plueme/wizJson huggingface dataset:
Healthcare financing is one of the building blocks of health systems.
Understanding how hospitals deal with various payment schemes and finance their
health care services would be crucial in improving health financing policies at the
macro level, particularly in the health systems with multiple heath-financing
schemes. In Thailand, there are currently three public healthcare financing schemes:
the Universal Coverage Scheme (UC) which covers approximately 75 percent of the
population, the Social Security Scheme (SSS) which covers approximately 13 percent
of the population, and the Civil Servants Medical Benefits Scheme (CSMBS) which
covers approximately 10 percent of the population (HSRI & WHO, 2006). It is crucial
to note that, there still remains a group of patients who choose to give up their
health benefits from the above three schemes and decide to pay out-of-pocket to
receive health care services from both public and private health care providers.
In the past, health systems researchers have focused only on the financing
mechanisms within particular health schemes, without addressing possible side
effects on other schemes. Given that the reimbursement policies for the three
schemes are quite different both in terms of reimbursement rates and payment
methods, hospitals are likely to have different financial incentives in treating patients
from different health schemes. Thus, this research attempts to address hospitals’
financial incentives in responding to the difference in reimbursement policies. In
particular, it seeks to identify and analyze possible cross-subsidization across health
schemes within the public hospitals in Thailand. Based on the qualitative content analysis, 13 sub-themes related to the
concept of cross-subsidization emerged. They can be categorized into four major
themes. First, the concept of cross-subsidization is perceived and understood very
differently among hospital administrators. Second, payment policies of health
schemes create obstacles to hospitals’ financial management. Third, organizational
factors of hospitals also create obstacles to hospitals’ financial management. Lastly,
hospitals respond to payment policies of health schemes by various measures.
The quantitative data analysis revealed that unit-costs are different across
schemes even if other characteristics are controlled for, and the differences between
reimbursement and cost vary across different schemes in a systematic pattern. In
particular, there is a gain from providing healthcare to CSMBS patients, while there is
a loss from providing care to other groups of patients, such as UC and foreign
patients. Nonetheless, these quantitative results do not indicate that the hospitals
intentionally make a profit from providing care to CSMBS patients in order to
subsidize its loss. In fact, this could be an evidence of “passive cross-subsidization,”
where the cross-subsidy results from insufficient reimbursement from particular
groups of patients. Lastly, there is no evidence that the hospital “cost-shifts” by
increasing the price charged to OPP patients to compensate for the UC loss.
This study aimed to better understand the management and the operation of health
facilities under 'Health Insurance Policy for People with Citizenship Problems: the Cabinet
Resolution on 23rd March 2010', which enabled the target population to access to essential
health services, through a case study in Ranong and Tak province.
This study suggests that HIS-PCP successfully reduced the expenditure from receiving
healthcare services in the target population and also made health facilities gain more revenue. However, it did not signifcantly change the utilizations of the target population and the service
burdens at health facilities. Futhermore, there remain unsolved problems in managing the
system. A comprehensive review on advantages and disadvantages of the operation of HISPCP
as status quo comparing with other alternatives in managing the system is recommended.
This study has three main objectives first, to study influence of social model of
disability and human rights of disabled people approach which reflect to project, plan
and social movement of disabled people in Thailand. Second, to study interaction
between ideology and discourse in Global level with social practice and implement of
organizations in local setting which exercise over disabled people’s social life. Third, to
develop the contemporary social science research on disabled people program
This study shows that transformation in policies of the Thai state, economic and
political contexts, the discourse power of international organisations and Humanitarian
reason of Theravada Buddhism contribute to the generation of an ethic regime of the
proper body of Thai citizens. As a result, the impaired body became a ‘political object’
and problematized as ‘moral-political object’. People with an impairment in Thailand
have lived in an ambiguous situation between citizen and non-citizen, or between able
bodied and disabled bodied. Their ambiguous situations are excluded by means of an
inclusion through the technology of power in the modern Thai state. This study argues a
weak point of the social model’s dualism: the model considers that impaired body is
neutral phenomena while disability is a social construction this study discusses the
emphasis within the model that there is no pure or natural body, impaired body is not a
naturalistic and it is, in essentialist term, as pre-social and ahistory which is free from
biopolitics, and existing outside of discourse. This study shows that disabled people are
products of technology of power and biological discourse in modern Thai state
Moreover, this research reveals the ideology of human rights as the political-moral
project in global that is translated in local by associations and social activists in Thailand.
As a result, human rights as moral language and moral progress are being transformed into
a political apparatus to respond to the discourse about morality in local by Karma
ideology and rhetoric of Vedana of Theravada Buddhist. This research also shows that the
human rights of people with disabilities to establish itself to become a dominant moral
discourse has created a singular moral category. The results is that it is discrimination
against people with disabilities of some kind especially blind singers whose image is close
to the image of beggars that social activists who are active in social politics on the
concept of human rights tried to eliminate.
The finding of this study lead to the suggestion that the framework of social
science research on disabled people program should understand disabled people’s life world as the produce of interaction between Global ideology with local moral world.
Moreover, this study suggests that in order to develop the research program has to
focuses on strategies which use research process as knowledge generating tool and tactics
which emphasize on management cooperation and research cooperation
This report presents a draft proposal of the organization, scope,
missions, structures, mechanisms and linkages of a national data clearing
house (NDCH) for the Thai health security schemes. It is drawn from the work
of the assigned taskforce under the supervision of the steering committee
appointed by the Health Insurance Systems Research Office (HISRO), using
brainstorming sessions, extraction of key contents from technical papers written
by selected Thai experts in the field, and reviews by the committee.
In sum, the basic missions of NDCH should include data assessment
and information processing for reimbursement purposes for health services;
research, development and determination of data standards, databases and
information systems to be used in reimbursement processes in order to meet
requirements of health security organizations and related government agencies,
while feasible for providers to comply effectively and efficiently; building and
administering warehouse of reimbursement data, as well as performing data
analysis, review, and creating information applicable for policy management,
system management, utilization review of health resources, and for use in
research and development; information services for other governmental
agencies for academic research; and revenue generating to support its operations
and development. To accomplish the missions, NDCH needs to develop effective
work systems, organization structures and governance.
We aim to study the rates and correlating factors of stroke patients returning to work after treatment
byretrospective descriptive cohort at Prasat Neurological Institute. 198 stroke patients who received treatment
and were subsequently discharged from the Prasat Neurological Institute during January 2010 to
December 2011.Patient medical records were reviewed to select patients who satisfied the inclusion criteria
of the study. Follow-up questionnaires about patient’s return to work were sent to the patients via post.
71.72 % of the 198 stroke patients surveyed could return to work. Statistically significant differences
were found when accounting for occupation, job characteristics, muscle weakness, aphasia of speech,
altered level of consciousness (Glasgow coma score<15), pre-discharge Barthel Index (BI) score, and physical
therapy during hospital admission. Multivariate analysis indicated that only occupation and pre-discharge
BI score contributed to the prediction of returning to work. Patients from private companies vs. governmental
employees had BI scores of 80-100 vs. 0-39, with an odds ratio of 1.279 (0.255-6.41) and 7.333 (2.821-
19.062) respectively. Significant predictors for returning to work after stroke were occupation and predischarge
BI score.
The action research was conducted to study the potential of local organizations on elderly care
management, especially for the disabled elderly in the community, and to assess their needs. The results
showed the potentials of local organizations on disabled elderly care management in 1) manpower: multidisciplinary
teams give care in community 2 ) money: there are budgets to support health promotion
activities, 3 ) materials: materials and equipments were distributed to the elderly and 4 ) management:
local organization provides peer-education programs, training for community leader and health volunteers,
communication assistance and also 24-hour mobile car for referral. Lack of trained elderly caregivers
and the cooperation of family members were the barriers on elderly care management. The elderly needs
a day-care center, trained caregivers, a suitable environment, increased welfare allowance, and 24-hour
hot-line service. Both government, private organizations and family members should therefore collaborate
on establishing an elderly care training, budget or material support, and a day-care center.
This is a participatory action research on the Holistic Care Model Development for the Elderly of
mechanisms involving Local Administrative Organizations, sub-district health promoting hospital,
volunteer, elderly, community leader, monks, teachers, caregivers and community people to share their
knowledge with the Mahidol University research team and the local research team in eight sub-districts of
Nakhon Pathom and Kanchanaburi provinces. The process was divided into 6 steps: 1) community preparation
2) the elderly-need assessment 3) Assessment of potential mechanisms 4) Community feedback
5) Additional activity development 6) Public data dissemination.We found that the holistic care model for
the elderly should cover health surveillance and care for the depressed, continuous development of occupation
for the elderly, distinguishing selection in urban and rural areas, coverage of every elderly group,
and the networking mechanism in the community
Study on Alcohol’s Harm to Others (HTO) is an innovative paradigm for revisiting the whole range
of alcohol-related problems. It comprehensively focuses on the negative consequences of alcohol drinking
to non-drinkers. Patterns of relationship between drinker and non-drinkers play a major role for this
harm. Problems emerged from drinking by family member, relative, friend, colleague or stranger in
society can be vastly different in terms of magnitude and pattern. The range of HTO covers from the less
severe such as mere annoyance to the most severe such as assault and death. HTO-related national data
were only available from social cost study, population survey and data of service system such as the
hospital, the police and court cases. But due to methodological or conceptual constraints, the data might
not best reflect the real situation. While Thai society may recognize alcohol-related traffic accident and
domestic violence as HTO, other problems have been largely ignored. Other HTO issues have not been
covered such as quality of life, impact on physical, mental health and belonging of people surrounding
drinker, impact to children and youth from parents and caretakers as well as impact on co-workers in
workplace. Comprehensive HTO data could demonstrate panoramic magnitude and severity of negative
impacts to the public, support alcohol policy development, and raise public awareness.
This descriptive study aimed to explore oral care utilization among children aged 5-14 years under
the Civil Servant Medical Benefit Scheme (CSMBS) and the Universal Health Coverage System (UCS)
which have been implemented since 2001, using the data of 2003, 2007 and 2011 Health and Welfare Survey
conducted by the National Statistic Office. Members form households selected by stratified two-stage
sampling were interviewed. Total samples were 68,433; 69,679; and 71,847 persons, respectively, in which
there were 12,048; 11,395; and 10,489 persons respectively, in the 5-14 age group. The data were weighted
to represent total population.
Among three surveys, this age group had decreasing utilization rates and frequencies. The UC children
had lower utilization rate than those of CSMBS (14.89 vs. 22.35 persons/ 100 population, 11.99 vs.
20.26 persons/100 population, and 10.60 vs. 15.74 persons/100 population, respectively) as well as lower
frequency (0.23 vs. 0.40 visits/ per capita, 0.16 vs. 0.33 visits/ per capita and 0.15 vs. 0.27 visits per capita,
respectively). The greater differences were found in regional areas than in departmental areas.
The differences of utilization rates increased from 33.38 % to be 40.82 % in 2007 and decreased to be
32.66 % in 2011 while the frequency percent differences increased to be 51.52 and 44.44 % in 2007 and 2011,
respectively. These evidences indicated inequity of oral care accessibility between the two schemes.
We aim to examine the food advertising in children’s television programs based on Notification of
the Public Relations Department Announcement on “Criteria and duration of time for advertising on
radio and television that may have an impact on children”, dated 18 January 2008, and to propose policy recommendation in regulating food advertising in children’s television programs in Thailand. The study
on advertising during children’s programs in free TV on 18th September- 8th October 2010 was conducted
to identify the duration, frequency, technique and strategy used for advertising, and type of products
advertised based on the previously mentioned Notification.
25 (64%) of 39 of children’s programs advertised more than 10 minutes per hour. Of the 39 children’s
programs, 15 (38%) had half of their advertising time that could have an effect on children. Technique and
strategy used for advertising did not follow the criteria in the Notification. Eight products no warning to
consumers to children announced by the Food and Drug Administration regulation. 82 percent of children’s
television programs had indirect advertorial.
Advertising in children’s television still did not follow the Notification of the Public Relations
Department Announcement. The duration and frequency that were in violation of the Notification
decreased from the year before. The Office of the National Broadcasting and Telecommunications
Commission (NBCT) should establish new regulations to protect children and enforce compliance from
the media.
This study reviewed the prevalence of moderate and severe visual loss, as indicated by the World
Health Organization’s definition of low vision and blindness, in the Thai population. Three data sources
from national surveys of the Thai population during 2006-2009, namely 1) the forth National Survey of
Blindness and Low Vision in Thailand during 2006-2007; 2) the 2007 Disability Survey; and 3) the fourth
Health Examination Survey in Thai Population in 2008-2009, were reviewed. In addition, reviews of
visual loss in other countries were conducted using structured search terms in PUBMED. Due to differences
in the definition in each Thai survey, the prevalence of visual loss revealed varied results. The 2007 Disability Survey showed visual loss prevalence (moderate: 0.80%; severe: 0.063%) was lower than the
2006-2007 National Survey of Blindness and Low Vision (moderate: 3.69%; severe: 2.04%). The prevalence
of moderate and severe visual loss in the 2008-2009 National Health Examination Survey was 30.2% and
3.4 respectively. In conclusion, every study revealed that prevalence of visual loss in Thais increased with
age and was greater in female. It is also found that high-income countries have lower visual loss, as
indicated by prevalence of blindness and low vision, than medium- or low-income countries.
Although the provision of school lunch for primary school children was established since 1952 in
Thailand, evidence indicates the limitation of the school-food program in tackling over- and under- nutrition.
This cross-sectional mixed method study aimed to analyze school food management systems and
determinants which affected the nutritive value of school lunch, food safety and types of food and drink
available in school. The qualitative study was done by in-depth interview and focus group discussion
with key informants. Quantitative data was drawn from self-reported questionnaire from 226 primary schools. Descriptive statistics and correlation analysis were used in data analysis. The results showed that
the nutritional values from lunch menus achieved only 74.11% of the target. For energy and types of
nutrients, lunch menu achieved only 79.24% of the target energy; and 56.94%, 48.89% and 37.51% of the
target iron, vitamin A and dietary fiber, respectively. Size of school, type of school and use of the community
farm products were significantly associated with the nutritive value of the school lunch (p < 0.05).
Most of the school had the food safety program, whereas two-third of the schools had food and drinks
high in fat, sugar and sodium contents. The result indicated that the schools under the Bureau of Border
Patrol Police (BPP) can provide better nutritive lunch than others and can thus be a role model. Challenges
include the improvement of the food safety management and the control of high fat, sugar and sodium in
school food and drinks
Regional Medical Sciences Center 10th Ubon Ratchatani is the medical and public health laboratories
which play an important role in public health surveillance and improvement for the Regional of Service Provider 10th. Laboratory Quality System was used as a parameter for customers reassuring.
To evaluate the development of laboratory quality system, the CIPP model including context, input,
process, and product evaluation was used. In this process, the secondary data was collected as well as the
questionnaires for customers, satisfaction surveys of the target groups including customers, official
workers and executive/head of the agency in the Regional of Service Provider 10th during July to
September. The results concern the quality, efficiency of the service, and outcome of the development.
The service quality showed that 82.3% of the items passed the criteria for an inter-laboratories proficiency
testing while 90.4% of the proficiency testing showed the accurate results. The customer’s satisfaction also
showed 83.0-90.0 % and moreover, customer’s complaint showed 2-19 items in fiscal year 2009-2013. The
service efficiency showed that 89.2, 97.5, 98.8, 97.6 and 95.2% of the tests were completed by the cutoff
time in fiscal year 2009 - 2013, respectively. In addition, development outcomes are ISO/IEC 17025 for
testing laboratory; ISO 15189 for medical laboratories; and the silver award for excellence in medical and
public health laboratory of the year 2013 from the Ministry of Health. The present study showed that the
development of the Laboratory Quality System of the Regional Medical Sciences Center 10 Ubon
Ratchathani is consistent with an organizational policy for international standard. Laboratory Quality
System is a continual improvement process which requires continuous support so as to become the
reference laboratories in the Asian region.
This is a cross-sectional descriptive study which aimed to explore prevalence of stress and its associated
factors among medical interns. 283 medical interns in 2012 participated in this study. A self-administrative
questionnaire was used to collect the data during April to August 2013. The response rate was
71.11%. The study results revealed that the prevalence of stress among the medical interns was 29.40%.
Most of them illustrated normal and none of stress levels. The significant factors associated with stress
found in this study were income (p value=0.036), preparation before working as a medical intern
(p value=0.007), time constraint ( p value<0.001), risk of being sued due to duty ( p value=0.004) and lack of
leisure time (p value<0.001).
Dementia is a common condition in clinical practice. Its prevalence has been on
the rise, due to the rapid increase of elderly population. Alzheimer’s disease is the
most common cause of dementia syndrome. It often presents with progressive
cognitive decline and followed by behavioral and psychological symptoms. Patients
always had cognitive impairment in many aspects which impact their daily livings.
Therefore, proper evaluation and diagnosis are very important in the patient’s care.
Certain systemic and psychiatric diseases need to be excluded prior the diagnosis of
neurodegenerative disease. Further investigation is often needed for specific diagnosis
according to the standard criteria for each disease. During the past decade, the criteria
have been changed significantly due to better understandings in their pathophysiology.
Biological markers are incooperated to aid in earlier diagnosis. This will eventually
hasten the research and development for more effective treatment, or at least slowing
the disease progression.
New understanding in its pathophysiology has paved the way to potentially
more effective therapy. Pharmacological treatment for Alzheimer’s disease has been
progressing for the past decade. However, the currently approved therapy is still
limited to acetylcholinesterase inhibitors (AchEI) and memantine. AChEI (donepezil,
rivastigmine and galantamine) is mainly indicated for mild to moderate disease. Each
medication may have additional indication, according to its individual study.
Memantine is indicated for moderate to severe disease and may be used as
monotherapy or combination therapy with AChEI. They should be started and slowly
titrated up to the recommended dosage. Treating physician should periodically
monitor their side effect as well as efficacies. Even though their efficacy is modest,
they are helpful in maintaining the patient’s cognitive function and possibly delaying
the disease progression.
Other drugs such as antioxidants and anti-inflammatory agents were not proven
to be effective. Immunotherapy is the novel treatment strategy which may directly
affect Alzheimer’s pathology. It either inhibits the accumulation or eliminates Abeta or
amyloid protein in the brain.