plueme/wizJson huggingface dataset:
The aims of this study were to explore the situation of obesity among undergraduate students and to
determine the socio-economic and economic factors associated with obesity. A cross-sectional survey using
questionnaires was conducted among 398 students in 7 universities in Chiang Mai Province, Thailand. The
data were then analyzed by using a logit regression model. We found the situation of obesity in undergraduate
students as follows: 29 percent of the study sample was either overweight or obese. Of those, 64 percent
were male, 54 percent stayed in the dormitory, 35 percent failed to exercise, 27 percent were not willing to
pay for obesity treatment, 91 percent did not acknowledge themselves as obese and 38 percent had health
insurance. The socio-economic factors significantly associated with obesity among undergraduate students
were family incomes, fast food consumption, place of living, willingness to pay for obesity treatment and
sex at the 0.10 significance level. However, economic factors, such as myopic view underlying eating habits,
asymmetric information and incomplete information on nutrition and causes of obesity, did not show a
significant impact on obesity among the undergraduates. It was concluded that undergraduate students
possibly had no myopic view behavior or they knew very well concerning the information on nutrition and
causes of obesity.
This study is aimed at exploring the current situation concerning risk factors and behaviors that
construction workers were facing at both individual and community levels as well as to examine existing
health promotion interventions. This information was expected to be used for constructing useful recommendations
for the development of existing and new interventions employing “social marketing” principles.
Methods: The study began by employing qualitative methods. The research team was assigned to
stay in a purposively selected construction camp for two months to collect data concerning lifestyles,
social values, as well as risk behaviors and risk factors. Afterwards, a cross-sectional survey on issues of
concern was implemented. Finally the data were analyzed and presented to the community representatives
in focus group discussions. This was to verify and investigate explanations underpinning the findings;
moreover, it was expected that such a payback method, including findings, would be beneficial to
people in the communities. Results: It was found that one of the major risk behaviors observed in the
study community was alcohol and tobacco consumption. Although the target group had a number of
constraints in terms of purchasing power and time, they received relatively low payments for these excessive
workloads; however, they were offered convenience and motivation to access alcohol and tobacco
products. It was observed that legal interventions, i.e., restriction on alcohol-selling times did not perform
effectively as the study population usually purchased these unhealthy products from small community
groceries where there was a lack of inspections from police officers; besides, these workers rarely knew
about this regulation. For those who had seen or known about the law, they still did not understand the
reasons behind such a restriction on selling times. Strengthening law enforcement was therefore recommended
by academics as a strategic solution. On the contrary, this study pointed out that the use of social
marketing principles to communicate with the target group regarding the true purposes and relevant
facts of the interventions tended to help increase the effectiveness of legal interventions. Conclusions: In
order to develop suitable health promotion interventions for the target groups, health promoters needed
to understand the context and develop ways to limit their access to unhealthy products. It was recommended
that social marketing should initially be applied for promoting behaviors that are easy and require
low cost to change, such as to stop drinking in certain periods of time. This is to offer reachable
targets to the target group and once they achieve such a goal, they would be empowered to believe in their
abilities, and this would help them to step up to overcome more difficult goals, such as to stop drinking or
smoking altogether. The application of social marketing principles to existing legal interventions could
help facilitate prompt behavior change, as well as maintain desired behaviors in the target populations.
Free trade agreements are intended to spread high-quality goods to all member countries without
any barriers so that the standard of living and the wealth of the member countries would be heightened.
Tobacco, however, is not a typical good. On the contrary, it is detrimental to human life. The more cigarettes
are smoked, the more harmis incurred by both the consumer and the people in the same environment.
Hence, the dissemination of tobacco products should be controlled. This paper considers statistical
data and relevant articles, and then presents the negative impacts of free trade agreements. After a tariff
reduction of 5 percentage points resulting from the ASEAN Free Trade Agreement (AFTA), the production
of domestic and foreign cigarettes rose. Likewise, the tobacco consumption rate among adolescences
expanded. Despite a wide-ranging campaign to reduce smoking, the decline in the tobacco consumption
rate in other age groups was not as remarkable as it should have been. Moreover, AFTA hindered the
development of tobacco-control regulations. The government was likely to soften the new regulations to
avoid infringing on the free trade agreement, whereas the tobacco industry worked to prevent such regulations
in the first place by threatening the government with the terms of the free trade agreement. This
paper, therefore, suggests that, in order to strengthen tobacco-control schemes, tobacco products should
be put on the exclusion list of free trade agreements.
Background: Evaluation of the diabetic management programs among community hospitals is not
comparable. Therefore, it is recommended to use data analysis from EMRs in evaluating diabetic care in order to drive the quality of diabetic care at the community hospital level. Objective: To compare and evaluate the process and clinical outcomes of diabetic care. Method: EMRs from the period 2006-2009 were
retrieved from 18 community hospital database systems to evaluate the process and clinical outcomes of
diabetic care. The process of care was measured as having received at least one clinical lab test each year.
Data were encoded for patient confidentiality. Results: Process of Care Quality of the diabetic care process
increased from 2006 to 2009. The proportion of patients who received at least one HbA1c lab test, CHO,
TG, HDL, LDL, UA and Scr were determined in 3.95%, 37.85%, 39.80%, 29.40%, 34.14%, 17.61%, and 65.98%
of patients in 2006, respectively. These numbers increased to 26.55%, 56.09%, 59.30%, 52.07%, 57.52%,
32.15%, and 66.52% in 2009, correspondingly. Outcomes of care: Compared with 2006, the proportion of
patients who had LDL<100 mg%, TG <150 mg%, HDL ≥40 mg% were 39.53%, 32.88%, and 19.30% in 2009
respectively. In 2009, however, the proportion of patients whose HbA1c<7%, FBS 90-130 mg%, BP ≤130/
80 mmHg decreased to 25.63%, 11.55% and 12.01%, compared with 31.40%, 11.86% and 20.47% in 2006,
correspondingly. Conclusion: Although the process and some clinical outcomes of diabetic care improved
from 2006 to 2009, other clinical outcomes decreased. Proactive diabetic management programs should be implemented to enhance diabetic control.
The objectives of this study were to evaluate the effectiveness of health screening and education for
prediabetes and prehypertension individuals by randomized controlled trial. The samples were randomized
into an experimental group that received health education and a control group that had not received
follow-up for two months. Outcomes were the modifying of health behaviors, blood pressure, fasting blood sugar (FBS) and knowledge. There were 367 participants who attended the health-screening process;
6.56 percent were prediabetes, 33.75 percent prehypertension and 13.75 percent prediabetes and
prehypertension. Thirty-one of the prediabetes (15 in the experimental group and 16 in the control group)
and 49 of prehypertension (24 in the experimental group and 25 in the control group) were followed up.
The result showed that eating, alcohol drinking and exercise behavior of those who were prehypertensive
individuals in the experimental group were significantly changed (P-value <0.05) and that eating salt and
drinking alcohol among those who were prediabetic significantly decreased (P-value <0.05). Blood pressure
levels and FBS were significantly decreased from the baseline (P-value <0.05) in both experimental
groups but there was no difference in the control group. The knowledge scores were significantly higher
in the experimental group than in the control group (p-value <0.05). The results indicated that effectiveness
of health screening and education for prediabetes and prehypertension individuals could help subjects
realize the need to modify their health behaviors and reduce blood pressure and blood sugar levels.
This study was aimed at developing criteria and guidelines for identification and classification of
hardship areas. This was part of a study on “Reform of Financial Incentives for Public Health Personnel”
submitted to the Ministry of Public Health, Thailand. Criteria to identify hardship areas included transportation,
city-life effect and economic development. It was found that, in classification of hardship areas
using developed criteria, 69.8 percent corresponded with the opinions of the provincial chief medical
officers. A guideline to classify hardship areas using hardship scores and confirmation by using opinions
of the provincial chief medical officers and health inspectors involved some difficulties and limitations
during implementation. There is a need to improve this methodological approach.
This study is aimed at analyzing the health policies proposed by political parties during the campaign
for the general election on July 3, 2011. A review of official documents as well as information
disseminated through websites and mass media were used for analyzing their policy contents. It was
found that many health policies were proposed by the political parties, although they were not the main
policies used for the campaign. Policies on universal health-care coverage and development of healthcare
systems were given almost equal importance while there were fewer policies on health promotion.
Civic movements and mass media could introduce new policy agendas for the consideration of politicians.
There is a need to follow up these political parties to determine whether or not they will do as
promised once elected as the leading parties to form a government.
This study was aimed at analyzing cost savings, cost addition, and cost avoidance from medication
error interventions at Sawangdandin Crown Prince Hospital, Sakon Nakhon Province. A prospective
descriptive study was conducted from a provider’s perspective during the period February-July 2010.
Cost analysis data were direct medical care costs, probability of harm if the patient did not receive
pharmacist’s interventions, relative weight of the related drugs, and average cost of drugs.Results showed that the incidence of medication error involving out-patients was 7.56 per 1,000
prescriptions and inpatients was 5.01 per 1,000 patient-days. The cost saving was 6,309.21 baht. The cost
addition of interventions to dispense the right medicines was 5,676.52 baht. The cost avoidance of outpatient
treatment was 50.60 baht. The cost avoidance of inpatient treatment was 199,280.66 baht. Cost addition
for treatment of medication error category E-I was 7,361.90 baht. The net cost saving was 192,602.05
baht in 6 months.
In conclusion, medication error interventions can save the hospital budget and promote patient safety.
Older persons are an important resource of the nation; however, they previously had been viewed as
persons only receiving support from family and society. This research project was aimed at developing
friendship networks and increasing the potential of self-help groups to promote healthy aging among
community-dwelling older adults. Participatory action research was applied to older adults in
Woranakhorn subdistrict, Pua district, Nan Province. Data were collected using focus group discussion
and questionnaires. Content analysis was performed for qualitative data. For quantitative data analysis,
the mean, standard deviation, and paired t-test were used. The development of friendship networks and potential self-help groups resulted in several self-care
activities, including performing basic physical examinations and health evaluations, reciprocal caring
and taking care of each other within the community, and creating health-promoting activities applying
folk art and local wisdom. Compared with changes in older adults after developing friendship networks
and self-help groups, it was found that, after project intervention, the older adults who regularly participated
in the friendship group activities had friendship networks, friendship support, self-efficacy, healthpromoting
behaviors, and healthy aging greater than before the intervention, with statistical significance
at the 0.05 level. Therefore, promoting the potential of elderly individuals, empowering and using social
capital within the community can promote friendship group activities and self-help groups among community-
dwelling elders, thus facilitating the achievement of healthy aging.
Input-orientated Data Envelopment Analysis was used to measure the technical efficiency of 7
university hospitals, 24 regional hospitals and 43 general hospitals in Thailand in year 2009. The results
revealed there were 53 efficient hospitals (71.62%) from 74 total hospitals; in addition, the percentages of
efficient hospitalsin order of highest to least percentage were university, regional, and general hospital
(85.7%, 83.3%, and 62.8%).While the percentages of scale efficiency (SE = 1) in order of highest to least
percentage were regional, university, and general hospitals (75.0%, 71.4%, and 44.2%).
The next step was to identify the determinants of hospital efficiency with regression analysis using
ordinary least squares (OLS). The results revealed three significant explanatory variables for TEVRSi scores
such as bed-physician ratio, numbers of physicians, and nurses-physician ratio. The most positive influential
determinant of TEVRS scores was bed-physician ratio; however, the negative influential determinant of
TEVRS scores was nurse-physician ratio. While the significant explanatory variable for scale efficiency (SEi)
scores was the in-patient visits adjusted with median relative weight of DRG
This study aims to find factors that affect total hospital costs significantly. These
factors may be considered for adjusting the payment of contacted healthcare providers in the
Gold Card scheme. Therefore, contacted healthcare providers may obtain more appropriated
budgets from the NHSO. This study uses translog cost function to find the factors that affect
total cost hospital. Fifty-two contacted healthcare providers where have a good efficient score
are used as the sample of this study.
This study found that Case MIX Index (CMI) and Referral (In) rate affect total hospital
costs significantly. The new budget for the contracted healthcare providers may need to
consider on these two factors. Also, this study notes that doctors and nurses’ work load at IPD
are other two factors that are important in the management of hospital costs.
Non Communicable Diseases (NCDs) is the most important health problem in Thailand, in terms of
both mortality and morbidity. In the Global Status Report on Noncommunicable Diseases 2010, World Health Organization recommends 26 effective and cost-effective interventions to tackle NCDs crisis. Further
divided into 12 Best buys intervention and 14 Good buys, these population-wide policy interventions
aim to address NCDs at their five major risk behaviours. These include tobacco use, alcohol consumption,
food and beverage dietary, physical activity and Hepatitis B vaccination. This study describes theoretical
concepts of the intervention, and analyses situations, gaps and opportunities of Thailand to adopt these
26 interventions. These interventions differ in terms of strength of policy content, implementation and
feasibility to be strengthened. In conclusion, Thailand faces many major limitations in embarking these
Best buys and Good buys health interventions, including priority, resources, capacity, sustainability, monitoring
and evaluation, and coordination. While some are not exists at macro scale in Thailand, some interventions
were not primarily designed for health purposes.
Services to provide screening, treatment and rehabilitation of alcohol-related problems are covered
under the Universal Health Coverage Scheme in Thailand. However, massive number of population with
risks and patients are practically ignored, do not get what they should be serviced, from the current health
care system and practices. Unintentionally but significantly, the shortage to provide proper care, escalates
the magnitude and severity of alcohol problems. Technical evidence shows the need, appropriateness,
benefit and practicability of the comprehensive services for alcohol related problems with in Thai health care system. The comprehensive service should cover four interconnected components; 1) alcohol screening
and brief intervention, 2) Detoxification and treatment of physical co-morbidity, 3) Alcohol treatment
and rehabilitation, and 4) Long term after care. Major limitations at macro scale is the lack of policy to
strengthen health care system in addressing alcohol problems, including in raising significance, building
up preparedness and capacity of the systems, providing incentive, and resource management. Critical
constraints at institutional level include awareness and capacity of health workforces, the lack of risk
assessment and management, the unavailability of clear and comprehensive policy. The framework to
strengthen Thai health care system response to alcohol problems should tackle major system gaps in
current systems, and strike balance of and cover all four components in parallel.
While a fiscal policy has been shown to influence food and beverage prices in ways which help encourage
healthier eating behaviour, evidence about the use of tax and price interventions is still unclear and
questions about their effect still remain. A systematic review on food and beverage tax and price interventions
was conducted in order to explore evidence about tax and price interventions to promote healthy
dietary behaviours and investigate their effect on consumers. The English and Thai-language published and
grey literature for studies on tax and price interventions including monetary subsidies or taxes levied on
food and beverage and their effects were searched. Twenty-seven studies met the inclusion criteria. 4 were
from the peer-reviewed literature, 21 were published online and 2 were from grey literature. The studies
mostly focused on taxing snack, confectionary, soft drink and soda, and on subsidizing staple food such as
rice, wheat and maize. These interventions particularly taxation were found in influencing diet and body
weight. In conclusion, taxes and subsidies in food and beverage may be a useful tool contributing to healthier
consumption patterns at the population level. However, more information is needed on actual response on
food and beverage and consumers in food and beverage taxation and subsidy in developing country particularly
Thailand along with information on how effective food and beverage taxation and subsidy would
be and particularly their effect on people in developing countries.
According to the cost-of-illness studies, economic impact of alcohol consumption is substantial. Impact
of alcohol and smoking on productivity loss due to premature mortality and morbidity is enormous and clearly affect economic system of the country. According to the cost-of-illness studies, the followings
are policy recommendation; 1) Alcohol control policy should be set as the national priority; 2) collaboration
from all related organizations not only those from the health care sectors but also other economic
organizations both government and private as well as enterprises at all levels are needed; 3) Policy/
intervention aims at preventing new drinker as well as encouraging drinker to quit at the early age are
essential. However, policy/intervention targeting at prevention of adolescent from start drinking are more
cost-saving than policy encouraging drinker to quit. In addition, encourage drinker to quit at early age is
more cost-saving than at the older age; 4) Policy/ intervention targeted at preventing new responsible
drinker or encouraging responsible drinker to quit is still important, as responsible drinkers accounted
for the highest proportion in the country; and 5) All related organizations should collect data in term of
the number of new drinkers or quitters attributable to the policy/intervention in order to use them to
conduct cost-effectiveness of such policy/intervention in the future.
The adherence of antiretroviral therapy (ART) higher than 95 % is needed for the effectiveness
of HIV suppression. prevention of opportunistic infections, reduction chance of HIV transmission
and overall health improvement. Aim of the study was to find facility factors related to adherence of
ART under the universal coverage. Methods: A cross-sectional study was conducted among 823 HIVinfected
individuals who were receiving antiretroviral under National AIDS Program (NAP) in 9 public
hospitals in 3 provinces (3 regional and 6 community hospitals). Adherence had been assessed by pill
count and self-report using Visual analog scale (VAS). This study was approved by ethical committee of
the Ministry of Public Health. Results and discussion: Average adherence from pill-counts and selfreport
was 87.4% and 49.7 % respectively. Adherence from regional and community hospitals evaluated
using pill-count respectively was 82.7 % and 95.2 % while using self-report respectively was 46.3 % and
56.5 %. Logistic regression model shows community hospitals were correlated with higher adherence
than regional hospital from self-report by VAS (OR=1.51; 95 % CI:1.13 -2.02, p=0.006) and from pill-counts
(OR=4.17; 95 % CI:2.10-8.31, p<0.001). Although ART service in all hospitals was under the same Universal
Coverage scheme, the difference of adherence is existed. Related factors might be from patient-staff
relationship, ease of travel, ART-one-stop service and exclusively isolate clinic in small hospitals while in
large hospitals there are many patients visited under limited service area and not separated from other
clinics for receiving ART. Conclusion(s): Regional/general hospital might need substantial supports on
budget and personnel as well as the allocation of service space and increasing interest of the clients on
adherence on ART.