plueme/wizJson huggingface dataset:
Ambulatory Care Sensitive Conditions (ACSC) are disease groups or medical conditions
that, if patients are effectively taken care of in the ambulatory setting, hospital admissions can
be avoided or preventable. This study aimed to assess performances of primary-care provision
in the Bangkok area using 13 ACSCs set by Agency for Health Research and Quality (AHRQ),
USA. The analyses were conducted by using inpatient-service reimbursement databases from
2007 to 2014 of the Universal Coverage Scheme (UC), the Civil Servants Medical Benefit
Scheme (CSMBS) and the Social Security Scheme (SSS).
The study findings indicated that it was very likely to use ACSC statistics to assess
primary-care performances in the Bangkok area. Based on the year 2011 data which was the
most complete for all population groups, the Top 3 ACSCs were urinary tract infection,
congestive heart failure and adult asthma, respectively. The other close-call groups included
hypertension and angina without procedure. Surprisingly, the hospital admissions caused by
short-term and long-term complications of diabetes mellitus were not as high as expected.
ACSCs’ Inpatient services in the Bangkok area, particularly for the UC population, were
mainly for patients from Bangkok itself rather than those from vicinity provinces or other
provinces. It was worth noted that the amount and proportion of the hospital admissions in most
of the ACSCs were highest among patients registered with private providers (e.g. private
hospitals), followed by those registered under Bangkok Metropolitan’s provider network. It was
also found that the CSMBS patients tended to be in older than UC and SSS patients in almost all
ACSCs. They were also more likely to get admitted with Hypertension and COPD, compared to
the latter two groups.
Nevertheless, ACSC might not be applicable without restriction. There were problems
with the databases as they were from different responsible agencies with differing working
processes and data-processing capabilities. Quality of the databases varied somewhat.
Moreover, data analyses were affected by the fact that the three health schemes were designed
differently in terms of beneficiary registration.
In sum, primary-care services in the Bangkok area needed improvement. The most
significant ACSC target would be around heart and vascular diseases, along with the development of ACSC measures and quality of the databases such that they could be applied
in monitoring access to and quality of primary care.
The objectives of the study of Social Care System for Elderly are to study and
synthesize meaning, area and format including mechanism of social care for dependent
elderly in abroad to present guidelines for integrating health care and social care system for
dependent elderly in Thailand. This study is documentary research which data are collected
from textbooks, research reports, academic journals, theses and related electronic data about
social care in Thailand and other countries such as United Kingdom, United States, Canada,
Australia and Japan. Due to those countries have good role models for elderly welfare that
could be applied and presented integrating of health and social care for Thailand. The findings
are as follows;
Social care is the system designed to help, protect and educate elderly who face
physical and psychological problems. It would help elderly to self-support in daily life or help
them to better develop their potentials. The formats of social care service are family, social
and also institutional levels. In addition, social care mechanism setting must start from
government agencies as the center to set policies, resources, administrative formats, service
formats, budgets including responsibility transition to local authorities and create formal and
informal social care networks for always and thoroughly driving care to elderly and families to
create good quality of life to elderly. The important mechanism to push dependent elderly to
effective service is to consider elderly qualifications and set channels to access social care
services as the following steps: 1) Examining elderly rights 2) Evaluating elderly for considering
care activities 3) Paying care expenses 4) Getting services according care activities.
The recommendations for developing social care system for elderly divide into 5
aspects: 1) Creating basic concept, importance and readiness of social care 2) Seeking ways for
developing suitable social care service for elderly 3) Planning to produce and develop human
resources who expertise in caring elderly with quality 4) Setting administrative approach for
driving elderly implementation 5) Setting and integrating funds for health and social care.
This paper aims to review and describe method to determine outlier trim point for outlier cases in
diagnosis related group. This review demonstrates concept and experiences in each country. The outliers
cases divided into 2 categories: length of stay (LOS) outlier and cost outlier. Outlier trim point methods for
LOS were 4 methods: inter-quartile range (IQR) method, 10th - 95th percentile method, L3H3 method and
geometric mean method. The literature review will be information for decision in formula of outlier trim
point in Thailand. Since the trimming of outlier cases will effect for relative weights that used for payment
to hospitals.
Background: Increasing trend of traditional and alternative medicine use has been documented
worldwide. In many developing countries, the majority of the population continues to use traditional
medicine to meet its primary health care needs. In Thailand, the Thai traditional medicine service using is
a fundamental right for all Thais according to the constitution as well as Universal Health Care Coverage
program. However, none of the study has been conducted to survey for Thai traditional and alternative
medicine (TT & AM) services together. This study therefore aimed to survey the data of TT & AM services
as well as to study the factors influencing utilization of TT & AM services in the outpatient department of
the hospitals under Ministry of Public Health. Method: The data of TT & AM services were collected
from October 2013 to March 2014. 456 data collecting forms were distributed through representatives of
Thai Traditional services in 76 Provincial Health Offices under Ministry of Public Health. The factors
influencing the utilization of TT & AM services at the outpatient department were analyzed with multiple
linear regressions. Results: 266 out of 456 data collecting forms were filled and sent back. The response
rate was 58.33%. Only 231 hospital responses (86.84%) could be analyzed. 186 hospitals (80.52%) provided
only Thai traditional medicine services while 45 hospitals (19.48%) provided Thai traditional medicine
services together with alternative medicine service. 10.93% of the total outpatient department (OPD) visits
was the utilization of TT & AM services. Factors influencing outpatient department utilization of TT &
AM services were the number of staffs (p-value < 0.001), clinical competency for inpatient services
(p-value = 0.002), the number of staff receiving wage at least 15,000 Baht per month (p-value = 0.017),
being a study/visiting site for education (p-value = 0.011), continuing year of services (p-value = 0.004)
and herbal consumption value (p-value < 0.001). Recommendations: To strengthen the support of TT &
AM service, the relevant agency should develop more suitable workforce in service units and pay them
appropriate salary. In addition, the practitioners need to be developed in their clinical competency and
academic networking with universities is also crucial for implementation.
The use of legal process to protect and prevent the Thai youth from easily accessing to tobacco is one
of the important missions at the national level. In the past, some facts indicate failure. This article aims to
review the weakness and to present proposals for reform the laws for restriction of access to tobacco
among youth in Thailand. Using the literature review of research and article related to both domestic and
foreign that published or produced since 1990 to 2015 in databases, Cochrane Tobacco Addiction Group,
PubMed, Thailist and google.This study found that Thailand needed to reform limiting youth access to tobacco laws on two
issues. First) the content of the law is not up to date with the new marketing strategy of the tobacco
companies and sale behavior of tobacco retailer, and second) the law enforcement is ineffective. Two
reforms related to tobacco laws are proposed. First, amendments of 2 Acts: 1.1) The Tobacco Production
Control Act B.E. 2535: (1) changing the definition of the term “advertisement” and issuing additional laws
on prohibiting all types of indirect advertisement of tobacco, (2) prohibiting sales of individual cigarette
or in small packages, (3) demanding plain packaging practice of tobacco product, and (4) identifying
provincial authority to control tobacco at provincial level. 1.2) The Tobacco Act B.E. 2509: to limit the
number and location of the tobacco retailers in the community and near schools. Second, strengthen law
enforcement: 2.1) developing the database of tobacco retailers, 2.2) developing the measures that enforce
law more effectively, and 2.3) developing the community participation in solving the problem of easy
access to tobacco among the youth.
This study aimed to quantify the cost of institutional long-term care at Thammapakorn Social Welfare
Development Center for Older Persons in Chiang Mai Province in 2014. The population of the study
was all 104 older persons who lived at the center. The sample comprised 24 older persons with at least moderate dependence level as measured by activity of daily living or ADL scale (N = 24). Activity-based
costing was used. Cost allocation was based on long-term care needs of each older person in the sample,
documented through activity logs and records of resource utilization pertaining to each activity within 72
consecutive hours. Two sets of costs were estimated, depending on assumptions related to depreciation
expenses of the following cost items: buildings, vehicles and equipment. It was found that, based on the
first set of assumptions, the average costs of institutional long-term care for older persons with total ADL
dependence (N = 19), with severe ADL dependence (N = 4) and with moderate ADL dependence (N = 1)
were 461.39, 456.91 and 445.20 baht per person per day respectively. Based on the second set of assumptions,
the average costs of institutional long-term care for older persons with total ADL dependence, with
severe ADL dependence and with moderate ADL dependence were 449.89, 445.42 and 433.71 baht per
person per day respectively. Approximately 17% of the estimated costs came from cash and non-cash
donations. The results reflected the fact that the budget received from the government, without monetary
and non-monetary support from other sources, would be insufficient for the level of long-term care being
provided at the center.
Alcohol-drinking is one of the most important public health problems related to an increase risk of
suicidal behaviors. The objectives of this cross-sectional analytical study were to determine the prevalence
and factors associated with suicidal ideation and suicide attempt in mental and behavioral disorder
due to use of alcohol. Subjects were 303 patients diagnosed with ICD-10 code F10.xx and admitted in
Suanprung Psychiatric Hospital during 1 October 2012 to 30 September 2013. Data of various factors were
collected from medical records. Results of the study revealed that prevalence of suicidal ideation and
suicide attempt were 22.4% and 5.0%, respectively. Factors significantly associated with suicidal ideation were having psychological comorbidities (adjusted OR = 2.58 95% CI; 1.14-5.85, p-value = 0.023), previous
suicidal ideation and previous suicide attempt (adjusted OR = 3.00 95% CI; 1.40-6.40, p-value = 0.004 and
4.27 95% CI; 2.31-8.94, p-value < 0.001, respectively), numbers of problems or life-events, more than 3 and
2 life events (adjusted OR = 4.36 95% CI; 1.53-12.41, p-value = 0.006 and 3.22 95% CI; 1.08-9.57, p-value =
0.036, respectively), and patients who drank 40 degree-rice clear liquor (adjusted OR = 3.10 95% CI; 1.33-
7.20, p-value = 0.009). Regarding factors related to suicide attempt, it is found that previous suicide attempts
and psychological comorbidities were statistically significant associated with suicide attempts
(adjusted OR = 4.36 95% CI; 1.53-12.41, p-value = 0.006 and 3.22 95% CI; 1.08-9.57, p-value = 0.036, respectively).
In conclusion, close monitoring should be emphasized in patients who had problem associate
with alcohol drinking and had previous suicidal ideation or previous suicide attempt(s), particularly in
those with psychological comorbidity and had more than 2 life-events.
Birth asphyxia and low birth weight were important causes of mental retardation, delayed development,
learning disabilities and cerebral palsy. This retrospective research was aimed to study the outcome
of Thai Child Development Integration Project in Sungmen Hospital. The subjects studied were 51
patients who attended the Well Child Clinic from October 1, 2013 to September 30, 2015. Developmental
Assessment for Intervention Manual [DAIM] was used to evaluate child development. The majority of
patients were low birth weight (86.3%) and were female (64.7%). Most of the low birth weight (72.7%)
were intrauterine growth restriction. The influencing factors of birth asphyxia were from delivery and
abnormal delivery (57.1%). Most mothers had secondary education (37.2%). Primary caregivers were
parents/grandparents (51%). Infants fewer than six months of age were predominant breastfeeding (62.1%).
The majority of patients had normal child development (78.3% - 97.8%). The growth, weight for age,
height for age and weight for height were normal in range. Neurodevelopmental assessment at 1, 4 and 12
months of age were normal. Anemic patients (hematocrit less than 33%) at 6 months of age were 22.6%.
Iron supplement statistically improved anemic condition (P = 0.012). The Thai Child Development Integration
Project could be established in a community hospital by training DAIM skill and be most effective
for birth asphyxia and low birth weight.
This study was an analysis of the situations and trends in the Thai Traditional Medicine (TTM)
services in Thailand, especially the illnesses and treatments with TTM, based on the data derived from the
2009, 2011, 2013 Health and Welfare surveys, conducted by the National Statistical Office, which interviewed
a sample of 28,000 households across the country each year. The trends in such services were
compared with those derived from other data sources during the same period.
The results showed that most Thai patients attended state health-care facilities, whereas a small
proportion of them sought medical care from Thai folk/traditional healers or masseurs at less than 2% of
all patients. Among all patients, the 25-59 age group sought TTM services, about the same proportions
ranging from 50.0% to 60.3% in 2009, 2011, 2013. Regarding their illnesses, the second most common
illness was chronic back and muscle pain, but their use rates were highest at 27.3%, 33.4%, and 31.1%,
respectively.
In conclusion, only a small proportion of the Thai population use TTM including herbal remedies,
but with a rising trend. Thai massage therapy is most popular in working-age people. Thus, such service
should be further developed and promoted through the integration with the use of herbal remedies and
other TTM services.
The Pharmacy Council of Thailand has set a system of accrediting pharmacies
on standard professional practices. Pharmacists in accredited pharmacies are capable of providing professional services to people under the universal health coverage scheme (UCS). Community pharmacies
in Thailand are, at present, not included in the UCS. Consumers’ opinions on integrating pharmacy
services to the UCS are useful for the model design in the future and are the objectives of this study.
Methodology: This study was composed of 2 parts. In part 1, two percents of clients from accredited
pharmacies in Khon Kaen province were conveniently sampled to answer 4 levels of agreement questionnaires
regarding a proposal if accredited pharmacies were incorporated in the UCS. Opinions to overall
and each proposed activity were analysed into percentages, Chi square test and multiple logistic regression.
In part 2, in-depth interview was conducted in another 36 clients regarding scope of pharmacy services,
advantages-disadvantages, and service charge, if accredited pharmacies were incorporated in the
UCS. Data were analysed by content analysis. Results: From 298 analysable questionnaires, more than
80% of the respondents replied that they agreed and would come for the services in 7 out of 11 proposed
activities. Agreement and intention to come for the services of the rest activities were: 78% for pharmacist
monitoring drug treatment in chronic patients, 69% for patient registering with accredited pharmacies,
62% for pharmacist recording patients’ profiles, and 44% for pharmacist doing home visit. In-depth interview
revealed that the consumers expected to receive quick and convenient pharmacy services which
were real problems of the existing system. They also mentioned about the extended roles of community
pharmacies. Discussion: Clients’ opinions were in accordance with the opinions from the high rank administrators
and from the experts in previous studies about incorporating accredited pharmacies into the
UCS. However, the proposed pharmacy activities needed to be justified to the consumers’ requirements
and in accordance with the existing system.
Thailand has experience of health care reform for a decade. Therefore health care services require more new health workers with more capabilities and competencies according to the changes in the system. Praboromarajchanok Institute for Health Workforce Development (PIHWD) is a government organization and responsible for production and development of health workforce to serve the needs of the Ministry of Public Health (MoPH). This qualitative research was designed to study health workforce needs, the desirable competencies of the graduates and distribution of health workforce who graduated from Sirindhorn College of Public Health under PIHWD, MoPH including Bachelor degree in Community Public Health, Community Dental Public Health and a high class certificate of Pharmacy Technician. Data were collected by in-depth interviews and focus groups discussion between June and October 2558. The purposive sampling was applied and 8 provincials were determined by using geographic information system (GIS) distribution of health workforce. The samples consisted of executive’s administrator from Ministry of Public Health, PIHWD and Provincial, District and Sub-district of Public Health Offices. They were also chiefs of Local Authority, supervisors and co-workers of the graduates and local people. Content analysis was applied using transcriptions from audio recordings and memory information. Data summary were then classified and interpreted for research conclusion. The study showed that most executives have commented that three professionals’ health workers are still shortage consideration by using GIS and the hourly rate equivalent employees (FTE). The distribution of health workforce of these programs is disproportion mainly in the central region where is densely than in the Northeast. In addition, the retention rate in position was decreased because of the lack of motivation at work. Producing health workforce of the 3 programs should come from Sirindhorn College of Public Health under PIHWD because of the expertise of the staffs and they provide specific training programs that serve community needs, especially bachelor of community dental public health and a high class certificate of pharmacy technician. These are the only programs that have been produced in Thailand. The desirable performances of the health workers are not only
their specific health professionals. They should have a new set of the 2 1 st century
skills including learning, literacy and life skill such as abilities of leadership,
Knowledge Management, conducting research, plan strategic, information technology
and necessary languages. The results indicated that the production of health
workforce is still the needs in order to serve the changes of health care system.
Stake holders who are involved should consider various factors that come into effect
on the production of health workforce. Thus, a mechanism for driving the
development of research on the health professionals from three programs should
continue and systematic develop in order to force the policy into practice, literally.
Development of an integrated data visualization system for health examination survey data on
the internet is an extension of data presentation and utilization of the 4th national health examination
survey during 2008-2009 by increasing the variety of variables used in the system for responding to
wider demand of users and providing more accessibility of data via the internet.
Steps of development started with the study of variables collected in the survey for adults aged
>= 15 years and children aged 1-14 years followed by selecting and grouping of variables for
preparing dataset used in the next steps. Design of data presentation and visualization composed of 3
models. The first model is the presentation of outcome measures including proportion, multinomial
proportion and mean divided by 1-2 categorical variables which can be either characteristic or
outcome data. The second model is the presentation of correlation pattern at individual level between
a pair of continuous variables which can be either characteristic or outcome data and can be filtered
by one categorical variable and disaggregated by another categorical variable. The third model is the
presentation of distribution pattern of samples divided by 1-2 categorical variables which can be either
characteristic or outcome data. The number of outcome measures for the first model is 103 in 21
groups for adult and 30 in 10 groups for children. The number of categorical variables for all models is
106 in 27 groups for adult and 63 in 19 groups for children. The number of continuous variables for the
second model is 35 in 12 groups for adult and 23 in 8 groups for children. The next step was data
processing for each data presentation model. This process provided summary data or corresponding
data for each model. Finally, the data visualization on the internet was designed and developed using
appropriated data visualization tools. Users can select the variables to generate the graphical
presentation as demanded and can export graph to image file and excel table for further usage.
The result of development of data presentation and visualization for the 4th national health
examination survey data showed the possibility to extend to the 5th national health examination data
with one more model for comparing the 4th survey data with the 5thsurvey data to show the changing
trend overtime. Moreover, from the variety of outcome measures and variables selected in the system,
this system can provide various objectives of data utilization including targeting population and area
target, monitoring disparity of health and health care among population, exploring relationship among
risks and between risks and outcomes, and building new research question and hypothesis.