plueme/wizJson huggingface dataset:
Vision and Direction toward Health System Reform:views of civil aging societyThe participatory research aimed to understand the following aspects which are related to aging issues in Thailand: a) the existence and situation of network of community based agecare organizations; b) roles, capacities and strategies of community based agecare organizations; c)  vision and mission toward improvement of quality of life of older people in Thailand.  The information fed by the participants, most of whom were older people from rural poor areas throughout the country, through participatory discussion that included A.I.C, focus groups techniques.  There were 127 participants from non-governmental age related organizations, indigenous group of older people. 	Comparison of the image of Thai older people in future compare to current situation (2000), it is revealed that about half of the participants (55%) indicated that the living condition of the older people would be better than present because aging issues is being campaigned and well-recognized by public increasingly.  The participants of all four regions stated that the aims of organizing activities are similar in terms of achieving the objectives of the establishment of the elders' clubs which aim to encourage older people to live with their families in communities as long as possible.  However, the types of activities are different in accordance to the needs and preference of the older people and the conditions of the areas.  The recommendations presented by the participants are similar which can be concluded as followed:All cares and services provided by the government sectors need to be reviewed, particularly actively provisions, instead of passively ones.  Such provisions should be accessible by all older people and equally.Health promotion measures should be sustainable and should emphasis on health information for community and self health care. Prevention and control of diseases measures should go along and make sure that it can be brought to practice effectively.
According to advance technology now the patients who suffered from hematologic malignancy can be cured or at least live longer with better quality of life. However the standard treatments that were used internationally are costly and it is impossible to give best treatment to every Thai patient who suffered from hematologic malignancy due to shortage of budget and man power involved in this problem. In routine practice there are variation on investigations and treatments depend on the patients socio-economical status and health insurance scheme leading to difference cure rate and survival time of the patients. The suitable clinical practice guideline (CPG) for treatment of this group of disease in Thailand can not establish at present because of lacking basic data about the situation of these disease in our country. To establish disease registry of hematologic malignancy would give the information about epidemiology, variation of practice and clinical outcome which is useful for developing suitable CPG for treatment of hematologic malignancy in Thailand.The study was performed by establish the network of hematologist form 9 leading institute in Thailand who deliver treatment to this group of patients working together to create case record form. System of data collection and quality control concurrent with development of web base data entry system was done in the first 6 months of the project, starting on January 15, 2003. Then the process of data collection and data entry on web was performed during July 1, 2003 to March 30, 2004. The quality controlled and monitoring was performed concurrently. It was planned to register the patients and follow up them for at least 3 years.During the first 9 months of data collection there were 1,124 patients registered to the system. The diagnosis were malignant lymphoma 51.2%, acute leukemia 20.3%, CML 10.7%, multiple myeloma 7.7% . About the expense of treatment, 56.5% of the patients using universal health coverage or “30 baths” scheme, 26.3% using government welfare, 6.8% under social security scheme and 8.7% pay out of pocket. The patients who are under government welfare have tendency to receive more effective and expensive treatment than patients under other scheme. There is an interesting data that 12.2% and 8.3% of lymphoma patients infected by viral hepatitis and HIV consecutively.There are some problems about using web based data entry system. Even though it is good to get data on real time but it is rather difficult to manage because the internet system and local network of the participate institutes were attacked by virus computer several times. And some research assistants are not familiar to computer program. After first phase of study, the data entry will be changed to sending case record form to the center fordata entering instead of using web base system.
HIV  Infection  and  AIDS  in  ThailandThe Acquired Immune-deficiency Syndrome(AIDS) was recognized in 1991 when a cluster of pneumocystis carinii pneumonia was reported in the United States. Disease surveillance systems were sets up in several countries including Thailand so that the first case in Thailand was reported in 1994. Because the epidemic was confined to special groups ie. Homosexual men, injecting drug users, and commercial sex workers during the first year, health authorities misunderstood that AIDS was disease of the foreigners and interventions for the Thais were not necessary. Control measures started in late 1980's, from Veneral Disease (STD) division using epidemiological data to propose justified control measures. The AIDS Division was extablished in 1990 to coordinate national activities. During the 1990's, the epidemic expanded to general population through heterosexual people especially those who visited commercial sex establishments and through casual sex later. The median infection rates among women attending ante-natal care (ANC) clinics and 21 year old Thai men were 1.5 The essential control measure now is to reduce risk per act among sex and drug related population through condom promotion and needle exchange with bleach supply. Long term goal is to promote and maintain safe behaviors which will enable individuals, families, and society to protect themselves and their society. Biomedical, epidemiological, and social research studies allow as to understand patterns and determinants of the epidemic that there had been two distinct  epidemics among sex and drug acquired populations. Studies also allow us to learn the difference of normal ranges of CD4 between Thai and Caucasian people. More studies are in great need for rapid and effective control measures.
The prospective study was conducted at Kutchum Hospital during April 2000 to January 2001.The objective was to determine the effectiveness of holistic health care that provided to type 2 Diabetes mellitus ( type 2 DM ) by health care team. The health care team were consist of a pharmacist, a nurse, a dietition , a doctor, a patient and other related. person who take care the patient. The effectiveness were determine by comparing of patient compliance,chronic complication and individual problems before and after interventions. The subjects were intervenced after visited a doctor.Patient counseling was the most important instrument of interventions. There were fifteen out-patients without chronic complication were included,11 females and 4 males.Average age was 40 – 50 years old. They were diagnosted as diabetes around 1 – 5 years ago and nine cases had diabetes relatives. Most of them were farmers and also had health cards. The compliance to prescribed medication, usage of appropriate diets and self-care behaviour were increased from 2 to 8 cases, 3 to 13 cases and 9 to 15 cases, respectively. In addition, we found no report of their complication and trend of their individual problems had been decreased after forcing interventions. The result indicated that holistic health care in diabetic mellitus by health team should be applied to make the patients taking care their health according to their basic conditioning factors and health care demand.
Health Service System for Emergency Conditions in Developed countries	Health service system for emergency conditions in developed countries was originally built in attempt to reduce life lost from road accident. Early response to injuries was a principle of reducing death and injuries especially in working group. Later, the system was extended to cover other injuries especially heart disease and considered as social safety net. To quicken the service provision, mobile service was made possible to reach the situation area and available for 24 hours. The system could be activitated by anyone either involving or seeing the scene. The study was carried out by reviewing the systems of the US, France, Australia and Sweden. 	The system of the US, Australia and Sweden had central call centres and mobile emergency team some of which had physicians for example the French and the Swedish while the US and the Australian had advanced emergency staff. The US, the Australian and the Swedish had doctors who had specialty in emergency care The provision system, patients’ right to emergency care and emergency team were legislated in all studied systems. Medicare, Medicaid, private insurance and special service contracts covered emergency care in the US. In France, Australia and Sweden, local government budget and national health insurance supported the emergency care. 	The development of the emergency system in Thailand should focus on the system of call centres and its reporting, mobile service, emergency room and referral system. Integrating the system into the health care system should be done for efficient use of resources. Community participation in all process should be strengthened. Legislation, budgeting, personnel development and research were important issues to support the system. Equity principle should be considered and put into practice.
Hospital Autonomy in Thailand: Operations Manual	The sharing of economic and administrative power / responsibility between the Ministry of Public Health and autonomous government hospitals would be created to improve communication, reduce administrative complexity, enhance effectiveness and efficiency of hospital management, increase accountability to the public, improve resource mobilization and local knowledge of development priorities and attain political objectives. Six main areas which would be enhanced in case of autonomous hospital should be strategic management, procurement, financial management, human resources management, administration and clinical governance.
The purposes of this descriptive research were to study factors influencing health
promoting behavior and health utilization behavior among people under the universal coverage
project in the southern region. The sample comprised of 1200 people who were drawn by
multistage sampling technique from suratthani, pang-nga, trang and yala province respectively.
The instruments consisted of indepth-interview form, focus group form and questionnaire which
were passed the quality examination by the expert and field try out. The reliability of
questionnaires were 0.69-0.91. The qualitative data was analyzed by content analysis, the
quantitative data were analyzed by descriptive statistics, Multiple regression analysis, Multiple
logistic analysis, ANOVA and Chi-square test. The results were as follows:
1. Health promoting behavior among people under the universal coverage project was
fair level.
2. Health utilization behavior, most of the sample used health center and general
hospital. Folk medicine was not popular for the sample.
3. Factors related to health promotion behavior were age, health value, quality of care,
self efficacy and social support. The variance explanation of all factors was 32.9
4. Factors related to health utilization behavior were sex, education, type of insurance
,health need, perceived of right of universal coverage, perceived of right of government official .
health information, health need, quality of care and health service accessibility.
5. The comparison of health promoting behavior revealed that the sample of
government official group had more health promoting behavior than universal coverage group
and social security group. 6. The comparison of health utilization behavior revealed that the sample of universal
coverage group had more used health service at health center and community hospital than
government official group and social security group. The sample of government officer /private
corporation group had more used health service at general hospital than the sample of social
security and universal coverage group.
Drug utilization evaluation programme on third generationcephalosporin use in Khon Kean hospitalObjective: To assess the effect of the interventionnal programme (DUE and Education) on the inappropriate use of third generation cephalosporins in Khon-Kaen regional hospital. Design : Before-after experimental study. Setting : Three medical and six surgical of Khon-Kaen regional hospital. Partipants: Prescriptions of all hospitalized infectious patients, over 15 years of age, treated with third generation cephalosporins, were included. Intervention: The intervention programme was consisted of one educational convention, a standard criteria for appropriate cephalosporin usage and drug utilization      evaluation (DUE) programme. Main outcome measure : The percentages of inappropriate use were compared with regarding to any of the following seven categories; no indication, no evidence of infection, other alternative drugs could be use due to culture and sensitivity, possibility of toxicity,      improper dosage regimen, improper duration of treatment and economic reason. Results: Four hundred and seventeen prescriptions in pre-intervention period (1997, May-July) and one hundred and forty prescriptions in post-intervention period (1998, February-April) were evaluated for inappropriate use and compared. The percentages of inappropriate rational use all three cephalosporins were significantly decreased, from 62.6 to  40.0. And individually, cefotaxime, ceftriaxone, ceftazidime from 65.4 to 39.7, 45.8 to 39.3 and 91.9 to 41.2 respectively.However, economic crisis of the country on the physician's prescribed behavior needed to be determined. Conclusion: The DUE programme in addition to physicians education could decrease the inappropriate use of third generation cephalosporins. Therefore, this may be applicable for other drugs and useful for other clinical institutes.
Universal health care coverage (UC) is an important policy by the Thai government, 75% of population covered by the Scheme, but capitation rate did not adequately match with the utilization rate and cost of services. While rely totally on government annual budget, its long-term fiscal sustainability is a worrying problem. This study was conducted in order to provide financial reform options for UC Scheme. Long term projection of total national health expenditure of Thailand between 2004 and 2020 was constructed using four models namely Demographic and Labour Model, Economic Model, National Health Expenditure Model and Government Model. Several information from various sources were retrieved for example; population and economic information from National Economic and Social Development Board, Labour statistic from National Statistical Office, National Health Account of Thailand 1994-2001 and Government expenditure from the Comptroller General’s Department, Ministry of Finance. Moreover, many possible assumptions were applied in these models and three scenarios of reducing UC expenditure and/or ensuring adequate budget for UC were created in order to illustrate financial implication.  	The model estimates showed that the total national health expenditure was around 3.50% of GDP in 2004, it would increase to 3.64 and 3.88 % of GDP in 2010 and 2020, respectively. The first scenario simulated the effects of the suggested revenue increases by introducing personal health tax and additional excise tax on tobacco, alcohol and beer which some proportion automatically earmarked to UC Fund. This scenario resulted in substantial reductions in the government budget subsidy to the Scheme compared to status quo. The second scenario was produced based on assumptions that Social Security Office would expand its coverage to non-working spouse and dependents of the contributors. Its effects were that the expenditure of UC reduces by around 9,210 million baht in 2005. The first and second scenarios. when combined together into the third scenario suggested, it showed that UC almost fund by itself with few budget subsidy from government.   	Three policy recommendations on the Scheme financial reform was provided. First, an earmarked sin tax with or without increase in the sin tax rate. Second, the expansion social security scheme health benefit to non working spouse and dependents of the contributors. This could be done without increasing contribution. The last was the reform of Traffic Accident Protection Act (TAP). The Department of Land Transport would be outsourced to collect premium from car owners, during the mandatory annual renewal of car license, this would enhance law enforcement.  The scheme would cover all victims by either insured and uninsured cars.
Payment Systems, Mechanisms and Approaches for Health Service for Equity, Efficiency and Quality Various payment mechanisms for health care and their impact on equity, efficiency and care quality were reviewed in this study. Recommendation for appropriate mechanisms for Thailand was also proposed to put in National Health Bill. Development of health insurance in Thailand and experiences of using various payment mechanisms in other countries were reviewed. A number of well experienced people, health care users and providers in both public and private sectors were interviewed. The study found diverse mechanisms in Thailand which could be grouped as following; out-of-pocket payment was directly made to providers, fee-for-services was remunerated to the insured under the Civil Service Medical Benefit Scheme and private insurance (some schemes having ceiling level per year),payment was made under fee schedule for example the Social Security Scheme and the Substitution Fund, capitation payment was used under the Social Security Scheme in order to contain medical costs and expenditures but was problematic to care quality, per-case payment on the basis of DRGs (Diagnosis-related groups) was made, budgeting by capitation was solely implemented in public sector, line item budgeting was used for allocating salary, operating and capital expenditure in public sector.
This study aims to 1) to review the policy and process of implementation for provision of antiretroviral therapy, 2) to assess quality and adequacy of hospital services for ARV provision. 3) to assess the effects on health and behavior of people with HIV/AIDS receiving ARV and 4) to study costs and cost-effectiveness for provision of ARV therapy comparing between provincial and district hospitals. The study conducts the documents relevant to national HIV policy was analyzed, and in-depth interview was performed with people responsible for ATC project. The 12 provinces stratified by region were randomly selected: Ayutthaya, Lopburi, Prajinburi, Prajuabkeyrekhun, Surin, Udonthani, Aumnartchareon, Sukothai, Nan, Chiang Mai, Krabi and Songkla. In each province, a provincial hospital was purposively selected and two district hospitals were randomly selected. The total numbers was 36 hospitals. The hospital visits was performed by the research team to assess quality of services for ARV. Practice guidelines, record form, and documents relevant to ATC project were reviewed. Focus group discussions and individual interviews were conducted with hospital personnel including doctors, nurses, counselor and laboratory technician, who provide care for people with HIV/AIDS. The hospital records of people enrolled in the ATC project during the fiscal year 2003 were reviewed. Survivals, incidence of opportunistic infections, clinical failure, changes of CD4 cell count at six months after treatment initiated, were analyzed. People with HIV/AIDS who currently receives ARV treatment were interviewed for their perceptions on health status, adherence, social and behavior impacts of ARV medication. The costs and cost-effectiveness study was conducted in three hospitals in Chiang Mai province. The overall cost of ARV provision was a combination of provider cost at ARV clinic, laboratory cost, ARV drug cost and patients cost. The overall costs/person/year and cost-effectiveness were analyzed. Results found that at present, after seven months of expansion of existing ATC project to reach the target of 50,000 in the year 2004, an average enrollment of new cases was 5 percent per month. The 33,381 people with HIV/AIDS were enrolled and this was about 66.7 percent of the project target. However, a number of people were with some reason dropout from the project and 29,549 people remained in the project during this period of time  The cost of ARV drugs was approximately 60-80 percent of overall costs of ARV services. The fundamental ARV formula in the ATC project was GPO-Vir which was cheapest compared to the others.
In this study the working population was defined as Thai people aged 13-59 year old. The data showed that this population accounted for more than 50 percent of the total Thai population. The majority of them (51-56 percent) worked in agriculture. The remaining people worked in industrial sector (16 percent) or in service sector (12 percent). The study found that 85 percent of Thai working people felt they were healthy. Factors affecting health status included age, sex, behaviors, occupation, and environment. For example, health problems among elderly people were mainly degenerative diseases, such as, heart disease, hypertension, and diabetic mellitus. On the other hand, health problems among young prople were accidental injuries and AIDS.