plueme/wizJson huggingface dataset:
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Drug price control: Lessons from the past, present findings and recommendations for the future 
abstract:Drug price control is one of the measures to contain health care costs. This paper briefly reviewed
the price control methods that have been commonly employed in developed countries. Experience in controlling drug prices by government agencies in Thailand was analyzed and recent findings from the
Research Projects on Drug Prices (B.E. 2553-2555) that have been supported by the Health Systems Research
Institute were summarized. Policy recommendations for the control of both purchased and reimbursed
prices were additionally proposed. The National Lists of Essential Medicines should be strategically
mobilized as an indirect measure of price control. To control the purchased prices of new drugs,
innovative strategies of pool purchasing and price negotiation should be implemented under collaboration
with health insurance funds. Routine monitoring of the hospital-purchased prices should be supported
so as to obtain the regular and update information on drug pricing. The reimbursed price of a
generic drug that is covered by the National Lists of Essential Medicines should be set at an adequately
high rate that can incentivize the use. An agency for the development and maintenance of standardized
drug databases should be established. The long-run development should include the price monitoring
infrastructure in every step, from essential drug selection, drug purchasing, utilization and reimbursement.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Urban Primary Care System in 14 countries 
abstract:People living in urban areas are growing; therefore, urban primary medical care is more crucial.
Studying urban primary care systems in various countries will make us learn from best practice in each
country which may be applied to Thai urban medical system. Objectives of this study were to analyze and
compare urban primary care systems among each country. Study design was documentary research about
urban primary care systems in 14 countries including Brazil, Canada, Spain, Cuba, Republic of Korea,
Japan, Taiwan, Hong Kong, Denmark, Sweden, Belgium, United Kingdom, United States of America, and
Australia. Primary Care Evaluation Tool (PCET) of WHO European Region was used as a framework for
analysis. From this study, countries with gatekeeper system (patients were screened by general practitioners
or family physicians ) had good continuous, collaborative, and coordinate care with appropriate
health care costs. Most of countries which governments spent budget for people’s medical care expenses
had provided general practitioners or family physicians as gatekeepers acting in patients screening. There
was no gatekeeper system in countries which people were responsible for their own medical care expenses
but co-payment system was involved to reduce unnecessary service uses.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: A review of drug pricing control system in Thailand 
abstract:This study focused on a review of the national system for drug price policy. Methods including
interviewing key persons in various organizations, meetings with experts, studying related documents
and literatures, were used. The study revealed that Ministry of Public Health (MOPH hospitals) had several
indirect drug price control mechanisms for government sector especially for the MOPH hospitals themselves. Drug price control has been started in the process of national essential drug list (ED) selection.
Cost effectiveness and budget impact analyses were parts of the consideration criteria. After drugs
were selected as the ED, median price would be set as the price control measure for procurement process
of MOPH hospitals. In addition, central negotiation was used for controlling price of single source nonessential
drugs in MOPH hospitals. National Health Security Office takes the leading role in price negotiating
of high cost ED to ensure accessibility for their beneficiaries. However, limited items were negotiated
in each year. Group purchasing in level of provinces and regions was not much expanded from the
past.
There exists no autonomous body and no regulation for controlling of manufacturer price setting
before drug registration processes. No regulation and system for controlling mark up in private sector
have been implemented. Selling price was controlled to not more than price list. For drug price monitoring,
only voluntary reporting of MOPH hospital purchasing price was available under the Drug and
Medical Supply Information Center (DMSIC).
As the ways to improve drug price control system in Thailand, manufacturer production cost structure
should be submitted as the condition for national essential drug list consideration. In terms of negotiation,
knowledge management of negotiation and purchasing strategies, expanding of items for central
negotiation for all three health insurance schemes are encouraged. Drug price setting for procurement
and a monitoring system should be improved. Moreover, a study on adverse effects of drug price control
system on domestic pharmaceutical industries is necessary.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Quality of Out-Patient Prescribing: An Analysis of 18 Standard File Datasets of Hospitals 
abstract:Rational drug use would lead to sustain health care financing. Currently, most hospitals have prescribing
data recorded in standard electronic databases. However, an analysis of these electronic data-bases providing a performance feedback on quality of prescribing is limited. The analysis algorithms to
assess prescribing indicators for 18 standard files on out-patient services using SQL program were developed.
Pharmacists and computer staff from 134 hospitals voluntarily attended the 3-day training sessions.
We reported the results of analyses of fiscal year 2553 data of the 88 attending hospitals. The information
presented could be used to guide not only health care settings, but also health policy makers, in terms of
rational antibiotic prescribing for common cold and diarrhea, inhaled coticostroid (ICS) prescribing for
asthma patients, and angiotensin converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers
(ARBs), and statins prescribing for diabetes patients.
More than half of hospitals had greater than 50% of oral antibiotic prescriptions in common cold,
and quinolones prescriptions in non-infected diarrhea. ICS prescriptions in asthma patients, and ACEIs/
ARBs and statins in diabetes patients were moderately prescribed. However for the latter two conditions
high variations across hospitals were found. The findings urge that all hospitals should promote analysis
of the hospital electronic database to obtain the feedback information, which in turn can guide the implementation
of activities to increase quality of prescribing, at least for the reported conditions.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Drug pricing measures for the reimbursement 
abstract:Background: There are many effective drug pricing systems which Thai Government should employ
to solve drug pricing problems especially at the reimbursement level. This research focuses on a
comparison of budget saved by the payer after the application of different drug pricing measures at the
reimbursement level.
Methods: This was a quantitative research. The budget impact analysis modeling to estimate the
budget saved from the pricing policy implementation was employed.
Drugs belonged to the group HMG-CoA reductase inhibitor (statins) were purposive sampling to be
the sample for the budget impact analysis. They were divided into 3 groups and the sample of each group
was shown in the bracket: 1) Innovative drug with therapeutic improvement (Rosuvastatin), 2) Innovative
drug with technical improvement (Amlodipine+Atorvastatin), and 3) Innovative drug with Generic
drug (Atorvastatin).
Drug pricing measures assigned for each drug groups were 1) Price Volume Agreement, 2) Value
Based Pricing, 3) Maximum Allowable cost, and 4) Reference pricing.
Results: In terms of budget saving for: 1) Innovative drug with therapeutic improvement group:
Reference Pricing measure saved more budget than Price Volume Agreement. 2) ) Innovative drug with
technical improvement group: Value Based Pricing measure saved more budget than Price Volume Agreement.
3) Innovative drug with Generic drug group: Reference Pricing measure saved more budget than
Maximum Allowable Cost.
Discussion: The magnitude of saving in each measure depends on the factors such as percentage of
drug rational use, numbers and prices of drugs available in the market, and availability of local made
drugs.
Conclusion: There are many effective drug pricing measures which can be used to reduce the reimbursement
budget. The government should place the right measure to each drug to gain its most benefit.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Determination of 2010 Reimbursed Drug Price and Its Budget Impact in Public Hospitals in Thailand 
abstract:Total drug expenditure for Civil Servant Medical Benefit Scheme (CSMBS) has rapidly increased.
Reference pricing (RP, or maximum reimbursable limit) for drugs is proposed as a means to control drug
expenditure. The objectives of this study were to determine the RP of five high expenditure drug groups
and estimate the budget impact of RP implementation. Prescription records of 29 public hospitals in 2010
were collected. Drug utilization and several RP’s of each drug product were determined. Then, overall
budget impact was determined for RP under three different scenarios.
Results showed that there were 1.7 million prescriptions, accounted for 2.5 billion baht. By drug
group, total number of prescriptions were 39.96%, 26.25%, 16.57%, 13.68% and 3.55% while total expenditures
were 44.65%, 20.43%, 20.59%, 4.47% and 9.85% for statins, Proton Pump Inhibitors (PPI), Angiotensin
Receptor Blockers (ARB), Angiotensin-Converting Enzyme Inhibitors (ACEI), and Bisphosphonates
(BIS) respectively. Brand name drugs accounted for 94.8% of expenditures but 50.6% of prescriptions. If
RP was implemented, the highest savings (50.39% of expenditure) would be from pharmacological substitution
(eg. price of Atorvastatin is equal to median price of generic Simvastatin). Generic substitution
(median price of generic for brand Simvastatin) would result in 20.56% savings while 15.91%-17.26%
savings would be achieved if brand drugs were reimbursed at cost plus 50 or 30 baht dispensing fee per
item respectively.
Use of high price, brand drugs has burdened the overall drug expenditure of government hospitals.
Reference pricing would encourage generic drug use and thus, help not only to control overall expenditure,
but also strengthen the local manufacturing drug industry.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Hematopoietic stem cell transplantation in severe thalassemic patients in two university hospitals in Bangkok: Experiences of caregivers 
abstract:This qualitative research used purposive sampling through in-depth interviews from main caregivers
whose severe ex-thalassemic children underwent successful hematopoietic stem cell transplantation (HSCT). Participated caregivers were interviewed using a semi-structured questionnaire based on openended
questioning and tape-recorded after receiving their informed consent. Transcripts of the interviewed
were created verbatim and examined using content analysis.
Results revealed that HSCT treatment procedure requires comprehensive understanding and cooperation
from patients and their families. Economic household burden is the main hindrance for accessibility
toward this service owing to its high direct non-medical costs as well as service charges although
HSCT can be reimbursed from all Thai health insurance schemes.
It is very crucial to prevent new thalassemic cases in order to alleviate the impact on the resource
allocation for treating a preventable disease in both household and public sectors. Therefore, public health
policy makers should consider creating a disease awareness campaign among citizens as well as healthcare
personnel who should have the comprehensive understanding about potential obstacles of the patients or
families and should commit to perform more effective thalassemia screening and prevention both in policy
and routine practice aspects.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Responsiveness under different health insurance schemes and hospital types 
abstract:The Statue on National Health System B.E 2552 section 7, the health system must promote human
value and dignity and attach importance to fairness and equity in society. This concept leads to an attempt
to capture interaction between providers and users in order to improve and develop the health service
system. Every person should be treated equally even though he/she accesses to care under different health
insurance schemes and hospital types. The purpose of this research was to assess the responsiveness of
Thai health care service system according to different types of national health insurance schemes and
health care facilities in 9 provinces. An exit survey of 6,507 out-patients covered by 3 health care schemes:
Civil Servants Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS) and Universal Coverage
Scheme (UCS), was conducted. The health care settings included 4 hospital types: regional/general hospital,
community hospital, university hospital and private hospital. The field survey period was from April
to June 2011.
The study revealed that there were significant difference between median scores, both overall and
hospital-type based, of responsiveness to users among three schemes in some domains and responsiveness
scores under the CSMBS was higher than those from the SSS and UCS. Nevertheless, results from
logistic regression show that, when 75 percentile of score of each component was adopted as cut point for
high responsiveness, health insurance scheme was not significantly associated with all responsiveness
components, except choice: the scores of the CSMBS was significantly higher than those of the UCS. On
the other hand, type of hospital was significantly associated with responsiveness in all components. Overall,
the score of private hospital was significantly higher than those of the others, whereas that of the
university hospital was significantly lower than the scores of the other hospitals, except choice, which was
significantly higher than in the university hospital than in the regional/general hospital.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Rural retention of medical graduates trained by the collaborative project to increase rural doctors (CPIRD) 
abstract:The collaborative project to increase rural doctors (CPIRD) has been implemented since 1995. This
study therefore aims to assess whether the medical graduates trained by the CPIRD project were retained in rural areas longer than those trained by regular training project.
The total of 1,093 CPIRD medical graduates and 6,064 medical graduates from regular training project
during 2001 - 2007 were included. The data was traced back from 2001 to 2010 in relation to their mobility.
Survival analysis was used for data analysis.
The study found that at the 4th year of their work, 69% of CPIRD medical graduates were retained in
the Ministry of Public Health (MoPH) compared to 59% of those trained by regular training project were.
Harzard ratio was 0.66 (p<0.001) and it indicated that normal track medical graduates had a probability to
resign from the MOPH 1.5 times than that of the CPIRD, significantly. After 3 years of public compulsory
work ended, 52% of CPIRD medical graduates were retained at rural hospitals while 47% of the normal
track medical graduates were. Harzard ratio was 0.88 (p= 0.001) and it indicated that normal track medical
graduates had greater chance to move out of rural areas 1.14 times than that of the CPIRD ones, significantly.
The median survival time in rural of the CPIRD medical graduates was declined from 10 years to 4
years, comparing to that of the normal track medical graduates that was declined from 6.5 years to 3 years.
Although physicians under the CPIRD project have higher rural retention, the median survival time
in rural had declined over 10 years and it become close to that of the normal track physicians. The trends
indicated that the improvement of the CPIRD project is needed in order to attract and retain more physicians
in rural areas.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Impacts of financial measures on retention of doctors in rural and public health facilities 
abstract:This study aimed to assess the impact of a financial measure on public and rural facility retention of
physicians in Thailand. It used a retrospective approach using secondary data from the Ministry of Public
Health (MoPH). The study population included all physicians who graduated and entered the workforce
during 2001-2007, and the data were retrieved from 2001-2011. Survival analysis was used.
Results showed that the high turnover rate of young physicians was still persistent. Large proportions
of physicians, at about 30%, resigned before the 3-year compulsory contract ended, and this trend
repeated even after the financial measure was implemented. Resignations from MoPH have increased
since 2001, and the rate remained high after the increase of special allowance. Rural retention was low,
especially after 3 years of compulsory public services. The proportion of physicians retained in the rural
area after the 3-year compulsory period was about 20-24%, and this trend repeated even after implementation
of the financial measures in 2009.
The results suggested that to retain physicians in the rural area we need both the financial and nonfinancial
measures in an appropriate combination. Non-financial measures such as, working close to hometown,
opportunities for specialist training, improvement of work environment and infrastructure would
be important for rural retention of physicians as well.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Good Governance Mechanisms for Medical Profession Regulations in the United Kingdom, New Zealand and South Africa 
abstract:Medical council is the core component of health system governance and the regulatory body of
medical profession in many countries. In the case study of the medical councils in the United Kingdom,
New Zealand and South Africa, they have development and changes from time to time so as to protect,
promote and maintain the health and safety of the public and to keep the public trust and confidence. The
study is a qualitative and documentary research and aims to study the philosophy, conceptual framework
and the role of these medical councils as an organization regulating the medical profession, and to propose
the good governance to be applied to the Medical Council of Thailand as appropriate.
The results showed that Medical Councils of these countries have good governance mechanisms, especially,
the General Medical Council (GMC) in the UK which is the model of the Medical Council of Thailand.
The reform or changes of the these medical council have been developed with its aims of effective,
accountable with greater patient and public involvement and with faster, fairer and more transparent
procedures in making decisions on fitness to practice of alleged physicians.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Relationship and relative risk of cardiovascular diseases attributable from smoking: A systematic review and meta-analysis 
abstract:Cigarette smoking is one of the most important causes of chronic diseases and immature deaths
globally which has led to numerous epidemiological studies conducted to identify the association between
smoking and various types of diseases. The objectives of this study are systematically review existing
epidemiological literature on cardiovascular risk from smoking and to synthesize a pooled relative
risks based on meta-analysis of those literature. Review protocol has been developed to identify relevant
and comprehensive keywords and to ensure appropriate inclusion/exclusion criteria are applied without
bias.
Between 1994- 2011, 881 and 272 papers have been identified from the literature search for ischaemic
heart diseases (IHD) and cerebrovascular diseases (CVD) respectively. This was later reduced to 14 for
IHD and 20 for CVD. When meta- analysis was performed, it was found that the relative risk of developing
IHD from smoking was 2.14 (1.76-2.60) for men and 2.84 (1.90-4.24) for women, while for CVD, it was
1.66 (1.43-1.93) for men and 2.18 (1.67-2.85) for women. For sub-group analysis, it was found that for Asian
population, the relative risk of developing IHD was 2.15 (1.69-2.75) for men and 1.99 (1.18-3.34) for women,
and for CVD, it was 1.31 (1.19-1.44) for men and 1.60 (1.25-2.04) for women.
This study has confirmed the harm from smoking and the association between smoking and cardiovascular
morbidity. The fact that relative risk in Asian population is relatively lower compared to the rest
of the World does not imply that there is less harm from cigarette smoking in this population but may
occur as a result of significant presence of other risk factors, such as quality and access to medical treatment
for hypertension and dyslipidaemia, within the population.
location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Physicians’ attitudes, obstacles, and sources about the use of cost-effectiveness information in clinical practice in Thailand: a cross-sectional survey 
abstract:Efficiency in clinical practice has become of increasing concern in the healthcare system in Thailand.
Cost-effectiveness analysis is a concept that helps in the efficient allocation of healthcare resources; however,
evidence showing the use of the cost-effectiveness (CE) information in clinical practice in Thailand is
limited. The aim of this study is to assess physicians’ attitudes towards the use of CE information in
clinical practice.
A cross-sectional survey was carried out to collect information from 140 physicians at Suratthani
Hospital, a central hospital in Southern Thailand, during 12-26 March 2012. The questionnaire consisted
of 3 main parts: physicians’ attitudes, obstacles in the use of CE in clinical practice, and sources of CE
information.
The results showed that the sample response rate was 52.1%. Concerning physicians’ attitudes, 68.5%
of physicians agreed that it is appropriate to consider CE information in the clinical decision-making
process. 76.7% of physicians agreed that cost containment in current healthcare system is necessary. The
main obstacles in the use of CE in clinical decisions are: 1) unwillingness to accept that healthcare resources
are limited by the public; and 2) social expectation for medical services exceeding the capacity of
public health system. Results pertaining to the source of CE information showed that 96% of physicians
attributed CE results to clinical practice guidelines. In addition, CE information from the same source
gains more attention from physicians when presented verbally rather than in written form.
Increasing the use of CE information in clinical decision-making is one way to improve efficiency in
resource allocation in the healthcare system. Findings from this study can be used to inform policies that
promote more efficient utilization of healthcare resources.