plueme/wizJson huggingface dataset:
The study of strengthening the quality of life of village health volunteers in the 8th Public Health Region for supporting primary health services during the COVID-19 pandemic was conducted by a mixed-method study using a survey and group interview procedure. The sample for this study was 800 individuals of village health volunteers from 7 provinces under the 8th Public Health Region, which are Udon Thani, Sakon Nakhon, Nakhon Phanom, Loei, Nong Khai, Nong Bua Lamphu, and Bueng Kan. Descriptive statistics utilized percentage, mean, distribution, and standard deviation for data analysis. Most of the village health volunteers were females aged between 51-60 years old 43.5%, married 77.3% with secondary education65.9%. Most of them were farmers 62.2% with an average income of under 6,000 baht per month56.3%. The duration of being a village health volunteer was between 10 and 19 years39.0%. The longest duration was 41 years, and the shortest was one year. The village health volunteers were responsible for looking after 10-15 households. The majority used a smartphone 97.7% and paid a phone bill of over 300 baht per month. Half of them had received the award or glorification50.3%. Most of them do not have congenital diseases 70.9% and are members of the funeral assistance 72.7%. The village health volunteers know the practice of disease prevention and control during the COVID-19 pandemic at the highest level (x̄ = 4.38, SD = 0.64). The aspect of strengthening the quality of life of village health volunteers found that they have strengthened the quality of life in seven aspects. The aspects that have been strengthened at the “highest” level are mental, value, and pride (x̄ = 4.37, SD = 0.66). The aspects that have been strengthened at the "high" level are societal and social support (x̄ = 4.19, SD = 0.34), working environment (x̄ = 3.92, SD = 0.59), physical (x̄ = 3.85, SD = 0.55), advancement (x̄ = 3.77, SD = 0.88), compensation, and welfare (x̄ = 3.62, SD = 0.77), and working balance (x̄ = 3.06, SD = 0.46 ). The aspect that has been strengthened at the "moderate" level is having enough money to spend as they wish (x̄ = 3.19, SD = 0.88). The suggestion from this study is that at the policy, working via the smartphone should be promoted and support the phone bill that they have used for their work. Review and increase the welfare, compensation, and glorification of the village health volunteer to encourage morale in working. Enhance the quality of life of the health aspect in various ways for the village health volunteers to be healthy and be role models for health.
A Rapid increase of older persons and improving public health system may affect life expectancy as well as a higher number of older adults with dementia. Nonetheless, a promising approach is to adopt a strategy of early detection and intervention for providing treatments or delaying the symptoms. By considering speech and language deficits has been evident of early decline of the brain in relative to other functions, the current study aimed to develop a tele-neuropsychological test battery using speech and language-based parameters and validate it in 403 community-dwelling older adults. All participants were divided into 252 healthy controls (HC) and 151 older adults with mild cognitive impairment (MCI). Also, all participants could be divided into two phases, that is, lab- and community-based testing. The lab-based testing composed of 300 community-dwelling older adults (i.e., 196 HCs and 104 MCIs) and the community-based testing consisted of 103 community-dwelling older adults (i.e., 56 HCs and 47 MCIs). Standardized neuropsychological tests were used to classify older adults with MCI. The given tests composed of the subjective memory complaint questionnaire, the Mattis dementia rating scale-2, the Wechsler’s memory scale –Logical memory I & II, the Montreal cognitive assessment, the activities of daily living and the Instrumental activities of daily living checklists. The tele-neuropsychological test battery consists of 10 subtests and a voice recorder for phase 1 and smartphones/tablet PCs for phase 2. The main findings revealed that the developed test battery produced good-to-very good reliability, small-to-moderate criterion validity, and acceptable predictive validity by using machine learning algorithms for both phases. Furthermore, language-based parameters outperformed speech-based parameters across settings. Whilst the 1st phase demonstrated a better classification than those of the 2nd phase. Thus, the automated scoring program was developed based on the unique findings from both phases.
This research article studied the role of the National Committee on International Trade and Health Studies (NCITHS) in terms of policy coherence linking knowledge to performance and outcomes. The research employed qualitative methods including documentary research and in-depth interview to collect data based on the research framework namely strategic-constituencies approach, goal attainment, and theory of change. The findings showed that NCITHS could frame knowledge and policy coherence in case of monitoring public policies and became a participatory platform to create ‘trust’ among policy actors to willingly share information. However, there were some obstacles, including the organizational structure, limitation of policy recommendation, inconsistence of position and person in committee’s composition as well as the limitation of presenting academic information to reach policy stream. The research suggests that NCITHS should become a formal platform for participation and create a databank about international trade and health policy. Moreover, the working process should be proactive and support political communication beyond academic circles to the broader public.
Non-communicable diseases (NCDs) are important health problems in working population. Workplace health promotion (WHP) plays a crucial role in reaching this group; therefore, the measures to promote WHP need exploration. This study aimed to review literature and explore stakeholders’ perspective to synthesize policy recommendations. The mixed method research was used, including literature review and stakeholder interview by Delphi technique. Results revealed 5 major issues: 1) policy, laws, and regulations, 2) behavioral economics and social theory, 3) data system and application supporting lifestyle modification (LSM), 4) personal data protection laws, and 5) WHP package comparison. This paper explored policy, laws, and regulations in details. Fifteen stakeholders representing the Ministry of Labor, employers and employees were interviewed twice. The opportunities to improve WHP through policy and legislations were listed: 1) health insurance scheme, especially the social security scheme (SSS), 2) welfare and quality of life 3) control, diagnosis and compensation for work-related illness or injury, and 4) control of NCD risk factors in workplace. Stakeholders agreed upon most of the proposed amendments, except reducing the allowed working hours. These changes needed merely ministerial level amendments. Recommendations: Legislative amendments to improve WHP were proposed: 1) include LSM consultation in the essential health benefit package, 2) register the workplace first aid room in the SSS provider list with payment schedule, 3) define health promoting environment in workplace as welfare at workplace, 4) retrain the first aid room health personnel to be capable in giving LSM consultation, 5) extend the role of workplace safety committee to cover WHP, and 6) specify diseases from long working hours as the work-related or occupational diseases eligible for compensation.
This action research aimed to develop and evaluate the emergency medical service (EMS) in the local government administration Ban Tad subdistrict, Udon Thani province. The research was conducted during December 2021 - June 2022. Three target groups included: 1) 34 participants in academic group; 2) 23 participants of the local government administration; and 3) 388 people of Ban Tad subdistrict municipality. Three research processes were conducted: 1) exploration of the EMS problems; 2) development process; and 3) evaluation by using qualitative in-depth interview and focus group discussion. Data were analyzed descriptively by percentage, average, standard deviation, and by inferential independent t-test. It was found that the development of emergency medical service improved people’s knowledge on the EMS call center (before and after implementation p-value = 0.001). The EMS workforce’s time performance improved significantly after development (p-value < 0.05). The preparedness of resources for EMS operations improved from 96.4% to 99.4% after development. In conclusion, the Ban Tad local government EMS development success required indispensable cooperation from all parties.
Background: Acute kidney injury occurs when the kidneys lose their function over hours or days. If a pharmaceutical intervention is not available, renal replacement therapy can play an essential role in increasing patient’s survival chances. Currently, there are four methods of renal replacement therapy, and the preferred method depends on patient’s clinical indications. The most recent continuous renal replacement therapy (CRRT) already included in the benefit package paid by the National Health Security Office (NHSO), has been commented by providers for low reimbursement hence low access. Objective: The purpose of the study was to analyze the incidence, cost, and budget implications for acute kidney injury patients requiring CRRT. Methods: Reviews of literature and the NHSO e-claims during 2016-2019 provided incidence cases needed renal replacement therapy, and the empirical costing approach using standard top-down costing and micro-costing methods for two years from 2 regional hospitals provided framework for a 5-year budget impact analysis at the national scale on provider-insurer perspective. Results: If there were between 3,540-6,049 acute kidney injury patients requiring CRRT annually in Thailand, the total cost of CRRT would be between 57,502 baht (for 1 CRRT needed) and 116,890 baht (for CRRT needed over the average of 3 days). For a 3,540 acute kidney injury incident cases, the five-year budget impact would be between 1.017 and 2.068 billion baht. For a 6,049 incidence, the budget impact would be between 1.739 and 3.535 billion baht. These findings could assist the NHSO in planning an incentive to support hospitals to provide CRRT and subsequently improving patient access.
Background and Rationale: This research and development aimed to review, develop, and evaluate the new normal emergency stroke care system in public and private hospitals during the COVID-19 pandemic. Methodology: A research and development methodology was employed using system implementation form and semi-structured interviews for evaluation. Participants included 40 individuals, comprising 10 acute stroke patients exhibiting symptoms outside the hospital, 2 heads of accident and emergency departments, 4 emergency department physicians, 20 emergency department nurses, and 4 emergency medical workers. Results: The developed system unfolded in three phases. (1) Pre-hospital care phase integrated telemedicine for on-scene patient care, addressing the imperative of preventing COVID-19 infection, and transportation to the hospital systems. (2) Care phase in the emergency department with rigorous COVID-19 infection screening protocols and diligent patient care. (3) Patient in-hospital transfer phase needed a heightened focus on infection prevention and patient isolation during the transfer process. The new normal emergency stroke care system diverged significantly, emphasizing patient isolation, mandatory mask-wearing for patients, utilization of personal protective equipment by healthcare teams, a cautious approach to administering the blood thinner rt-PA (recombinant tissue plasminogen activator) to COVID-19 patients displaying severe symptoms, and enhanced monitoring of patients receiving rt-PA, with the potential inclusion of telemedicine to mitigate exposure risks. Summary: Ninety-nine percent of the samples agreed on the suitability and practicality of the new system’s content and procedures. The new normal model would serve as a robust safeguard for patients and healthcare staff alike, but with an increasing time-to-treatment. Suggestions: To maintain the quality of care, all healthcare staff involved in stroke care must receive comprehensive training on the new system.
This article reflects on issues in COVID-19 remedial measures based on group-targeting principle. The article drew on document research combined with fieldwork research. Document research explored online sources of government COVID-19 remedial measures, including online research papers and articles discussing the socio-economic impacts of COVID-19 from national and international institutions and experts. Fieldwork research was a qualitative research study conducted in two communities: an urban slum community and a rural community in Ubon Ratchathani province. Data collection involved in-depth structured interviews with purposively selected 22 samples, as well as non-participatory observations over short period in both communities. The findings indicated that in the context of the pandemic, the major population suffered significantly and required urgent remedial measures. However, the targeting remedial measures did exclude affected individuals at the outset. During the implementation phase, the online registration screening had resulted in the exclusion of more affected individuals. While the recovery measures faced challenges in achieving success due to limited financial compensations compared to impacts, the delays in delivering economic and social recovery programs, and the inadequate social welfare designs. The present study recommended that the remedial measures should be applied on a universality principle, which needed no registration nor screening that expedited the remedial process, and avoided mis-exclusion of the affected individuals. By implementing the remedial measures prioritizing universal social welfare principle, a more allocative efficiency of remedial measures in future pandemic is foreseeable.
Type 2 diabetes (T2D) is a chronic disease and a major health problem as the 9th rank leading cause of global deaths. Therefore, a well-controlled glycemic level within the target is essential as it is associated with a reduced risk of complications. Findings from previous literature demonstrated that self-monitoring of blood glucose and insulin self-titration were effective for glycemic control. A number of international and Thai clinical practice guidelines for diabetes have also recommended these approaches to patients with T2D. However, patients may encounter obstacles to adjust their insulin dose. In response to this problem, insulin self-titration support can help T2D patients to understand and gain confidence for insulin self-titration, achieve effective treatment, reduce the burden of healthcare professionals, and receive appropriate continual care. Although there are no specific criteria for the classification of insulin self-titration support strategies, it could be classified based on: type of the program, program duration, contact frequency, etc. Findings from previous studies also showed that several insulin self-titration support strategies can reduce glycosylated hemoglobin (HbA1c) and the risk of hypoglycemia in T2D patients. Nevertheless, other studies demonstrated contradicting effects on these outcomes in some support strategies. Currently, the most effective strategy to support insulin self-titration is yet to be determined. Hence, further comparative studies of these support strategies are warranted to inform appropriate diabetes care.
This study aimed to define the scope and to develop a conceptual framework for monitoring commercial determinant of non-communicable diseases (CDoNCDs). A qualitative study was performed by applying a scoping review, interviews, and focus group discussions among Thai experts and relevant stakeholders on NCDs prevention policy. From the literature review, the definition of CDoNCDs referred to “strategies and practices used by corporations or industries related to NCDs to promote their products and choices, increase sales and profits, and generate business stability which had both direct and indirect effects on population’s health.” This CDoNCDs framework involved three components. (1) the production involving raw materials or ingredients and production process that might have effects on health (comprised 2 strategies and 6 practices). (2) the marketing and distribution including market expansion and marketing practices that aimed to promote sales and consumption among consumers (4 strategies and 10 practices). And (3) the policy interference both directly and indirectly intercepting government policy interventions (5 strategies and 16 practices). This study provided policy recommendations that relevant government agencies, civil society, and academic should consider establishing system and network to monitor the CDoNCDs, and regularly communicating to raise awareness on CDoNCDs in the society and among policy makers at all levels, especially the policy interference by industry.
This study presents findings on cost variations using clinical-case level microdata from public hospitals under the Office of the Permanent Secretary, Ministry of Public Health. The objective was to evaluate differences in costs of health utilizations of 3 universal health coverage schemes, including universal coverage scheme (UCS), civil servant medical benefit scheme (CSMBS), and social security scheme (SSS). The microdata covered 252 million outpatient visits and 12 million inpatient admissions in the budget year 2019 (B.E. 2562). The average costs of outpatient and inpatient utilizations were econometrically controlled for 140 disease categories using principal diagnosis codes (ICD-10), as well as factors such as age, gender, service time, hospital stay, and health region. The linear regression analysis computed the average costs independently for different healthcare facilities, encompassing primary, first-level secondary, second-level secondary, third-level secondary, and tertiary care levels. Results show that the average outpatient costs for CSMBS beneficiaries were higher than those of UCS by around 16-30 percent and those of SSS by around 25-30 percent in the secondary and tertiary hospitals. However, the outpatient costs at the primary care hospitals were similar across different health insurance schemes. Inpatient reimbursements based on the diagnosis-related groups (DRG) might confound in similarity of inpatient costs compared to outpatient costs. Nevertheless, the differences on average inpatient costs were around 25 percent in the third-level secondary and tertiary hospitals. Therefore, the research findings emphasize the importance of the integration goal of the three schemes of UHC in compliance with the Sections 9 and 10 of the National Public Health Security Act B.E. 2545 (A.D. 2002).
The universal coverage scheme has included drugstores as health care provider networks running refill prescriptions from October 1, 2019. The evaluation of the pilot program focused on lessening hospital congestion and waiting time by displaying the number of hospitals, pharmacies, patients, and prescriptions filled. The purpose of this study was to expand key performance indicators (KPIs) for evaluating the drugstore networks. The study design was a mixed method, with a qualitative analysis comprising in-depth interviews and observations and a quantitative assessment of data in the form of a pharmacy operations report. The findings indicated that all drugstores used a five-step operation management process. The highest operation management efficacy (25.7%) was in the process of dispensing and counseling. This process also provided value to the project. The process of data handling for reimbursement and patient’s pharmacy information update to the hospital’s database achieved the second highest operation management (22.0%). The pharmacists commented on process complexity and non-value added to the project. The present study proposed that the simplified standard pharmacy information practice of drugstore network to reduce the length of this operation but increase efficacious time duration.
Background and Rationale: COVID-19 is the pandemic that has significantly impacted disease control measures, daily life, and healthcare services. Pregnant women and newborns are vulnerable populations at increased risk of severe illness and adverse outcomes. This study aimed to identify the incidence and associated factors of newborn COVID-19 infection. Understanding these would benefit in developing effective strategies to mitigate the risks associated with COVID-19 infection during pregnancy and infancy. Methodology: This cross-sectional quantitative study utilized data from a country-wide reporting system of pregnant and postpartum women infected with COVID-19 and their newborns in Thailand. The study included 6,048 newborns born to infected mothers from December 2020 to May 2022. The outcome was the incidence of newborns infected with COVID-19. The exposure factors were mothers’ characteristics including age, nationality, vaccination status, gestational age at infection detection and at delivery, the severity of COVID-19 infection, delivery mode, and newborns’ characteristics including birth weight, mother-newborn separation after birth, and infant feeding. Multivariable logistic regression was used to examine associations between characteristics and newborn COVID-19 infection. Results: The proportion of newborns infected with COVID-19 was relatively low (6.4%). Maternal age was associated with infection risk, with newborns of mothers aged 20-34 years (adjusted odds ratio: AOR = 0.60, 95%CI: 0.43-0.81) and ≥ 35 years (AOR = 0.64, 95%CI: 0.44-0.93) having a lower likelihood of infection compared to the youngest age group. Newborns of mothers known of infection during postpartum had a higher likelihood of infection (AOR = 3.75, 95% CI: 2.16-6.51). The severity of COVID-19 infection in mothers was inversely associated with newborn infection risk (AOR = 0.67, 95% CI: 0.47-0.96). Term newborns had a lower likelihood of being infected with COVID-19 (AOR = 0.49, 95% CI: 0.29-0.84) compared to preterm newborns. Complete separation of mother and newborn after birth was associated with the lowest likelihood of infection (AOR = 0.18, 95% CI: 0.11-0.30). Newborns who were fed breast milk substitutes, or a combination of substitutes and maternal milk had a higher likelihood of infection (AOR = 4.16, 95% CI: 2.32-7.45) compared to those directly breastfed or fed with expressed breastmilk. Conclusion: This study contributes to the understanding of newborn COVID-19 infection and its risk factors in Thailand. The relatively low proportion of infected newborns and the identified factors provide guidance for preventive measures and optimizing care during the pandemic. Continued research is needed to further explore these factors and address knowledge gaps for effective prevention and management strategies.