plueme/wizJson huggingface dataset:
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: International Political Economy and Tobacco Control Policies: A Case Study of European Union, France and Germany 
abstract:Tobacco control is one of the most contentious political-economic issues at present. The Framework Convention on Tobacco Control (FCTC) of 2003 was crafted to be a global mechanism for tobacco control. However, the degree of tobacco control differs greatly among countries. FCTC has faced strong resistance because tobacco markets are globalized and highly profitable. This study employed global health governance (GHG) as an analytical framework and argued that the FCTC was not sufficient as an effective tobacco control instrument. It required a regional mechanism such as the European Union as well as national level actors, both state and non-state, for effective tobacco control. This research study used the European Union, France, and Germany as case studies. Findings show that France had strict tobacco control measures because political actors, non-governmental organizations, and medical personnel had strong influences on shaping tobacco control policy and took stance against transnational tobacco companies and retailers. In contrast, Germany encountered significant delays in developing effective tobacco control policies because of both the ignorance of political actors, and the weakness of the anti-tobacco civil society network. Moreover, powerful and profitable international and national tobacco companies stood firm against Germany’s tobacco control policies. This research study discovered that the European Union performed a significant role in harmonizing member states’ tobacco control policies, and ushered them in developing their own tobacco control policy measures, especially in the case of Germany. Tax measures had a positive impact on people’s health. They helped reduce the number of deaths from tobacco consumption, as well as reduce tobacco consumption rates among smokers. However, tax harmonization measures respected national jurisdiction and minimized economic impacts. Tobacco tax still remained a national source of income. This research study proposes that ASEAN and its member countries adopt the EU’s harmonization of tobacco-related legislations in order to develop ASEAN’s tobacco control mechanisms and to minimize the gap between members’ tobacco control policies.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Promoting Walking and Cycling in Daily Life: A Case Study of four Communities in Thailand 
abstract:Walking and cycling are common physical activities that can be performed regularly in daily life which provide health, environmental and economic benefits. This study aimed to 1) assess community-level walking and cycling promotion strategies or activities by stakeholders in selected communities, 2) investigate implementation gaps and 3) provide recommendations on walking and cycling promotion in community. Qualitative method was employed. A total 28 key informants in 4 communities of 4 regions were recruited: 1) King Taksin community in Bangkhla district, Chachoengsao province, 2) Suksabaijai community in Mueang Kalasin district, Kalasin province, 3) Ban Khaoniwet municipality school community in Mueang Ranong district, Ranong province, and 4) Ban Thatsobvan community in Chiang Kham district, Phayao province. Content analysis was used. The results showed that three main actors to promote walking and cycling in community were local government, civil society, and academia. These actors had different roles but worked collaboratively to achieve common goals. The implementation gaps were the negative attitude as well as improper and unsafe built environments towards walking and cycling. Recommendations for further program implementation include communication campaign to promote positive attitude and social awareness on the value of walking and cycling, improvements on built environments especially a speed reduction intervention in community, and leadership and supportive policy towards walking and cycling in daily life.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Cost of Palliative Care for Cancer Patients of a Community Hospital in Khon Kaen Province 
abstract:Palliative care is crucial care for cancer patients, especially those who are moving toward the end-stage. The World Health Organization states that palliative care is low cost. However, a cost analysis of such care is limited in Thailand. This study aimed to perform a cost analysis of palliative care for cancer in a community hospital. The analysis was conducted based on two perspectives: the health care provider’s and the patient’s. Cost data of 42 palliative cancer patients were recorded from January 1 to December 31, 2018. The cost of the provider’s perspective included labor and material costs from three departments: outpatient, inpatient, and home-visit, whereas the patient’s perspective covered the direct medical cost, direct non-medical cost, and opportunity cost. Results show that the average cost of the provider’s perspective was 16,525 ± 14,979 baht per patient: from outpatient 4,309 ± 7,103 baht, inpatient 10,915 ± 11,704 baht, and home care 1,301 ± 1,977 baht. The cost on provider’s perspective was mainly born by medical materials (68%). The average cost on the patient’s perspective was 38,707 ± 32,943 baht per patient: 5,262 ± 5,571 baht for outpatient, 6,231 ± 7,355 baht inpatient, 20,806 ± 20,454 baht home care, and 6,408 ± 17,336 baht for seeking other healthcare. The patient cost was predominantly opportunity cost (69%). The Ministry of Public Health and the National Health Security Office should consider the budget plan for palliative care.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Cost-effectiveness of Refracture Prevention Program for Fractured Hip Patients in Lerdsin Hospital 
abstract:Background and Rationale: Hip fracture in the elderly is a common problem in all countries worldwide and tends to increase every year along with the number of older adults. Treatment and rehabilitation of the patients take a long time, resulting in financial burdens for each country. The repeated fractures rate within 1 year was 2-11%. The current treatment of hip fracture patients was to cure and focus on the prevention of recurrent fractures. Therefore, the Refracture Prevention Program with multidisciplinary care was created. The purpose of this study was to investigate the cost-effectiveness of patients with fractured hips in Refracture Prevention Program compared with traditional treatment in healthcare provider’s aspect. Methodology: A prospective and retrospective study was conducted in 2 sample groups, with the control group receiving traditional treatment and the experimental group in the Refracture Prevention Program. Data were collected from 130 fractured hip patients of each group starting from admission day in Lerdsin Hospital for up to 1 year. The economic evaluation used a decision tree to show an incremental cost and effectiveness of each group. Results: The refracture prevention group had statistically significant higher quality-adjust life years (QALYs) than the traditional group (p < 0.05) and the program could prevent refracture better than the traditional group. Refracture rate per year reduced from 6.27% to 4.29%. The unit cost of hip fracture treatment in the Refracture Prevention Program was THB 139,504, while the traditional group was THB 150,720. The QALYs of the refracture prevention group was 0.6023, while the traditional group was 0.5106. New intervention was dominant: treatment under the Refracture Prevention Program was cheaper and better than traditional treatment. Conclusion and Discussion: The model of care for elderly patients with hip fracture should be the fracture liaison service model, with multidisciplinary cooperation and prevention of recurrent fracture risk factors. During the first year, there were 3 main costs of the program (operation, osteoporosis treatment and fall prevention) compared to only surgical treatment cost in the traditional treatment. Further study should be the long-term follow-up of the project. Besides the costing perspective, there should be a study on the financial burden of Thailand, in order to know the magnitude of the problem for future planning.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Treatment Pattern and Effectiveness of Trastuzumab in Early Breast Cancer Patient: A Real-world Data Analysis 
abstract:This study is a retrospective study using real-world data to compare treatment patterns with the guidelines for drug administration of the National List of Essential Medicine (NLEM) category E(2), and to compare effectiveness with the efficacy of clinical studies. This study focused on the treatment pattern and effectiveness of trastuzumab for early breast cancer (ICD-10 C50). Data were retrieved from the reimbursement database of the NLEM category E(2) during fiscal year 2015-2018. Time to follow-up was truncated at the end of fiscal year 2018. The data were analyzed by using descriptive statistics and non-parametric with Kaplan-Meier method. As a result, there were a total of 2,492 early-stage breast cancer patients, mostly between the ages of 50-59 years (37%), with a median follow-up of 34.98 months (interquartile range 16.75 months). The majority of patients received trastuzumab in accordance with the NLEM category E(2) guideline, 1,996 cases (80%) received drug less than 18 treatment cycles and 2,217 cases (89%) received drug less than 14 months. Subgroup analysis of the less than 14 months found 942 patients (38%) received the drug less than 12 months. Analyses of real-world effectiveness by using survival analysis in all trastuzumab patients found a 4-year survival rate of 80.02% (95% CI: 77.69-81.62); 78.74 % (95% CI: 76.36-80.90) for less than 18 treatment cycles, and 85.07 % (95% CI: 82.24-87.48) for the 12-14 months. These rates were lower than the efficacy reported from randomized controlled trials. Therefore, the present study of real-life data analysis concludes that most of patients received the trastuzumab in line with the NLEM E(2) guideline. Non-adherence may result in reducing the effectiveness of treatment lower than the efficacy from the RCT. However, this study did not explain the reason of non-adherence due to lack of important data, such as responses to treatment, recurrence and occurrence of side effects from drug use.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Cost and Unit Cost of the Top 5 Most Common Diseases Hospitalized to the Queen Sirikit Medical Center, Ramathibodi Hospital in Fiscal Year 2016 
abstract:The cost of health service is an important indicator for hospital administrators in making decision for efficient health service provision. The study aimed at exploring hospital care cost and unit cost of the top five diseases of patients hospitalized at the Queen Sirikit Medical Center, Ramathibodi Hospital, in fiscal year 2016. This was a retrospective study from health care provider’s perspective covering patients hospitalized to a special medical ward of a university hospital in Bangkok. Costing data were collected using a standard tool of unit cost analysis categorized by source of expenses, namely labor cost, material cost, and capital cost. Cost analyses consisted of two major processes: 1) hospital cost and 2) cost center analysis using top-down costing method. Top-down costing included four steps: 1) cost center identification, 2) direct cost determination, 3) indirect cost determination and 4) total cost determination. Unit cost analysis of top five diseases was classified by diagnosis upon hospital admission. Results show that the annual total cost was approximately 12,448,667 Thai baht: direct cost and indirect cost was 10,373,889 and 2,074,778 baht, respectively. For the direct cost; the proportions of labor cost, material cost, and capital cost were 88 : 8 : 4. Unit costs of the top five diseases were as follows: neoplasms 19,145 baht/day and 142,769 baht/admission, diseases of the genitourinary system 17,167 baht/ day and 182,710 baht/admission, diseases of the musculoskeletal system and connective tissue 15,495 baht/day and 122,765 baht/admission, diseases of the circulatory system 12,901 baht/day and 144,488 baht/admission, and diseases of the respiratory system 9,414 baht/day and 98,573 baht/admission. Results from this study could be utilized as guidance for cost management by reduction in the unnecessary admission days while maintaining quality. This will provide benefits and efficiency improvements in resource use to Ramathibodi Hospital and clients.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Cost of Emergency Patients in Public Hospitals for Financial Policy Recommendation to the Universal Coverage for Emergency Patients (UCEP) 
abstract:The objective of this study was to estimate the cost of emergency patients in public hospitals for financial policy recommendation to the Universal Coverage for Emergency Patients (UCEP). Financial and service information for the fiscal year 2019 was gathered from eight hospitals, two of which were general hospitals of the Department of Medical Services, four regional hospitals, and two general hospitals of the Office of the Permanent Secretary, Ministry of Public Health. The traditional cost method with the cost matrix method was applied to analyze the unit cost of emergency patients. We used the cost matrix in two steps: (1) cost distribution of the fundamental cost centers to each patient based on the services received; (2) summing all medical activity costs on each patient and reporting them as individual patient data. The result showed that there were a total of 82,811 emergency patients from eight hospitals, 20,503 were triaged as resuscitation patients (red), and 62,308 emergency patients (pink). Labor costs were the highest share of the overall costs, followed by material costs, and capital costs. Unfortunately, the present study could analyze complete cost information from only one hospital (hospital A). The total cost of 18,027 emergency patients was THB 472,317,273. The average cost per person was THB 26,201, and the average cost per adjusted relative weight by diagnosis related group was THB 9,661. This costing method that required accurate hospital financial and emergency medical service information reported only data from one hospital. Further studies should explore alternative appropriate costing methods that data from more hospitals could be analyzed as more representative.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Factor Affecting Length of Stay More Than 6 Hours in Emergency Department 
abstract:Background & Rationale: Extended length of stay (LOS) in the emergency department (ED) affects LOS in hospital, increased mortality and increased hospital resource uses. Knowing factors affecting extended ED LOS should lead to improved patient’s quality of care. Methodology: The study design was a retrospective analytical study in ED at Maharaj Nakorn Chiang Mai Hospital between January 2018 to June 2019 by collecting data from the electronic medical records. Data collection included factors expected to extend ED LOS 6 hours and longer by using multivariable logistics regression. Result: A total of 330 patients of whom 165 with ED LOS ≥ 6 hours were eligible. The risk factor for staying 6 hours and longer in the ED was having urine investigation (adjusted odds ratio [aOR] 3.43, 95% CI 2.05-5.73, p < 0.01). Moreover, patients in the evening and night shifts observed a shorter ED LOS compared to the day shift (aOR 0.26, 95% CI 0.15-0.47, p < 0.01 and aOR 0.40, 95% CI 0.21-0.77, p < 0.01, respectively). For patient presentation to ED, the refer-in patients had a shorter ED LOS compared to the walk-in patients (aOR 0.33, 95% CI 0.15-0.70, p < 0.01). Conclusion: The factors extending ED LOS ≥ 6 hours included urine investigation process and the day shift. Refer-in patients were likely to have a shortened ED LOS.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Full-length HLA Class I and II genotyping with long-read singlemolecule real-time sequencing in Thai kidney transplantation 
abstract:Organ transplantation is the treatment in patients with organ failure where kidney is the organ with the highest rate of transplantation in Thailand. Despite 50 years of an advancement in transplant surgical techniques and post-transplantation care, long-term kidney graft survival is not changed. One of the factor would be that the HLA matching technique used is polymerase chain reaction-sequence specific oligonucleotide (PCR-SSO, Luminex®) which has intermediate resolution for detecting variations in HLA gene. We conducted a HLA sequencing of 330 kidney transplant donors and recipients using Long-Read Single Molecule Real-Time (SMRT) Sequencing and observed the significant association of HLA long-read mismatch score to any type of rejection at 1 year post transplantation and any episode of graft rejection from transplantation to year 2021. This association was better than HLA Luminex mismatch score calculated with PCR-SSO technique. The HLA long-read sequencing information obtained from this study can be used as a reference allele for Thai population. There should be more population sequenced with HLA-long read technique to enhance robustness of the reference database. A prospective multicenter study comparing allocation of donor-recipients with HLA Luminex score versus HLA long-read score is warranted to evaluate outcomes such as death or allograft failure which were not be able to assessed in this study.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Outcomes of Pharmaceutical care in Hypertensive Patients by Pharmacists in Primary Care Cluster: Region Sixth Health Provider Case Study 
abstract:The sequential embedded mixed-method research consisted of two phases. 1) The qualitative phase is aimed to explore the situation, experience, problems, and barriers of the family pharmacists in primary care cluster. Focus group discussion was conducted in 24 pharmacists working in the primary care unit (PCU) distributed in 7 provinces of the health region, in January 2020 and April 2021. Average period of working experience was 5.6±5.0 years, and eight of them were full-time pharmacists working in the PCU. Findings of content analysis comprised three main themes: pharmacist roles; related factors from policies, colleagues, and the pharmacist; and the resolution of common drug-related problems (DRPs). Four roles of pharmacists were health services at the PCU, home health care, pharmaceutical management, and consumer protection. The patients’ care barriers were a limitation of the health information connection and information access from the PCU. Part-time working in the PCU limited the pharmacist’s roles; however, updated medication knowledge promoted the pharmacists for effective home health care with the team. In addition, local organizations also supported in home health care and the consumer protection. Communication skills, solving DRPs skill and working experience led the pharmacists to providing effective resolutions of DRPs. 2) The prospective, longitudinal quasi-experimental study was performed as quantitative phase. Data collection in 1,471 hypertensive patients for continuously three visits at the PCU in 2020. This aims to examine DRPs, blood pressure, and physician acceptance of pharmacists’ resolution change over the study including factors affecting DRPs resolutions. 379 DRPs were identified and the highest DRP was 164 non-adherence problems. Following the pharmaceutical care, all DRPs and non-adherence were significantly decreased by 3 2 .4% (X2(2)=46.78, p<0.001), and 61.0% (X2(2)=98.60, p<0.001), respectively. Blood pressure was unchanged. Physician acceptance of pharmacists’ resolution were 77.8%, 70.3% and 68.4%, at visit 0, 1 and 2 respectively. Factor affecting non-adherence resolution was physician acceptance of pharmacists’ intervention (rs=0.18, p=0.020). The family pharmacists can reduce DRPs in patients with hypertension. The relevant factor of DRPs resolution was teamwork due to working experience and skills of pharmacists. There should then be increasing experience and related skills through short course training for pharmacists.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Smartphone-Based Point-of-Care Testing (POCT) System and Platform 
abstract:Development of rapid diagnostic tests are a fundamental component for an effective public health system. At present, the availability of rapid diagnostic test and equipment quality in Thailand still insufficient. In this study, we aimed to develop the smartphone-controlled electrochemical sensor operated via Near Field Communication (NFC) as portable devices for screening test. This study used the electrochemical gas sensor to detect blood alcohol concentration from breath sample. For hepatitis B detection kit, the operating system was composed of a card-sized electrochemical NFC tag sensor integrated with a smartphone and antibody-modified electrode with gold nanoparticles to provide high sensitivity and β-cyclodextrin (β-CD). The modification and immobilization processes were verified by electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV). The electrochemical immunosensor was then used to quantify Hepatitis B surface antigen (HBsAg) by measuring the current-time response obtained from amperometric detection. The current from the Fe(CN)63-/4- redox couple was measured before and after addition of HBsAg. A resistance-based lateral flow immunosensor diagnosis device (R-LFI) that integrated NFC with portable smartphone for L. interrogans detection in clinical samples. The performance of R-LFI sensor was evaluated using recombinant LipL32 (rLipL32), L. interrogans, and clinical samples. The results showed that the performance of the smartphone-based breath alcohol sensor was acceptable (SD ≤ 1.4mg%). Under optimal conditions, a linear calibration curve and a limit of detection for HBsAg were found to be 10-200 μg/mL and 0.17 μg/mL, respectively. The R-LFI device exhibited linear responses toward rLipL32 protein in phosphate buffer and L. interrogans spiked in healthy human serum samples within concentration ranging from 1 to 100 ng (limit of detection, LOD: 0.16 ng). This platform is sensitive, specific, simple, label-free, and requires small sample volume. These desirable features make it particularly suitable for resource-poor settings. However, these device improvement needs to be studied for commercial use in the future.
location: nan, 'Thailand 
year: 2021 source: HSRI 
title: Risk factor associated with malignant transformation of astrocytoma 
abstract:Astrocytoma can be found to develop malignancy in 9-23 percent that is significantly associated with poor prognosis. From a literature review, lack of evidence mentioned about risk factors associated with malignant transformation. The study objectives were 1. to identify factors associated with malignant transformation 2. To identify the prognosis of astrocytoma that developed malignant transformation according to biomarkers. Method The present study was a retrospective cohort study and the study population was patients who were diagnosed with low-grade astrocytoma. The processes of the study comprised 4 processes as follows: 1. investigation of the candidate genes from fresh frozen tissue 2. Investigation of candidate gene mutations 3. survival analysis 4. nomogram development. Results Following whole-genome sequencing, IDH 1 and IDH 2 mutations were candidate genes. In 90 patients, IDH 1 and IDH 2 mutations were found in 12.2% and 10%, respectively. Malignant transformation was associated with a short survival time (log-rank test, p=0.006). Factors associated with malignant transformation were a supratentorial tumor, midline shift of more than 1 cm, the extent of resection, and IDH 1 mutations following multivariable analysis. Therefore, a nomogram was developed for predicting malignant transformation. Conclusion Malignant transformation was significantly associated with poor prognosis; therefore, a close follow-up strategy should be applied in high-risk patients.