plueme/wizJson huggingface dataset:
location: nan, '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: nan, 'Thailand 
year: 2019 source: HSRI 
title: Peritoneal Dialysis Satisfaction and Kidney Transplantation Attitude among Patients under the Peritoneal Dialysis First Policy 
abstract:The Thai Peritoneal Dialysis First Policy (PD First Policy) has improved
survival of end-stage renal disease patients since 2008. However, evidence on patients’ attitudes toward
the policy and the accessibility to kidney transplantation (KT) has been lacking. This study aims to assess
PD care satisfaction and KT attitude among continuous ambulatory peritoneal dialysis patients under the
Thai PD First Policy. Methodology: A telephone questionnaire survey asking demographic data, general
opinion on PD First Policy, PD treatment satisfaction, and KT knowledge and attitude was conducted in
April 2018 among 114 randomly selected PD patients from PD centers in Chanthaburi. Results: The mean
age of PD patients was 54.21 years, and their duration of peritoneal dialysis was 3.42 years on average.
Majority of them were satisfied (79.8%) and very satisfied (4.4%) whereas only 2.6% expressed their
dissatisfaction. One hundred and six patients (93.0%) agreed with PD First Policy, of which 65.1% stated
that this policy had saved their expenses. Of the total 114 patients, only 24.6% had KT knowledge but
73.7% would like to undergo KT. The main motivation for KT was the increased chance of returning to
work and contribute to family (88.7%). Conclusions: The Thai PD First Policy has been well received.
The perceived need for KT was high. A good strategic plan to improve knowledge on and access to KT
is required.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Effect of Rational Drug Use Policy on Antibiotic Prophylaxis Use in Normal Vaginal Delivery in Mahasarakham Hospital 
abstract:Background & Rationale: Ministry of Public Health introduced “antibiotic use in vaginal delivery of
normal term labor” as an indicator of rational drug use (RDU) service plan with target goal of not more
than 10% use. Mahasarakham Hospital implemented this RDU policy in October 2016 via meetings,
setting a goal and practice guideline together with regular monitoring and evaluation. The objective of
the present study was to examine effects of the RDU policy on antibiotic use, expenditure on antibiotic
and infection rate after implementing the policy among vaginal delivery of normal term labor in
Mahasarakham Hospital. Methodology: A retrospective study was conducted using hospital data of
vaginal delivery of normal term labor during October 2015 to April 2018. Antibiotic use and expenditure
were obtained from the 43-file standard dataset. Infection rate was collected from readmission record
of obstetrics and gynecology department. Patterns of antibiotic use after implementing the policy were
investigated from medical record reviews between October 2017 and April 2018. Mann-Whitney U test
was performed to compare antibiotic use rate and expenditure and infection rate between before (October
2015 – October 2016) and after (November 2016 – April 2018) policy implementation. Segmented
regression of interrupted time-series analysis was applied to examine policy effects. Results: Comparing
before and after policy implementation, the antibiotic use rate and expenditure were declined significantly
(median antibiotic use rate: 100% vs 13.2%, p<0.001 and median expenditure per month: 8,368
baht vs 1,328 baht, p<0.001). The infection rates were not significantly different (median: 0% vs 0%,
p=0.222). From time-series analysis, the policy significantly decreased antibiotic use rate (-82.1%, 95%CI:
-87.3 to -76.9, p<0.001) and decreased monthly-expenditure of antibiotic use (-6,663.2 baht, 95%CI:
-8,396.7 to -4,929.8, p<0.001) but no effects on infection rate by month (0.063%, 95%CI: -0.280 to 0.406,
p=0.709). From chart review of 721 vaginal normal deliveries, 45 women (6.2%) used antibiotics. The
major reason of antibiotic use was the 3rd - 4th degree tear (14 women, 31.11%). Amoxycillin and Cefazolin
were mostly used antibiotics. Conclusion: The findings of this study indicate that implementation of the
RDU policy significantly reduced antibiotic use and expenditure and did not increase infection rate. The
policy could improve rational use of antibiotic prophylaxis in vaginal delivery of normal term labor.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Economic Burden from Providing Care to Migrant Patients: a Case Study of Phaholpolpayuhasena Hospital, Kanchanaburi 
abstract:Kanchanaburi province borders with Myanmar and a large number of migrants are cared for at
Phaholpolpayuhasena Hospital. Financial expenses in providing care to migrant patients were analyzed.
The study population was inpatients and outpatients at the hospital during fiscal year 2017. Data collection
techniques involved a questionnaire, interviews and document reviews of medical records for the
previous year. A convenience sampling method was employed. Total sample size was 519 (412 outpatients
and 107 inpatients). Of the 412 outpatients, 305 had no admissions during the previous year, while 107
had been admitted in the hospital. The results showed that 18.4% of the outpatients and 38.3% of the
inpatients were not medically insured. When classifying patients according to the most costly disease
group, cancer comprised the highest proportion in the outpatient sample at 63,459 (SD 82,872) baht per
person per year. For communicable diseases, the largest group in the inpatient sample cost 43,100 (SD
53,384) baht per person per year. Costs of medical treatment and expenses, as quoted by the hospital,
were averaged at 15,757 baht per person per year for outpatients, with inpatients at 35,280 baht per stay.
Results from focus group discussions with various stakeholders showed that expenditures of Phaholpolpayuhasena
Hospital, Samutsakhon Hospital, Krathumbaen Hospital, and this research study in terms
of relative weight greater than or equal to 2 units were 19.2%, 5.3%, 2.4% and 23.4%, respectively, while
in terms of relative weight greater than or equal to 4 units were 5.8%, 1.9%, 1.2% and 3.7%, respectively.
The top 5 outpatient diseases were cancer, trauma, non-communicable diseases, neonatal problems,
and obstetrics, while the top 5 inpatient medical departments which admitted high numbers of migrant
patients were medicine, surgery, obstetrics, orthopedics, and pediatrics, respectively.
Results can be used to formulate a support policy to mitigate the cost burdens incurred by hospitals
in border provinces. A policy of cooperation with neighboring countries should be proposed by the
Ministry of Public Health to develop adequate medical facility capacities and also review the cost of the
health insurance card scheme for migrants to reflect the cost of medical treatment. Most importantly, a
policy should be implemented to adjust budget allocations to border province hospitals to cover the
cost of treating migrant patients.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Perception and Satisfaction of Stakeholders towards National Health Security System in Health Region 10 
abstract:This mixed method research aimed to study perception and satisfaction of stakeholders towards national health security system in Health Region 10. The data were collected by questionnaire and semi-structured interview. Data analysis was done by using descriptive statistic and content analysis. The results of this study were based on interviews with 294 clients aged between 15 - 77 years old, and 304 service providers aged between 22 - 59 years old. Perceptions of all aspects of the national health security among providers and clients were high to highest, and satisfactions on national health security among providers and clients were highest. Their recommendations included: health promotion and
disease prevention should be emphasized; cross-boundary medical expenses should be allowed to
manage locally; fund should be transferred directly to health promoting hospital; personnel of the local
government organization should be trained on relevant regulations of fund management.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Frequency and Associated Factors of Hypoglycemic Symptoms and Fear of Hypoglycemia in Elderly Patient with Type 2 Diabetes at Primary Care Unit of Songklanagarind Hospital 
abstract:Objective: To determine the frequency of symptomatic hypoglycemia and its associated factors and fear of hypoglycemia in a population of elderly patient with type 2 diabetes at primary care unit of Songklanagarind Hospital. Methodology: This cross-sectional study was conducted from July to October 2018 at primary care unit of Songklanagarind Hospital. The participants aged 60 and older with type 2 diabetes were included. The socio-demographic characteristic questionnaire was interviewed by a researcher or research assistants. Baseline clinical data, included body weight, height, underlying disease, duration of diabetes, complications of diabetes (diabetic retinopathy, diabetic nephropathy, cerebrovascular, peripheral vascular, neurovascular and diabetic foot complication), HbA1c, fasting plasma glucose, type and dose of glucose lowering drugs, were reviewed from the hospital information system (HIS). The participants were asked on their experiences of hypoglycemic symptoms in the previous month. Fear of hypoglycemia was measured by the Thai version of Hypoglycemia Fear Survey (HFS) covering behavior subscale (HFS-B) and worry subscale (HFS-W). The higher scores indicate higher fear of hypoglycemia. Chi-square, Wilcoxon, and Fisher tests were applied to study significant variables. Logistic regression analyses were performed to evaluate the associations between associated factors and hypoglycemic symptoms. Results: Overall, 160 participants were involved (mean age 68.6 ± 6.1 years, 53.8% females, diabetes duration of 10.5 ± 6.4 years, 57.5% diabetic complications, 7.5 ± 1.8% HbA1c), of whom 30% reported hypoglycemic symptoms. The associated factors of hypoglycemic symptoms were diabetic
complications (aOR = 2.75; 95% CI 1.23 - 6.14; p = 0.012), glipizide use (aOR = 5.03; 95% CI 1.99 - 12.71; p < 0.001) and fasting plasma glucose (aOR = 0.97; 95% CI 0.96 - 0.99; p < 0.001). The mean of hypoglycemia fear survey score was 16.9 ± 16. The score on the fear of hypoglycemia (HFS) and
worry subscale (HFS-W) for the patients with more frequent hypoglycemia episodes in the previous month (>2 episodes) was significantly greater than another group (1-2 episodes) (p = 0.006 and 0.002), indicating a greater degree of fear of hypoglycemia in the first group. Conclusion: The occurrence of symptoms of hypoglycemia is one of complications in the elderly with type 2 diabetes and their presence is associated
with complications of diabetes and glipizide use. Frequent symptoms can have a negative impact
on fear of hypoglycemia. Minimizing the risk of hypoglycemia represents a high priority in the diabetes
treatment of the elderly people.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Trends of incidence and survivals of clipping and coiling for cerebral aneurysm in Thailand and their cost-effectiveness analysis 
abstract:This research had two major objectives: 1) to determine incidence, access to treatment and clinical outcomes of patients with cerebral aneurysm who received clipping or coiling procedures; and 2) to examine whether coiling instrument should be included in the reimbursable list of beneficial package for patients under the Universal Coverage Scheme. Although coiling procedure has been performed worldwide, a slightly increasing rate of patients receiving coiling procedure in Thailand was observed during 2012-2018. In addition, increasing rate of patients under the Universal Coverage Scheme receiving clipping was significantly higher than that of those receiving coiling. Since the year 2012, survival rate among patients undertaking clipping was higher than the rate in 2006-2011. This finding did not support the hypothesis that patients receiving clipping had poorer prognosis than those receiving coiling or clipping was performed only in those who were not candidate to coiling. Survival rate of patients receiving clipping in the university hospitals was higher than those in the Ministry of Public Health (MOPH) hospitals and non-MOPH hospitals. Survival rate in hospitals with high volume of intervention (clipping or coiling >30 cases/year) was higher than the hospitals with low volume of intervention. Access to treatment and clinical outcomes varied across the health regions. Collaboration among the health regions to improve referral system for enhancing the service efficiency and patient outcomes should be addressed. Planning for neurosurgery or radiology manpower who have a specialized training for endovascular coiling should be considered, especially in the university hospitals. Based on the societal perspective, incremental cost effectiveness ratio (ICER) of coiling as compared to clipping was cost saving. Therefore, coiling instrument should be included in the reimbursable list of beneficial package for patients under the Universal Coverage Scheme.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Alcohol Drinking and Provincial Alcohol Problem Index (PAPI) in Thailand: The 2017 Survey 
abstract:The objective of this study was to report drinking patterns and alcohol-related health risks using Provincial Alcohol Problem Index (PAPI) of Thai population by region and province. Data from the 2017 Cigarette Smoking and Alcohol Drinking Behavior Survey, a stratified two-stage random sampling to select 120,003 Thai participants aged 15 years and over, were analyzed using descriptive statistics. The prevalence was estimated by weighted proportion and presented at national, regional and provincial levels. A composite PAPI score, ranging from 0-1, was also calculated to represent a relative level of alcohol risk problem in each province. At regional level, the Northern and Northeastern regions had the highest prevalence of adult (35.4% and 32.8%, respectively) and adolescent drinkers (19.0% and 16.8%, respectively), while the Central and Southern regions had the highest proportions of regular to heavy drinkers and drink driving. Provinces with the highest PAPI score were scattered in the Northern and Central regions, including Lampang (0.72 point), Chiang Rai (0.69 point), Phitsanulok (0.65 point), Chantaburi (0.64 point) and Sukhothai (0.63 point). This study showed that alcohol use and related problems remained significant health issues in Thailand with a diversity of specific problems that needed to be prioritized in each local area. Lampang, Chiang Rai, Northern, and Northeastern regions should urgently consider these issues. These hence warrant comprehensive measures targeting both establishment of local community actions and national alcohol policies.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Study of Lactation Consultant’s Services in Health Facilities in Thailand 
abstract:Lactation consultant nurses play an important role in the promotion of breastfeeding practices and to ensure optimal age-appropriate feeding of children. Responsible for supporting mothers in overcoming breastfeeding difficulties, they also play a prominent role in providing knowledge, techniques and skills, as well as instructing mothers on appropriate behaviors and building confidence; the critical factors for successful breastfeeding. In Thailand, professional nurses assigned to lactation clinics in health facilities take on the role of a lactation consultant. To date, there have been no studies on service provisions and practices of lactation consultants in Thailand.  This study aimed to understand the situation of lactation consultants working in health facilities, including their roles, knowledge and qualifications as well as the scope of services provided, the challenges faced, and recommendations for improving competency of lactation consultants. A qualitative study was conducted by collecting data from 53 lactation consultants working in public and private health facilities, through focus group discussions and self-administered questionnaires. The results found that lactation consultants had the primary role of providing knowledge and building confidence for pregnant women, mothers and families on breastfeeding, from pregnancy until post-partum period. Lactation consultants’ scope of work was to provide nursing care without invasive interventions which required extensive knowledge focusing on breastfeeding practices, infant formula, maternal nutrition and child development. In addition, they required skills of nursing services, academic and technical skills, as well as communication and administrative capabilities. The large majority of lactation consultants faced difficulties due to their heavy workload, career path uncertainties, and insufficient knowledge of complex breastfeeding complications. These problems were resulted from national and organizational policies, management and the work environment of lactation consultants. Based on these results, in order to improve the capacity of lactation consultants, well-defined national policies and policy implementation on the guidelines and promotion of breastfeeding practices in health facilities, as well as building a network for lactation consultants and developing a mechanism for long-term capacity building and monitoring are recommended.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Health Promotion Activity in Hospitals – A Systematic Review of Systematic Review 
abstract:Reorienting health services to be more engaged in health promotion is a key health promotion
strategy that is widely accepted. The strategy has been implemented in Thailand. However, the scope
of health promotion work by Thai hospitals and its related functions were hardly known.
This research project explored health promotion activities in the hospital settings. It identified systematic
reviews of health promotion using PubMed database.
There were 10 systematic reviews that met the inclusion criteria. The reviews of health promotion
activities included body mass index monitoring during clinical consultation, individual exercise encouragement,
diet control, quit smoking and drinking, program to help release carers’ stress, and risk reduction
interventions among mental health patients.
This systematic review of systematic review can be beneficial for health promotion management
at each organization. The information can help expand work and research on health promotion activity
in hospitals in the future.
location: nan, 'Thailand 
year: 2019 source: HSRI 
title: Expectations of Community Hospital Directors in Health Region 2 towards the Medical Curriculum of the Faculty of Medicine, Naresuan University 
abstract:One of the missions of the Faculty of Medicine, Naresuan University is to produce medical graduates to serve the Collaborative Project to Increase Production of Rural Doctor (CPIRD). The project recruits 145 students who reside in any of the 5 provinces in Health Region 2 annually. After graduation, the medical graduates are deployed to work at rural hospitals of the five provinces. The Faculty of Medicine aims to apply outcome-based curriculum to develop the graduate’s attributes according to the expectations of all stakeholders particularly of the community hospital directors. Thus, the present study was carried out to find the expectations of the community hospital directors in Health Region 2 to provide the basis for developing a medical curriculum satisfying community needs. Method: A cross-sectional descriptive survey was done using a structured and validated questionnaire to all community hospital directors in Health Region 2. Results: Based on the expectations of the respondents, leadership skill and teamwork, patient empowerment, health promotion and disease prevention, patient-centered care, and patient safety were regarded as the top five instructional topics significant to medical practice in community hospitals. Problem-based learning (PBL) was cited as the most beneficial learning approach. On the contrary, the respondents indicated that the medical graduates did not have adequate knowledge on the community health system. Conclusion: The above specified instruction topics and PBL should be incorporated into the learning experience. Moreover, instruction topics related to the WHO 6 building blocks of a health system are useful for practicing at community hospital. As a result, there should be the health system sciences in the medical curriculum aside from basic and clinical sciences in order to produce graduates conforming to the needs of society.