included mainly weight and height measurements, and vaccination. Seldom included were child
development assessment and advice on child-rearing and child development promotion. Satisfaction
with the health service was 53.3 percent of the samples before and after the introduction of the Universal
Health Coverage policy, denoting no difference. Satisfaction with the services related to height measurement,
vaccination, developmental promotion, health assessment and advice on child care did not differ
significantly statistically (p <0.001).


location: , 'Thailand year: 2002 source: HSRI

title: A study of health assembly procedure in Thailand : National and provincial Health assemblies 2002

abstract: Health assembly is one of a mechanism in the process of Thai Health System Reform which is an ambitious movement for total change of Thai health system fromideology to practices; from individual, community, and professional levels, to national level. Assembly is a new mechanism for public participation Thailand. This mechanism aims to bring multi-sectoral cooperation to promote new health system that emphasizes prevention rather than curative health where by the term ‘health’ was defined in a broader term included various aspects of well-being which beyond the realm of medicine. First movement of the health system reform is to launch the “National Health Bill,” that will be a new Thai health constitution, a guarantee for new health system to exist and maintain people participation. The National Health Reform Committee and the National Health System Reform Office, thus, form an ad-hoc committee to mobilize and organize health assemblies in almost 500 districts, 75 provinces, and one national assembly. The ideology behind organizing health assembly is to consider these assemblies as “social innovation” for people participation in the policy making and legislation procedure. Therefore, each sub-committee at all level is allowed to create different procedures to make people participated in this law making procedure as much as possible. The procedures are expected to be acceptable to local cultures and settings. The assemblies, thus, need not be formal, or totally informal; whatever types or forms of social gathering for this purpose is achieved there would be lesson learn to other assemblies that followed. Thus, the provincial health assemblies were organized according to local setting, which in turn gave lesson to the national health assembly. Every procedure is differed depend upon various factors. This study, therefore aims to document and analyze the procedures of the assemblies to see what the primary forces that bringing people participations in different kind of settings. It also aims at understanding the whole picture of people interaction in different kind of stage arrangements. This report also analyze the procedures of health assemblies as a form of social process that scrutinize, on the one hand, instrumental components of social transaction, environment, and tools for interactions; and expressive components of social transaction, emotional reaction, symbolic representation, and exchange of ideas and knowledge. The result of this study revealed numbers of factors influencing people participation in the assemblies, particularly the components of multi-sectoral participants which was a challenge to organizers; the nature of moderators and the dynamic of interactions which could enhance or became a barrier for people participation at the same time; the matter of the contents of the discussion which could bring cooperative or protesting atmosphere; and the formats of the meeting which create a pressures or accommodating nature for participation. On the other hand, this research also found that the assembly (particularly national health assembly), reveal a set of political procedure resemble of neo-communitarianism which emphasize on public/civic engagement of an eclectic group of participants. Even though, health is an agreeable subjects that people could easily accepted the ideas of change for the good will of people, health assemblies, emphasize communicative culture of formal talk and discussion with specific set of rules, people who are not familiar with the procedures could found a resistant to some of the subjects discussed by persons of different background. This study is only able to reflect what had happened at the front stage of communication which left the back stage of communication untouched, and to be further study with cooperation of those who organized the assemblies in the future.


location: , 'Thailand year: 2007 source: HSRI

title: Evaluation of a New Health-promotion Service in which Health Network Personnel in the Community Participated : A Case Study of the Wangchan Project, Rayong Province

abstract: The Public Health Coordination Committee of Wangchan District, Rayong Province
has started a new form of health promotion for the people of Wangchan District under a
project named “Caravan for active health promotion, conducted by networks of participants
in the community.” The objectives were: (1) to compare activities between the new
and the former health services on aspects of their activities, budget, personnel, time consumption,
and involvement of health networks in the community; (2) to evaluate the
outcomes regarding the expected target establised by provincial as well as ministerial
public health policy; and (3) to determine satisfaction with the project among public health
staff, the target group, community leaders and health network participants. Information
sources were derived from questionnaires and working records.
The overall results of the descriptive study demonstrated the superiority of the new
form of health-promotion service to the former one on aspects of health benefits to the
community as well as the satisfaction of the participants involved in the study.


location: , 'Thailand year: 2022 source: HSRI

title: Computer Modeling for Diagnosis of Abdominal Aorta Aneurysm Using Patient’s Computed Tomography Images and Computational Fluid Dynamics

abstract: Cardiovascular diseases are classified as non-communicable diseases (NCDs) that are dangerous and have an increasing trend nowadays. This disease is related to lifestyle behavior. It tends to accumulate symptoms gradually and become more severe if it is not treated properly and in time. Abdominal aortic aneurysm (AAA) is a dangerous disease and can cause sudden death if ruptured. This research project has applied an engineering tool called a computational fluid dynamic (CFD) for medical applications. Computed tomography images of patients with abdominal aortic aneurysms were acquired to perform a reconstructed geometry of AAA. There were 12 cases of patients who have AAA with a diameter larger than 3 cm. The blood properties and boundary conditions were assigned in the model. The results of this study found that the aortic aneurysm was highly turbulent in the diastolic phase and there was an increase in turbulence as the aneurysm size increased. This turbulent flow was also found during peak systole as well. Wall shear stress (WSS) in the artery was high at peak systole and during diastole. Furthermore, WSS was higher in the aortic aneurysm sac than in the rest of the aorta. The oscillating shear index (OSI) was higher at the aortic aneurysm sac than other areas. This may lead to a risk of rupture point of blood vessels. However, the results could not be directly compared in the same group of patients because each patient had a different geometries and degree of tortuosity. Therefore, this kind of calculation is individual as a personalized model. In addition, this work has 3D printed models of the abdominal aorta to create a testing mock-up for the aneurysm. However, it was found that the material used in the AAA phantom was not clear and flexible. These problems relate to the flow visualization in the blood vessels and the wall contraction simulation of the blood vessels. More studies are needed to explore suitable materials to mock-up the AAA model for flow testing.


location: , 'Thailand year: 2019 source: HSRI

title: An Evaluation of Management System of the National Health Examination Survey in Thailand

abstract: In Thailand, a series of National Health Examination Surveys (NHES) have been conducted every
five years since 1991. The NHES employed two approaches for data collection including basic physical
measurements and structured interviews. The NHES exclusively provided objective information on health
status and health risks of the population which cannot be obtained from other sources. Consequently,
this information has been used for development of health promotion and disease prevention policies
as well as for monitoring health indicators and policies. Throughout 25 years of the NHES, no systematic
evaluation of the survey’s management has been conducted. The present study evaluated the NHES
management system in four areas covering the role of agencies responsible for conducting the NHES;
resources used for conducting the NHES; database management and the utilization of the NHES data;
and ethical issues related to access to the NHES database with the aim to provide policy recommendations
for future developments. The present study collected data through document reviews from September
2016 to January 2019 and in-depth interviews with 26 people including personnel in funding
agencies, survey managers, researchers who were part of survey networks and potential data users from
December 2016 to April 2017. The scope of literature review and questions for in-depth interview included
the NHES I-V. The present study found that NHES I-V involved many agencies in different capacities such as responsible
agencies for conducting and managing the survey, funding agencies, and steering committees.
There were frequent changes of agencies responsible for conducting NHES reflecting the lack of long-term
policies regarding the implementation of NHES. Every NHES reported budget constraints, yet there remained
neither budget allocation from the government in the long run nor long-term funding agencies.
Hence, the agencies implementing NHES had to propose budget request for each survey. These limitations
inhibited long-term capacity building on survey practitioners and institutionalization. Furthermore, policies
and guidelines for the utilization of NHES data and other information were vague. Although there was a
guideline drafted in the IV NHES, the guideline has not been put into practice making it difficult for researchers
outside the NHES networks in getting access to NHES database and specimens, hence NHES
data have been under-used. On the other hand, some health issues investigated by the NHES might be
duplicated with those of other health surveys conducted by the National Statistical Office or other
higher education institutes granted by the same funding agencies as the NHES. Therefore, it is highly
suggested that relevant authorities should consider the integration of health surveys at the country
level in all aspects.


location: , 'Thailand year: 2020 source: HSRI

title: The Situation of Pay for Performance against Efficiency Increasing in the Health Services   System, The Ministry of Public Health

abstract: This retrospective research is aimed at; to study the situation, results of performance based compensation and analyze factors influencing the compensation according to the performance of service units under the Ministry of Public Health. The qualitative study was performed on group discussion committees (Focus group) involving in performance – based compensation, In-depth interviewing with health personnel. Moreover, the quantitative study was hold in this research which are the secondary data from related documents, data analyzation from various institutes. Including, the financial and accounting information form the hospitals that under Office of the Permanent Secretary, Ministry of Public Health, Health Data Center information, performant - base compensation scoring, human resources information and others. The results explore that Pay for Performance (P4P) is not a burden situation. Rather, it is an administrative tool that affects to the quality development of the hospital. Various hospitals pay for their performance less than the limits set by the Ministry of Health. P4P arrearage was found in many hospitals doe to financial liquidity. The compensation received by each profession in each hospital varies from person to person. P4P can be a drive for tangible outcomes clearly. The management of the P4P has an influence on the success of the P4P payment. It should be integrated P4P system with the hospital accreditation system and routine works development.


location: , 'Thailand year: 2008 source: HSRI

title: Legal Measures Involved Drug Substance Users

abstract: The objective of this documentary research is to review knowledge related to legislative measures in connection with addicts.  Results of this research indicated that each addictive substance is harmful and has medical necessity differently.  According to the Addictive Substances Law, 2522 B.E. categorized addictive substances into 5 separate classes.
1.	Most potent addictive substances
2.	General addictive substances
3.	Addictive substances which are derivatives of medicinal effect and has some category 2 addictive substances
4.	Addictive substances which are chemicals used in producing category 1 and 2 addictive substances
5.	Any addictive substances which are not included in the previous four categories
Basic concept and philosophy related to punishment measures for addicts is for retributive reasons, in order to control and paying for punitive damages.  At present, measures for punishment are of many varieties, to be suitable for those who committed wrongful deeds, and nature of crime.  There is less imprisonment measures and emphasize on community penalties as priority, by categorize punishment levels according to severity of the crimes committed.
The Law on Rehabilitations of Addicts, 2545 B.E., brought in the principle of drug user as patient, not criminal.  This law considers drug addicts as patients who need curative or rehabilitative care.  The law delays the use of court of justice, in order to replace criminal justice system for a better diversion.  Curative and rehabilitative processes are effective in separating addicts for a complete patient care, both by voluntarily and enforcement.  The complete patient care system provides follow-up system, support system, and encouragement for those who have gone through the curative and rehabilitative process, in order for them to be able to return to family, community and living normally.
There are preventive measures for drug traders, who pretend to be addicts, before or after being arrested, to use this law in order to avoid criminal justice system.  These drug traders do not have the rights for rehabilitative process according to this law.  The sub-committee on rehabilitative process for addicts should inform authority or prosecutor, to pursue criminal justice process.
By reviewing literature during 2547-2548 B.E., researches which study legal measures related to drug addicts, indicated that the Law on Rehabilitations of Addicts, 2545 B.E., emphasizes forced rehabilitative process for addicts.  Therefore, having institutions for rehabilitative process for addicts is of vital importance, but some areas do not have such institutions, or limited space for addicts in such institutions.  Moreover, there are some limitations for keeping up-to-date statistics of those who have gone through the process of proven for curative and rehabilitative process.


location: , 'Thailand year: 2008 source: HSRI

title: Foodborne salmonella poisoning outbreak in Kambok subdistrict, Khamcha-ee district, Mukdahan province

abstract: An investigation of a food poisoning outbreak in Moo 2 Village of Kambok subdistrict,
Khamcha-ee district, Mukdahan Province was carried out to confirm the diagnosis,
verify the outbreak and to determine the etiology in order to control the outbreak. The
descriptive study was conducted on seven outpatients and two hospitalized patients who
were diagnosed at Khamcha-ee Hospital on 26 February 2008. All nine patients involved
lived in two separated houses; their ages varied from 13 to 83 years, with the median age
being 38 years. The clinical features were abdominal pain (100%), headache (88.88%),
fever (88.88%), and diarrhea (77.78%). The incubation periods varied from 6 to 29 hours. The food suspected of causing the particular illness was koi (raw red-ants eggs), a kind of
native salad. Salmonella serogroup B was identified from the raw ant eggs in question,
and rectal swab cultures of all patients. This outbreak was most likely caused by Salmonella
serogroup B, based on the clinical features, incubation periods and the laboratory
findings. Health education was given to food handlers in Moo 2 village. The investigation
disclosed possible evidence of risk factors of poor sanitation and poor hygiene in the
kitchens and toilets. Active surveillance was maintained in the affected area for one week
without the emergence of new cases.


location: , 'Thailand year: 2007 source: HSRI

title: Efficacy of an Asthma Clinic Operation in Danchang Hospital

abstract: Bronchial asthma is a chronic debilitating illness highly prevalent in Thailand.
Danchang Hospital established an asthma clinic on July 10, 2006; it is operated by a patient care team who provide treatment according to international standard guidelines.
This research study was aimed at evaluating the efficacy of the Danchang Hospital asthma
clinic’s efficacy by comparing the results of caring before and after treatment on 85 selected clinic attendees during the period from July 10 to December 31, 2006.
The results showed that the rate of patients receiving medication by nebulizer in the
emergency room was reduced from 59 percent to 11.7 percent and hospitalization was
reduced from 27.3 percent to 2.35 percent; the severity of disease was reduced by 68.2
percent; the rate of correct use of inhalers was 38 percent; decreased use of short-acting
beta 2-agonists was reduced by 82 per cent, and the rate of patients who were able to
perfrom their daily routine activities was 87.3 per cent, which means that their quality of
life was better, and the necessity of emergency room visits and hospitalization was much
reduced.


location: , 'Thailand year: 2023 source: HSRI

title: Definition and Conceptual Framework of Commercial Determinants of Non-Communicable Diseases: A Scoping Review

abstract: This study aimed to define the scope and to develop a conceptual framework for monitoring commercial determinant of non-communicable diseases (CDoNCDs). A qualitative study was performed by applying a scoping review, interviews, and focus group discussions among Thai experts and relevant stakeholders on NCDs prevention policy. From the literature review, the definition of CDoNCDs referred to “strategies and practices used by corporations or industries related to NCDs to promote their products and choices, increase sales and profits, and generate business stability which had both direct and indirect effects on population’s health.” This CDoNCDs framework involved three components. (1) the production involving raw materials or ingredients and production process that might have effects on health (comprised 2 strategies and 6 practices). (2) the marketing and distribution including market expansion and marketing practices that aimed to promote sales and consumption among consumers (4 strategies and 10 practices). And (3) the policy interference both directly and indirectly intercepting government policy interventions (5 strategies and 16 practices). This study provided policy recommendations that relevant government agencies, civil society, and academic should consider establishing system and network to monitor the CDoNCDs, and regularly communicating to raise awareness on CDoNCDs in the society and among policy makers at all levels, especially the policy interference by industry.


location: , 'Thailand year: 2003 source: HSRI

title: Mahidol historical almanac for democracy : Phase I

abstract: The victory of China at the beginning of the decade 1947 has made the Asian Region and the group of Indo-China countries become one of the important strategic points of the world in the cold war age.  Thailand has been determined by the Western power nations to be the significant outpost to blockade and to conquer the Socialism which was expanding.  The United States of America gave supports to the military dictatorship Government which responds to the interests and the policy of the United States.  They governed the countries in this Region, including Thailand.	The Government of Field Marshal Sarid  Thanarat has seized power by the coup d’etat.  Responding to such policy, the Government dominated and suppressed the students’ and people’s movements.  The mass medias were also dominated so sternly and violently that all the movements could effectively be surrendered.  In the universities, the students’ organizations and activities were strictly controlled and inspected.  Only the activities based on sports, entertainment and the activities for praise of the national, religious and monarchic institutions could receive the permission.	Besides the impact from the Government’s political check policy, there were also  the internal factors caused by all faculties in the University of Medicine different campus.  The confusing system in recruiting the medical students  and the heavy curricula were also the complex conditions prevented the students from  attending the political activities and from creating the joint awareness of the same institute.  Only the activities based on sports, entertainment and music were arranged and caused the luxurious habits among the students.	Such conditions continued until the time of the Government of Field Marshal Thanom  Kittikachorn.  At that time there was an important international event.   The United States had completely launched the war in Vietnam in 1965.  Thousands upon thousands of soldiers were sent to Vietnam, and Thailand was also pulled to join the fight without avoidance.  This causes the problems on the aspects of national, social and cultural sovereignty  in consequence.  The large number of soldiers which were sent by the United States to such battle field causes the serious impact of the shortage of doctors in the United States.   The doctors from all the developing countries over the world were attracted by the United States in order to solve such    problem.  This measure remarkably sent the serious and consecutive impact on the shortage of medical doctors in Thailand.  Therefore, the measure that forces the graduates have to work in return was applied and the school of military doctor was to be started.	 Since the military governed the country in 1966 and many events caused discontentments in the society, a group of instructors and students arranged the first seminar at the Christian Student Center.  The Center was utilized as a place for  exchanging ideas until many activity groups were formed, such as the group that published the Social Science Review for students and that for the graduates, the Club for Discussion Review and the Student Group for Rural Area Reform.  This is the starting point of the student groups in different universities, including the University of Medicine, who work independently with the systematic concepts different from the Government.	The conflicts and the compromises within the military power groups allowed Field Marshal Thanom  Kittikachorn to relieve the political atmosphere, by proclaiming the constitution of the longest - day draft and providing the election in 1969.  Such factors engendered all of the students’ and the people’s movements, including the students of the University of Medicine.  They dare to use the right of expression, to assemble openly in public, as well as to establish the new students’ organizations to bargain with the official authorities.  The first protest was made by the medical students of the Faculty of Medical Technology, Siriraj Hospital.  The measure of working in return after graduation was the reason of the students to establish the Medical Student Center of Thailand (MSCT).  This Center has afterwards taken so much an important professional role that the praise was given to in the 3rd Workshop on Thai Medical Sciences Study.  The relation and co-operation have been promoted among the groups of instructors and doctors from different institutions in finding the recommendations of the resolution for national public health.	At the same time, the new Faculty of  Medical Sciences was established (the present Faculty of Sciences) and Mahidol University was founded to replace the University of Medicine.  The enrollment of its students was absolutely split from Chulalongkorn University.  The 1st and 2nd year students of all faculties came to learn together here, including the 3rd and 4th year Pre-Clinic students of the Faculty of  Medicine, Ramathibodi Hospital.  This concept could much contribute to promote the institutionism.  The Mahidol University Students' Club and other new clubs were established other than the Sports Club.  They became the new activity centers keeping abreast with the former activities of the Faculty of  Medicine, Siriraj Hospital.  Such characteristic could also form the various groups of activists spreading into different faculties, and four years later, they became the important force in the party-list election of which the Chairman of the Mahidol University Students' Club, came from  the Faculty of  Medicine, Ramathibodi Hospital.  from then.	The independent groups rooted from each individual who went out to seek  for  outside activities could now start to broaden the concepts to the younger generation of the same school and the same professional line.  The library group was established in the Faculty of Sciences, and two periodicals were issued - Medical Student Relations from the Medical Students Center of Thailand (MSCT) and Medical Journal Relations or Mahidol Bulletin from Mahidol University.  These platforms were used to pass on their systematic social and political concepts to the fellow students.  At the same time the formal activities and different clubs, supported by most  instructors according to the Government's policy which would like to see fruitfully spending their free time,  the students with different ideas were encouraged to join the activities therein,i.e. Speech and Debate Club, Buddhism study and Tradition  Club, Girl Guide Club, Ecology Club, Rotaract Club  and so on.At that period of time, the universal  tide of movement, which appealed to the civil liberty against the Vietnam War, also had an influence over the Thai students.  Such tide has also happened in Mahidol University.  The seniority system was opposed in 1970.   The demonstration was staged for the equal working in return of the male and female medical students.  There has been the opposition against the privilege system for the enrollment of the instructors’ and the benefactors’ child.  The movement has been in efforts against the acceptance of the pre-military students to study medicine, but  such effort was not much success.  Another protest occurred in 1973 and the result was effective in 1974.  All of the events entirely happened in the Faculty of Sciences, while “Mahidol Bulletin” was used as the important platform.  	As Field Marshal Thanom  Kittikachorn demanded for own interest in exchange with the support of the members of the National Assembly of the government party, he then made another revolution in order to prolong his dictatorship.  However, democratic movement grew unceasingly.  The Student Center of Thailand (SCT), of which Mr. Thirayuth  Boonmee was the Secretary-General, started its political role through these following means, i.e. by grasping economic issue, expressing its vision on solving the problem of trade balance with Japan, and managing the campaign against the exploitation made by foreign nations, in the forms of activities which well accepted by the students and the people.  These performances could give credit to the students’ movement which would be the leading movement of the society.  Some members of  Mahidol University Student Club who were intimate with the Student Center of Thailand (SCT) led a large number of the Mahidol University students to join in the movement.In efforts to control and centralize the State power, the Government, therefore, proclaimed the Revolution Announcement No.299 in order to put the justice power under the administration power.  The mistaken principle of power in democracy caused the widespread object by the people and the medical students.  The people’s discontentment with the military dictatorship continuously accumulated, especially with the extension of a term of office for two field marshals.  In addition, the case of hunting in Tung Yai had most undisguishedly violated the law.  The latter case had  pureheartedly been disclosed to the public by the groups of environment preservation which belonged to the ecology clubs of all universities, including Mahidol University.  They took the important roles in fact-finding in order to protect the national interests.  However, the Government’s behaviors were on the contrary.  So the students of the New Generation Club, Ramkamhaeng University, wrote the books to satirize the Government.  The result was that nine of them were dismissed from the University.  This situation was something like pouring oil on a fire.  The network of independent groups which were interconnected among the universities, as well as the Students’ Center of Thailand (SCT), was so much influential as it could persuade thousands upon thousands of the students and the people to make the assembly and protest that the Government was forced to retreat.  The appeal was also made to the Government to give the constitution with joint civil contract.	Later on, the movement was made by the groups of the students and the people to appeal for the constitution according to the civil contract, and in turn they were arrested.  Such arrest caused the movement of the students throughout the country, in order to  appeal to relieve the groups of appellants for democracy.  The movement of Mahidol University students grew unceasingly in strength, and almost every faculty came to join hands, especially the Faculty of Medicine, Siriraj Hospital, which participated in this  movement the first topmost in history.  The group of instructors as professionals gave support behind the scene.  And as they admired the equity, they assisted to take care of the wounded both at Thammasat University and at Siriraj Hospital.  The instructors and their students harmoniously worked to protect and help all the wounded and the escapees.	Although the movement on 14th October 1973 could change the Government  and the people won, some parts of the history have not yet revealed, especially the real causes of death and violence.  Some informations indicated various factors, one of which pointed out as an accident, while another collection mentioned that it happened  from the intention of the persons who could benefit from the situation.  However, the conclusion from various sections of Mahidol University students who participated in this event was the lack of communication between the leading center of the Students Center of Thailand (SCT) and the mass controller.  They had no modern tools for communication and the electric generator was forgotten to move along with the movement in order to assist in live broadcast.  While the Government and the official authorities concerned had the modern communication tools, but they let the event occur.


location: , 'Thailand year: 2015 source: HSRI

title: The Development of Appropriate Interior Environment of Hospital Ward for Senior Visibility and Recovery

abstract: At present, there is a dramatic increase of elderly in Thailand. There is an awareness and there are a number of studies of the significance of the effect of environment on elderly, especially in United State and Europe. However, there is a little knowledge about the design of health care environment for Thai elderly. Moreover, since there is a difference of physical characteristics and psychology between people from United State and Europe, the design recommendation from the studies in these areas seem to not apply to Thai elderly. This is especially there is a little knowledge about the design of environment for Thai elderly in terms of lighting, colour, material and view-out and their effects on visibility and health recovery.
	The main objective of this study is to develop interior environment suitable for the visibility and recovery of Thai elderly. There were two types of hospital to be surveyed,, which are 1) provincial hospital and 2) community hospital. There were two main parts in the study. The first part deals with the effect of interior environment of ward on visibility of Thai elderly. The second part related to the effect of interior environment of ward on recovery of Thai elderly. The results showed the significant effects of factors relating t interior environment of ward. The study also proposed an approach for design guideline of ward suitable for visibility and recovery for Thai elderly in provincial hospital and community hospital.


location: , 'Thailand year: 2010 source: HSRI

title: A Development of the Out-Patient Service Quality Satisfaction Indicators of Community Hospital

abstract: The purpose of this research was to develop the Out-Patient Service Quality
Satisfaction Indicators of Community Hospital . Applying research and development was
approached. Analytical statistics were qualtitative research methodology by Multi-Attribute
Consensus Reaching and quantitative research methodology for reliability by Cronbach’s
Alpha-coefficient and Model Validity finding by Confirmatory Factor Analysis:CFA with
LISREL 8.30. The samples were 759 cases from the Out-Patient of 8 community hospitals
in Phitsanulok Province. Eestablishing the standard for the evaluation by normative and
evaluating the handbook.
The finding of this research were as follow ; the Out-Patient Service Quality
Satisfaction Indicators of Community Hospital composed of the 5 domains TICTI 34
indicators ; 1) the Tangibles : T domain composed of 11 indicators 2) Interaction : I domain
composed of 6 indicators 3) the Convenience : C domain composed of 5 indicators 4)
the Trust : T domain composed of 8 indicators ; and 5) the Information : I domain composed
of 4 indicators. Reliability of the Out-Patient Service Quality Satisfaction Indicators of
Community Hospital was 0.77. Model of the Out-Patient Service Quality Satisfaction
Indicators of Community Hospital fit very well with the empirical data (2 =431.55 , df =
522 , p = 0.001 , GFI =0.94 and AGFI = 0.91 and root mean squared residual : RMR =
0.02). The standard for the evaluation employed in three level. The norm statistics were as <
102 scores at poor, 102 to 153 scores at fair and > 153 scores at very good. Evaluating the
appropriate of the Out-Patient Service Quality Satisfaction Indicators of Community Hospital
handbook was at good level .


location: , 'Thailand year: 1998 source: HSRI

title: Status and role of non-governmental organization on health promotion in Thailand

abstract: The research project on status and role of non-governmental organizations on health promotion in Thailand conducted by professor Yupa Wongchai and Associates, aims to explore the current finction of NGOs in thailand, and submit recommendation from research finding which analyzed from 513 questionnaires responded by organization authorities, 5 expert-interviews and 15 case studies of selective organization.	It is found that most of NGOs in this study have set up their own agencies for delivering services to their members amd target groups which mainly are the aging. The main activities are giving technical and managerial support and charity work. It is very clear that most of those activities mainly focuses on individual basis not community work. Most of agencies do not obtain support from the outside. Most Of those which gain outside support mainly get from the government side. If considering the amount of budget, the international agencies gave bigger amount the public agencies. It also fond that most of NGO's authorities have sufficent knowledge and clear-cut understanding principle of Ottawa Charter's Health Promotion. They understand that makingbetter environment will make target group's better health. The agencies should advise the target group in order to taking care the target groups health, Health promotion will support self health care, health promotion should be cooperation between government al and non-governmental parts but theyneed more knowledge of commonity resource mobilization. Most of agencies have potentail to involve in health promotion. Most of them have objectice to strengthening community, they can conduct actives following the agencies objectives and rhen follow up their work. They have qualify personnel's which understand their function and roles. However, their weaker points are they still facing uncontrollable health factors. Also, they need more management and administative skills, especially building and working through network. Most of thier activities mainly focus on getting to gather to do community, encouraging people to take good care of their own health. The rare activities are natural and environmental presservation, work plan design, campaigning for changing for target group's health behavioral change.	The NGOs programs in this study focus on individual basis more than community focus. In individual basis, the Y focus on enable people to taking caer their own health., offer health education program. They also conduct activities such as community leaning procees, The weakest point are they do not concentrate on environmemt al reservetion and technical part such as evaluative research, planing and data collecting etc. For their future trend, they aim to give health education health caer, health counseling service, community visit which still focus only on individual basis. The also need to be strainghten their organizational potentiality though resources and technical support. They need to cooperate with health promotion partnership through network and need to gian public recognition.


location: , 'Thailand year: 2015 source: HSRI

title: Health Problems and Health Care Behaviors Among Registered Nurses in Thailand

abstract: This study was aimed to compare health problems and health care behaviors between clinical nurses
and non-clinical nurses. This study used secondary data from Health and Working Life of Thai Nurses
Project that collected data from registered nurses who hold nursing licenses granted by the Thai Nursing
and Midwifery Council during 2002-2009. Data were analyzed using descriptive analysis with frequency,
percent, mean and standard deviation and using Chi-Square test for comparison.
Results: Total of 18,763 registered nurses includes 15,773 of clinical nurses (84.1%) and 2,992 of nonclinical
nurses (15.9%). Musculoskeletal diseases were the most common health problem in both clinical
and non-clinical nurses, 47.8% of clinical nurses and 53.7% of non-clinical nurses, followed by dyslipidemia,
hypertension and viral hepatitis. Clinical nurses experienced insomnia and job strain higher than nonclinical
nurses. In terms of health care behaviors, findings revealed that both clinical and non-clinical
nurses had awareness to get regular checkup. The non-clinical nurses preferred to visit medical specialist
more often than the clinical nurses, but used prescription drugs less often than clinical nurses.


location: , 'Thailand year: 2014 source: HSRI

title: Responsiveness to glucosamine negative list policy of civil servant medical benefit scheme

abstract: The objective of this study was to assess the hospital response to policy implementation of the Glucosamine
(GS) negative list. This study comprised both quantitative and qualitative approaches. A survey
form of quantity and expenditure of GS 6 months before and after policy implementation was sent out to
provincial hospitals, general hospitals and teaching hospitals (107 hospitals). A qualitative approach included
focus group discussion with head pharmacists of 11 teaching hospitals, in-depth interview with
pharmacists who deal with this policy, and an evaluation of patient’s written complaints sent to Comptroller
General’s Department (CGP). Completed data from 58 hospitals (54%) were analyzed. The total
drug expenditure 6 months before policy implementation was 185 million Baht, and total drug expenditure 6 months after policy implementation was 27 million Baht. Total drug expenditure saving was 158
million Baht, or 85% of total drug expenditure before policy implementation. It appeared that this policy
reduced the expenditure of original drug than generic/local drug. Results from focus group discussion
and in-depth interviews showed that hospitals which succeeded in excluding GS from their list because of
the decision of the pharmacy and therapeutic committee and hospital boards or authorized physicians.
On the other hand, hospitals that still retained GS in their list because they did not understand the
evidence which indicated that this drug was not cost-effective. An evaluation of patients’ complaints
revealed their perceptions as follows: GS are not reimbursable even this drug was indicated for joint
disorders, the policy seems to force patients to responsible for their drug expenditure and policy seems to
be cut off the subsidy for CSMBS beneficiaries. The results of this study showed the impact of this policy
on both health care providers and patients, and unveiled the problems and burden associated with the
policy.


location: , 'Thailand year: 2022 source: HSRI

title: Work-Related Factors and Mental Health Outcomes among Healthcare Workers during COVID-19 Pandemic

abstract: This cross-sectional research focused on studying the prevalence of mental health outcomes and preventive behaviors, and to examine work-related factors associated with mental health outcomes during the COVID-19 pandemic amongst the healthcare workers employed by the Ministry of Public Health Thailand. The data were collected by the online questionnaire from 12 health regions, 417 healthcare workers administered during the first wave (May 1-15, 2020). The Depression Anxiety and Stress Scale – 21 Items (DASS-21) Thai version was used to assess mental health outcomes. The Chi-square test was used to examine association between depression, anxiety and stress-related factors. The results found that 2.4%, 7.2%, and 3.9% of all respondents demonstrated severe to extremely severe depression, anxiety, and stress; while practices of preventive behaviors were as high as 82.0% of wearing masks and 76% of practicing hand-hygiene. The associated factors of mental health outcomes were: (i) working with COVID-19 inpatients; (ii) organizational management to ensure low infection risk; (iii) inadequate of personal protective equipment (PPE); (iv) work with the fear of contracting infection; (v) the non-adherence behavior of patients towards safety protocols. The study recommends that effective management practices towards reducing infection was predominant associating and modifiable factor of mental health outcome. In particular, this should be applied to the healthcare workers coming in direct contact with patients in the “new-emerging phase” or a “repeated wave” of COVID-19 outbreaks.


location: , 'Thailand year: 2021 source: HSRI

title: Health Service design in Primary care under situation Covid-19 disease: Study case of district Yarang, Pattani Province

abstract: The project, Health Service design in Primary care under situation Covid - 19 diseases Study case of district Yarang, Pattani Province., aimed to stimulate health personnel to recognize the importance of primary health care system and to design their own service delivery responding to unique context complexity at local level in the southern part of Thailand. The project consists of 2 processes as followed. 1) Self-review of Pattani’s health personnel in primary care system to respond to recommended procedures regarding the COVID - 19 epidemic control in communities. The procedures were based on the WHO primary care framework, a framework with community network partners and the analysis of the complexity of the epidemic situation. There has been a response to the government policies and agreements at the area level in order to achieve 3 goals, namely 1) Safety of personnel and provider, 2) Strong community for disease management, and 3) Effective disease control. As a result, target personnel could understand the complexity of the problems and be motivated to develop health service to respond problems that arise. At the same time, the researcher realized that the policy imperative to the main responsible agencies at the national level. There should be preparation and readiness of the whole structure, specific budgets and personnel to cope with future outbreaks and response to chronic disease problems that may require a different management approach. 2) Target personnel development for new health service design by using “Design Thinking” process. The result of the development was a new working design and service system responding to complex health problems at the local level in 4 issues: 1) Anemia problem in pregnant women, 2) Expanding the services access to vulnerable groups, 3) The development of rehabilitation service for stroke patients (Intermediate care), and 4) The development of health service systems for uncontrolled hypertension and diabetes patients. Regarding the new delivery processes design, it was found that the health personnel placed greater emphasis on the primary health care system and the patients were more confident about receiving the service, as evidenced by the co-rehabilitation of 21 stroke patients revealed that 18 patients (85.71%) had increased ADL levels and improved clinical outcomes in a sample of 22 pregnant women with anemia were able to manage the problem in 14 cases (66.66%) without anemia. In addition, all four services were prepared in order to response to the potential recurrent of COVID-19 epidemic in Pattani.


location: , 'Thailand year: 2009 source: HSRI

title: Study of Interventions and Strategies to Improve the Use of Antimicrobials in Hospitals in Thailand

abstract: An inappropriate use of antimicrobial is not only a major cause of antimicrobial resistance but also a huge wasted expenditure in many countries including Thailand especially in teaching hospital. Many appropriate antimicrobial prescribing interventions can improve rational antimicrobial use. Therefore, the objective of this study was to select the most appropriate rational antimicrobial prescribing interventions for Thai health care system. The focus group technique was used to select the rational antimicrobial prescribing interventions. The members of focus group included the experts who have had experienced in rational antimicrobial prescribing interventions and stakeholders who would have an impact if the selected interventions were implemented.
Based on all international and national literatures related to interventions, many rational antimicrobial prescribing interventions were available. Due to a diversity of setting and methodology used in each study, the efficacy of interventions was not concluded in a harmonious direction and a comparison between interventions were needed to compare by indirect method. Multifaceted interventions were more effective than single intervention. Moreover, the effective interventions such as education, antimicrobial order form, infectious disease specialist approval and clinical pharmacist acting as a reviewer and decision supporter were proposed to a focus group as a preliminary data. Then discussion and judgment of the intervention selection was made among members.
The consensus of focus group suggested that the above interventions were not appropriate for Thai health care system because there were many limitations.  For example, there were not enough infectious disease specialists and clinical pharmacists, the role of clinical pharmacists were not so accepted as compared to developed countries and physicians still had the highest power in prescribing. However, the intervention called drug use evaluation (DUE), a process to monitor and promote the rational use of drugs might be used as a tool for solving this problem. In addition, pharmacists who have had experienced with antimicrobial DUE in hospitals suggested that the explicit policy related to DUE from the central was very necessary and should be restricted. It may be a feasible measure to promote rational antimicrobial use in Thai healthcare system in the future.


location: , 'Thailand year: 2005 source: HSRI

title: Parenteral-oral drug switching in hospitalized patients

abstract: A quasi experiment was conducted at Lampang Hospital during August 2003 to January 2005 to compare the effectiveness of the pharmacist interventions between using case-based approach and group education in promoting parenteral-oral (IV-PO) drug switching in hospitalized patients. In the mean time, the study measures the satisfaction of health care team and factors affecting physician in switching from IV drug to PO drug. Medical charts of inpatients over one year of age were reviewed prospectively by a clinical pharmacist for two consecutive weeks in three phases for each type of intervention; phase I as baseline period, phase II as intervention period, and phase III as four months post intervention. Candidates for the switching were identified according to the developed guideline. Excess days, durations of IV drug use, length of stay, and potential waste were determined. The generalized linear model was used to adjust age, sex, Charlson index, history of intensive care unit admission, and departments in the multivariate analysis. A descriptive study also was done at Khon Kaen Hospital to determine and compare the incidence of switching candidates with the same switching guideline.The results revealed that the pharmacist intervention using the case-based approach was more effective than using group education, which the case-based approach could reduce (1) the incidences of switching candidates from 36.6% to 19.6%, (2) excess days by 70.2% (p<0.001), (3) durations of IV used by 11.8% (p<0.05) and (4) potential wastes by 60.9% (p<0.001) whereas the group education could reduce only the incidences of switching candidates from 31.3% to 25.5%. No statistically significant change of the studied outcomes including potential waste was found. The case-based approach could save an average of 200,000 Baht a month. However, the majority of physicians and pharmacists preferred the intervention using group education more than case-based approach. During phase II of the case-based approach intervention, the factors affecting physicians in switching from the IV drug to the PO drug were the drug categories A or B (p<0.05) and type of intervention via verbal or written (p<0.01). With the same switching guideline, the incidence of switching candidates at the Lampang Hospital and the Khon Kaen Hospital were comparable at 36.6% and 36.3%, respectively. Thus the case-based approach was the effective strategy in promoting IV-PO switching and it was also a cost-saving program. About one-third of IV drugs in the tertiary care hospitals could switch to oral drugs, which could save drug expenditures. This case-based approach might be applied in order to reduce the incidences of switching candidates and lead to reduce health care costs.


location: , 'Thailand year: 2021 source: HSRI

title: Health Insurance for People with Citizenship Problems, Including Non-Thai People in Thailand

abstract: The aims of this study were: First, to review the experience of health insurance management for non-Thai including migrant workers, refugees, stateless and people with citizenship problems. Second, to explore the organization of health insurance and benefit sets for non-Thai living in Thailand. Giving highlights on problems, obstacles, and the direction of future development in both general cases and C188 Case. Third, a synthesis of alternative forms and reforming the public and health insurance systems to cover to those people. Qualitative research has been applied along with documentary survey, in-depth interviews with semi-structured, and focus group to collect and analysis the data. The results indicated that the major problems for health insurance management for non-Thai derived from structural problem, politics and attitude. The structural problem caused by the identifying status inequitably of non-Thai. And the lack of national regulations to unite the status of non-Thai and health insurance legally, leading to the work fragmentation with no “authority” from central coordination to supervise. Besides, the status of non-Thai has been considering at the dimensions of nation state rather than an “individual”. Consequently, there is imbalance between security issues and human rights. This research has suggested 4 alternative policies to create sustainable health coverage for non-Thai citizen as follows: 1) Discontinuing health insurance system provided by Ministry of Public Health. All non-Thai must register to the social security system. 2) Applying both health insurance card and social security system as the parallel system. 3) Proposing inclusively health care law for non-Thai in the form of new public funding. 4) Amending or reinterpreting National Health Security Act B.E.2545 article 5 in order to cover Thai and non-Thai.


location: , 'Thailand year: 2016 source: HSRI

title: Addressing the Research Gap for Improving the Thai Health Systems: Choosing Health Research Topics for the Future

abstract: The desirable goals and directions of the Thai health system are to promote health prevention and
promotion for healthy Thai people. To achieve those goals, a number of innovations and new knowledge,
mainly derived from quality research, need to be generated in order to fill the current gap of knowledge.
Thus, a clear framework of potential research should be developed. This can help research funding agen-cies work transparently and effectively in granting research projects. This study presents a framework of
potential research that should be supported in order to achieve the desirable goals of healthy Thais. With
regard to each aspect of the goals, document and literature reviews were accumulated to collect background
information on the current situation and gap in knowledge. Interviews and meetings with seven
groups of experts were arranged to discuss and deliberate the potential research issues that should be
supported in the future. The results were then analyzed and categorized into three categories: (1) health
research issues by age groups - children, adolescent, adults, and elderly; (2) research issues in the health
systems - health service delivery, health workforce, health information, health technologies, health financing,
and health governance; and (3) research issues for promoting heath and health literacy. These issues
and sub-issues are also related to the policies of many granting agencies in Thailand. It is important to
raise the concerns of relevant agencies to determine the gap of knowledge that should be funded, then,
there would be enough research generated to move toward the desirable goals.


location: , 'Thailand year: 2022 source: HSRI

title: Development of an innovation related to stroke

abstract: Stroke has been regarded as an important health problem that produces a great impact on an annual healthcare expenditure, quality of life of the population, and the productivity of the country. However, the therapeutic efficacy is still limited because abundant of the stroke survivors live with the disability. Therefore, the efforts to reduce and to prevent the disability in the stroke survivors is essential and required. Our primary data in an animal model of stroke reveal that an anthocyanin-rich mulberry fruit can decrease brain infarcted volume, and brain dysfunction so we hypothesize that a consumption of an anthocyanin-rich mulberry fruit as an adjuvant therapy with the current therapy should decrease disability and dependency in the stroke survivors. The aim of this project is to proof this concept and to determine the consumption safety in the stroke volunteers. In the development of mulberry capsules for the application in volunteer testing, the product developed had a high humidity of 11.32%. It is slightly above the norm for most herbal products that should not exceed 10% except for some herbs because it is easy to have a microorganism accumulation in the high humidity condition. However, no contaminants were found, and the qualification of the developed mulberry product achieves the requirements according to the notification regarding to herbal pills of the Ministry of Public Health. In the developed mulberry capsule, anthocyanins especially cyaniding-3-glucoside (755.240±6.78 μg/g sample), were found in the highest amounts, followed by cyaniding-3-rutinoside (285.440±1.26 μg/g sample). In addition, chlorogenic acid (236.220±0.34 μg/g sample), gallic acid (108.500±0.24 μg/g sample), and quercetin (15.700 ±0.02 μg/g sample) also present, but in much smaller amounts. The developed mulberry capsule reveals the biological activities associated with stroke, especially the antioxidant, anti- inflammation, and neurotransmitters enhancement activities. When evaluating the storage time, the reduction of the phytochemical content, especially anthocyanin, and bioactivity when stored at 4 °C less were less than those at room temperature. Over a period of 3 months, the reduction of important phytochemicals and bioactivities remains in the range of about 20-25%. However, the longer they are stored, the lower their levels and bioactivities. Therefore, the process of extending product life must be developed in the case of commercial development. In the study regarding to the effect of mulberry capsule consumption in cerebrovascular disease subjects, the project is accredited by the Human Research Council, Khon Kaen University (HE631600), and it is registered in the Thai Clinical Trials Registry (TCTR) under the reference number TCTR20201222006. The research model is a three armed, randomized, double-blind, placebo-controlled experimental study. The volunteers are patients at the age between 18-85 years old with transient and ischemic stroke patients in the last 5-10 days that had weakness in one side of the body. All subjects are divided into 3 separated groups as following; the placebo group, and the groups that received mulberry fruit capsules at the doses of 1,000 mg, and 2,000 mg. Prior to the consumption of mulberry fruit capsule, and at 2 and 6 weeks of consumption, all volunteers are subjected to the assessments of the flowing parameters; body mass index, electrocardiography, blood pressure, respiration, clinical signs, and stroke severity with NIHSS score assessment. The assessments of hematological changes, and clinical chemistry are also performed to monitor the consumption safety of mulberry fruit capsule. The assessment of serum biomarkers consisting of MMP-9, S100β, vWF, and VCAM1 are performed prior to the consumption, and at a period of 1 and 6 weeks of consumption whereas the assessment of lactic acid producing bacteria which is regarded as probiotic bacteria particularly Lactobacillus spp and Bifidobacterium spp. In feces is performed prior to the consumption and at a 6 week-consumption period. The current results demonstrated that at 2 and 6 weeks of consumption, the Modified Rankin Scale (mRS) after stroke of volunteer in both placebo and mulberry fruit capsule show the significant reduction in mRS. However, the rates of change in mRS of the mulberry consumption groups both at 1,000 and 2,000 mg per day are significantly higher than that of placebo group. It has been revealed that the volunteers in a mulberry fruit consumption at a dose of 1,000 mg per day show a significant improvement of mRS only at 1 week after consumption whereas the volunteers in a mulberry fruit consumption at a dose of 2,000 mg per day show a significant improvement of the mentioned parameters after 1 week of consumption and this change is observed throughout the study period. In addition, the volunteers in the mulberry fruit treated group at a dose of 2,000 mg per day show the significant reduction of VCAM1 after 1 week of consumption, and the reduction of both VCAM1 and MMP9 are observed at 6 weeks of consumption. The current results suggest that mulberry fruit capsule at a dose of 2000 mg per day shows the good potential to reduce mRS in stroke and the underlying mechanism is partly associated with the reduction of VCAM1 and MMP9.


location: , 'Thailand year: 2010 source: HSRI

title: Art Adaptations for Children with Disabilities

abstract: This is a translated and edited article from chapter III (pp. 55-83) of the book published by Charles C.
Thomas Publisher, Springfield, Illinois, in 1994 entitled Art-centered Education and Therapy for Children with
Disabilities by Frances E. Anderson. Art adaptations for children with disabilities are focused on providing
children with an easy and comfortable way to obtain art experiences and produce creative artworks of
their own. The most important and challenging work for the working team (which comprised teacher,
physical therapist, occupational therapist, medical staff, art therapist, and the disabled child) involves the
method for solving various types of adaptation problems. In general, art adaptations are grouped into
four categories: in the physical space, in the art media and tools, in instructional sequence, and in technological
adaptations. Details on how these art adaptation categories are implemented in children with
mental retardation, learning disabilities, behavioral/emotional disturbances, physical disabilities, hearing
and visual impairments are elaborated in the text.


location: , 'Thailand year: 2019 source: HSRI

title: Health Technology Assessment and the Development of Benefit Packages under the Universal Coverage Scheme

abstract: The Universal Coverage Scheme (UCS) has operated the Universal Health Coverage Benefits Package Development Project since 2009. The project aims to develop the health benefit package to be covered under UCS with transparent and participatory process involving stakeholders based on evidence. The researchers reviewed the document related to the development of benefit package in 2009-2015 and participated in the meetings of development of benefit package, starting from proposal development, prioritization and selection of health technologies, assessment of health technologies, and results presentation in stakeholder meetings. During 2009-2015, there were 133 health technologies or health topics nominated by the stakeholders. Among the topics nominated, health care package, drug and vaccine, medical devices, screening and treatment topics were nominated at 31%, 25%, 23%, and 21% respectively. Out of the 133 topics, 65 were selected for the health technology assessment, 45 were completed, and 26 were presented to the Sub Committee for the Development of Benefits Package and Service Delivery (SCBP). The SCBP made the decision to include 9 topics in the benefit package, 2 more topics were interpreted as already included in the package, 10 topics were requested for further evidence, and 5 topics excluded. Among the 9 topics selected by the SCBP, the topics that were finally implemented in the UCS were the HLA-B*15:02 screening for carbamazepine-induced severe adverse drug reactions, and the refractive error screening by school teachers in pre-primary and primary schools in Thailand.


location: , 'Thailand year: 2003 source: HSRI

title: The situation of death and dying paradigm shift

abstract: The project is aimed to review health paradigm in which death and death management is considered.  The study is supposed to encourage society and relevant organization to review their concepts and pattern of death management, the current mainstream. Research should be supported in various dimensions, helping society to perform and confront with death effectively.  Invention, recommendation of various death management and congruent with Thai society, regarding of family, community context of patients and their relatives, are importantly included. ResultsThe study in patients and relatives, totally 12, data are collected form 10 relatives (after the death of patient) and 2 patients.  They mostly live in metropolitan area (Bangkok), and environ areas,  Only 30 percents live in outer area, supporting factors, and hindered factors, as follow:There is no integrity of thinking system.  There is a combined thinking system within society; there is still different way of thinking.  However, death concept is not always stable, it depends on the confronted situations.When facing with illness condition, there is a way of thinking like “when being ill, hospital treatment is needed”.  It is irrespective of social class, or economic status, They are all influenced by the same system of thinking.  The opportunity of accessible treatment may vary.  Therefore, tendency of hospital death increases.  In other words, the treatment gap of despair patient will be widened.For medical treatment procedures, it was found that there is communication gap between medical personnel and patients and their relatives, due to different way of thinking.  As a result, patients and relatives are lacks of treatment knowledge since their knowledge body is not the same as medical personnel, which brings about the limitation of accessible knowledge necessary to decision making for doctors and medical personnel.Opportunity provision for patients and relatives to participate in decision-making procedures during medical treatment is considered satisfyingly among medical personnel, patients, and their relatives.  A chance of knowledge accessibility is revealed, resulting in contracted gap, and furthers development in the system.Religious belief and ritual, family or community, and economic status are significantly considered as major factors lead to decision making of desirable death undesirable management.Home death could be both considered as good death and bad death; it depends on components of family, community, and social conditions.  Hospital death is not necessarily considered as bad death, if the medical personnel understand, interest.  Chance of displaying attitudes and potential of appropriate death management are revealed to patients and relatives, regarding of human’s pride respect.For revision of concepts, attitudes, patterns of death management, and medical system issues are included;  it was found that there are three core concepts as:Bio-medical model is focused on mechanism of physical performance.  Therefore, it should exclude death from ordinary life.Bio-psychosocial model is focused on mental and family dimension.  It is the concept that tries to reduce gap of Bio-medical model, providing opportunity to patients and relatives to participate in medical treatment procedures.  More medical standard are involved, for example, decreasing final pain and torture of the patients, counseling provision, and fact provision of treatment procedure, etc.  Those are all from palliative care, which provides convalesce residence for final stage patients.Spiritual model is viewed, as life is part of nature, Both are interconnected, Nothing is permanent, Death is natural.  Good health is just the only way to develop life more enrichingly, Death should not be avoided or managed, however, it should be reflected, This implies that death is not separated from life, Death objective is to release oneself from adhere belief.For basic information of organization working with final patient, including a case study of 15 initiative organizations, it was found that there are 50 percents of private organization working with HIV patients and final HIV patients.  The rest is in the early stage within medical schools, general hospitals, and community hospitals.  Mostly it came form patients’ problems in which they had to face with, and then the problems were gradually developed.  In addition, Catholic hospital is now focusing on patient governance, and treatment for final HIV patients is included.  From the interviews relevant issues were found as:Thai society has a certain resource of personnel and organizations pertaining to this area and develops a particular organization to help patients and relatives.  It is established in provincial areas, both public and private sectors.  It was unofficially merged by interested people, and circulated.Private organization of development is distinctive in terms of working closely with patients and relatives, more flexible, and neutral as a connector between medical personnel, and patients and relatives. For general hospital, especially for medical nurse faculty available, Catholic hospital is likely to pay more attention to final patients increasingly since there is academic research circulated among international academic stages.  At the same time, more mainstream acceptation of patient’ right is revealed.Community hospital should play an important role in supporting family and community to confront with death and death management effectively, through house visiting, Primary Care, and the convenience of patient transfer.The provision of hospital quality development system (HA) is responsible for clearer domain and more acceptation.  The relevant organization should employ the advantages to further or develop knowledge that can be actually practiced and congruent with local context of society.  The concept circulation and concept drive to relevant personnel should be included pervasively.RecommendationsThere should be deeper research and covered with various kinds of population.  Qualitative research should be focused since it can describe death into deeper dimension and it can access to human and spirit.  In addition, quantitative research can be used as result expansion and link of systematic change.Hospital quality development system (HA) is a critical channel to be forced into systematic change pertaining to treatment of final patient.  Therefore, practical research should be promoted as a pilot project in some hospitals whose interests are their primary bases.During data collection, learning opportunity is exchanged.  The organization network is linked both public and private sectors, which their interests and experiences relevant to final patient treatment are shown, it was found that most organizations have potential and readiness to develop newly trends of taking care and aiding final patients.  In addition, widely conditions of working are opened; the research institutes- public health system should grasp this advantage to develop knowledge body or to support the necessary and usable knowledge body collection.  Furthermore, patterns and various kinds of model should be broadcasted to the public as an alternative for patients and relatives.Documents pertaining to personnel, organizations, book, and research of death and other relevant documents should be made for anyone interested in to be accessed.