plueme/wizJson huggingface dataset:
Radiation therapy, an essential treatment for cancer, has been concerned over the recent years due to its enormous investment in both high technology medical devices and various specialists.  Anecdotal observation found inappropriate distribution of radiation therapy resources across the country which led to inefficient use of health care resources and possibly under-standard treatment in some radiation therapy units (RTUs).  A lack of evidence-based planning on health care services is supposed to be the major cause.  Thus, this study aims to demonstrate the current situation of radiation therapy comparing with expressed health needs and access to radiation therapy services of cancer patients.  This will bring about the policy recommendations on how to invest and distribute health care resources according to health needs.  The goal of this study is to improve efficiency of health resource utilization and equitable access to health services by using radiation therapy as the case study. Both quantitative and qualitative methods were employed in this research.  A census of 25 RTUs and 72 radiation therapists were conducted.  Cancer patients and some radiation therapists were interviewed by using semi-structured questionnaires.  Moreover, document and content analysis were also used.The results reveal that lacking of human resources, both radiation therapists and medical physicists, are more serious problems of the MOPH radiation therapy services than the shortage of radiation therapy devices.  The finding illustrates that no radiation therapy unit of MOPH passes the minimal standard amount of radiation therapists, whilst only 20% of them passes the minimal standard amount of medical physicists.  Moreover, access to radiation therapy services are inequitable among cancer patients.  Cancer patients in remote provinces tend to have poorer access to health care than those in RTUs neighboring provinces.  Factors influencing not access to radiation therapy services are physical barriers, and financial barriers in terms of medical care costs and transportation expenditure.  For socio-economic status, most cancer patients are the elderly and poor without doing any jobs.  Quality improvement on radiation therapy services as well as adequate vital human resources (radiation therapists and medical physicists) are urgent issues which the MOPH has to solve.  In the long run, the national plan of radiation therapy system which determines the amount, proportion and distribution of principle, advanced, and excellent radiation therapy centers have to be made.  For improving access to care, the improvement of health insurance coverage and the provisions of financial support for transportation are  better policy than investment in the new radiation therapy units.
This study explore grievance and compensation systems in the major public health insurance schemes, namely the Civil Servant Medical Benefit Scheme ( CSMBS ), the Social Security Scheme ( SSS ), the 30 Baht Scheme, and the Compulsory Car Accident Insurance Scheme.	The Servant Medical Benefit Scheme ( CSMBS ) has practically no grievance or compensation systems. However, its fee-for-service payment scheme coupled with eligible member’s rights to choose their ( usually public ) providers help making the scheme less susceptible to substandard care experienced in other scheme that pay providers mainly on capitation basis. The Social Security Scheme ( SSS ) was the first public health insurance scheme that set up a formal grievance system. The grievances are usually sent to the SS’s medical committee. If the committee decides that the provider is at fault, it will also recommend the penalty. The penalty ranges from warning, probation, reducing the ceiling number of insured patients, to termination of contract. However, the vast majority of grievances were lifted on the ground that they were caused by miscommunications or patient’s misunderstandings. The 30 Baht Scheme although the intention of such a compensation scheme is to provide relief/settlement that would curb the increasing trend of medical malpractice suits, medical associations view it as a vehicle that would lead to more lawsuits ( or at least complaints ) and have fought vigorously against it. Thus far, there is no convincing evidence to disprove either claim. As a result of the fighting, the scheme is now equipped with regulations that, if strictly interpreted, would allow only compensation to substandard or malpractice cases. In practice, however, many ( provincial ) compensation subcommittees still use the regulation’s ambiguity to interpret it in such a way that they could provide compensation to some other cases based on humanitarian reasons. The Compulsory Car Accident Insurance Scheme is private insurance based and is therefore using the same grievance and arbitrator systems as present in other private insurance schemes.
This study is a survey of the use of water supply by the Provincial Waterworks Authority among  resident villagers in Ronphibun subdistrict. During March-September 2003, 501 households were surveyed. The computerized data of piped water use from the Nakhon Si Thammarat Piped Water Office were extracted for the year 1999-2002 and were linked together with a survey data. The objective of this study is to evaluate the amount of piped water use per capita and per household, to evaluate the adequacy of piped water supply and to identify the factor associate with piped water use. The results revealed that piped water was used for drinking in only 5% of households and cooking in 32%. Piped water was mostly used for other consumption purposes (>90%). The total amount of water use was 89, 134 and 147 liters/person/day, respectively. The amount of piped water use depended on year of use, urbanization, household’s characteristics, owner status, satisfaction of the price and storing rainwater for using. The study showed that piped water use was highest in the year 1999 and village 13. The amount of piped water use was higher in single houses, owned houses or government accommodations, households with more than 3 persons, dissatisfaction with piped water price and storing rainwater for using.	In conclusion, the trend of piped water use among villages 2, 12 and 13 was and not high. Piped water from the Provincial Waterworks Authority was adequate. Urbanization, type of household, number of members in household, price of piped water satisfaction and use of stored rainwater influences the amount of piped water use.
The Participatory Learning of Alliance of Agricultural action to reduce pesticide using: case study in Phichit province	The opjective of this qualitative was to analysis a condition at situation, factors and system procedures affecting to abate the chemicals of agriculturist. To pick and choose 3 village in 3 subdristric of Phichit Provinec were the case study . Data were collected from the leader of villages, the leader of agriculturist, and a member of villages, using interview, observation and focus group discussion, in conjunction with the questionair. The data were interpreted and analyzed in accordance with the related literatures, theories, and narration . The detailed conclusions were introduced in form of report and the procedures for the scheme were also established.	The overall conclusion and procedures for affecting to abate the chemicals of agriculturist are as follows; Predisposing factors.To check a health of agriculturist by public health offices were to have an allergy on majority of agriculturist whom to do chemicals of agriculture, to cure a sickness always.To lose from capital of agriculture that to do chemical agriculture but price of produce to be lowly.The leader of agriculturist to training about the natural farming from government service and mon-government oganization, to training the agriculturist.An agriculturists to training about the matural farming and non-chemical agricultuer, to be convinced in effective of non –chemical agriculture.Enabling factor.The government service  and non-government oganization to support the capital and technique. An agriculturists to be participate of the learning process with the government service and non-government organization.Communication : make an agriculturists have good relationship and good understanding to one another, which leads to good incorporation in the development scheme. The quality of population are likely to have potential in self-learning and self-development, which, consequently, will influence other to seek for more development. The leader of agriculturist to be complete at the natural farming and non-chemical agriculture.The proposals of this qualitative researchThe promotion to selling or publicized of non-chemical agriculture should be search to change agents in community.The learning process ought to small group for interactive learning : the first, An interactive learning through action were to be considure.Non chemical agriculture were to increase by paticipate of agriculturist network to change the knowledge and technology to be consistent.The government service and non government organization should to increase in learning process development  the capable of change agent. The public service should be promote and development of participatory leaning process and skill to the public servant; sub-district agriculture, teacher, public health officer.The future ; should be research the appropriate process to search change agent and planing to promote non-chemical agriculture by integrate economic, society, and environment.
The objectives of this study are to review and analyze the standard setting processes both in Thailand and overseas, in order to propose recommendations regarding the appropriate and practical process for Thailand. The methodology included literature reviews both in relevant documents and Internet searching, in-depth interviews with the concerned officials responsible for standard setting in various organizations, and a workshop to brainstorm the involved experts. The results showed that many countries and organizations have the similar process, i.e., they use health risk assessment as a pivotal tool including scientific evidences to set the standards. Most of the standards are intended to be the guidelines for local authorities to modify in order to fit the public’s needs and to be enforceable. In Thailand, it was found that there are a variety of standard-setting agencies authorized under the different acts resulting in an inharmony of standard setting process, amendments, and monitoring. It is suggested that a national independent organization be set up to lay criteria and guidelines of standard setting, standard review and amendment, and people participation process and to select the standards that should be necessarily set in the Thai context in terms of studies in order to obtain an appropriate standard of Thailand. In addition, the decentralization of decision-making process of standard setting to the local areas should be considered in the future, including that the people participation in standard setting process should be imposed in the National Health Act.
Incidence of childhood cancer in Thailand has been roughly determined by population-based cancer registration. All cancers have been registered retro-and prospectively by Thai Pediatric Oncology Group (TPOG).OBJECTIVE: To find the incidence of childhood cancers in Thailand.METHOD: All Thai children aged < 15 years newly diagnosed with childhood malignancies according to International Childhood Cancer Classification (ICCC)during January 1- December 31, 2003 were registered into a national database. The data were collected through a web-based registry from 20 treatment centers under a standardized format, using double entry method and under internal and external audit process.RESULTS: There were 999 new cancer cases in children; 94.0% was histologically confirmed, 566 (56.7%) were males. The male: female ratio was 1.3:1, 80 (8.0%) were under 1 year, 361 (36.1%) were between 1 and 4 years, 282 (28.2 %) were between 5 and 9 years, and 276 (27.6%) were between 10 and 15 years old. The median age at diagnosis was 5.64 years old. The age standardized rate (ASR) of childhood cancer was 79.7 per million. Leukemia was most common (ASR 42.6, male=282, 28% vs. female=247, 24%) followed by CNS tumors (ASR 7.6, male=53, 5.3% vs. female 49, 4.9%): medulloblastoma and astrocytoma being the most common comprising 3.2% (male = 13, 1.3%; female=19, 1.9% and 2.5% (male= 13, 1.3%; female=12, 1.2%), respectively. Leukemia and CNS tumors constituted 63.1% of pediatric cancers and Lymphoma was third (ASR=6.4, male=68, 6.8% vs. Female 22, 2.2%). The ratio of non-Hodgkin lymphoma to Hodgkin disease was 1.9:1. Neuroblastoma (ASR 4.6, male= 24, 2.4% vs. female= 27, 2.7%) and retinoblastoma (ASR 4.2, male=29, 2.9%; vs female=13, 1.3%) ranked fourth and fifth, respectively, followed by soft tissue malignacies (ASR 3.6, male=30, 3% vs. female= 15, 1.5%), bone tumors, (ASR 2.4, male 21, 2.1% vs female 15, 1.5% ), renal tumors (ASR 2.6, male=15, 1.5% vs. female= 14, 1.4%), liver (ASR 2.4, male= 14, 1.4% vs. female=13, 1.3%), germ cell (ASR 2.3, male= 19, 1.9% vs. female=13, 1.3%) and nasopharyngeal carcinoma (ASR 0.3, male 5, 0.5%) Among leukemia, ALL (ASR 31.8, male=213, 21.3%; female=176, 17.6%) outnumbered ANLL (ASR 9.2, male= 57, 5.7%, female=62, 6.2%). Conclusion: The incidence of childhood malignancy in Thailand is lower in comparison to Western and regional countries. Leukemia was the most common cancer in Thai children. Lymphoma is much lower than that of Western countries.
Ayudthaya Metropolitan Peoples’ Health Utilization Behavior, Experiences, Health Care Expenditures, and their Attitudes towards ServiceDelivery of Medical Center.	People who lived in Ayudthaya Metropolitan were studied to understand their health care utilization behavior and their patterns of health expenditure so as to make comparison with the behaviors of those who lived outside the medical centers’ catchment area. Population factors for sampling in this study were various concentration, socio-economic status, distance to health facilities and whether the people were actually registered at the medical centers. 704 households or 1,794 people were chosen. According to the findings, 61.7% of the sampled population aging 14 or above were insured by any scheme of health insurance. In lower socio-economic area, the public health assistance scheme was mostly possessed. 85.6% of the selected population was insured by single health insurance scheme whereas the remaining was insured by two or more schemes. 	Self-drug use behavior was common for slight illness while convenient transportation was given for the most reason of those seeking care at the medical center. Private hospitals were largely selected as the first choice due to their specialization. Health care expenditures were various in ranges dependent upon where and what types of services were chosen; however, two-third of total expenditures were spent on private services. Chronic cases were reported highest in number at the medical centers. Most medical center users were satisfied with the providers’ communication and patient-provider relationship. 	When getting ill, 26.2%, 24.5%, and 19.7% of the population wanted to go to private clinics, the provincial hospital and the medical centers respectively. What the population firstly needed from the services was quick and convenient care. Good communication, price and well-skilled doctors came second, third and fourth respectively. The study suggested that the medical centers more closely work with both public and private facilities to provide increasingly comprehensive care and the multi-center study be taken in order to know overall health care utilization behaviors of the population irrespective of either micro or macro-scale level.
This study objective was to synthesise a number of vision, philosophy, and view regarding health reform system in Thailand in order to put these inputs into public debate. A number of social development leaders which were 3 politicians, 5 academics, 4 community leaders, 2 businessmen and 1 representative from mass communication group, were interviewed from August 1999 to February 2000. Prior to the interview, the VDO program was shown to the interviewee and the questions were previously structured. 	The study found that problems and changes in health system were complicated. The most problematic cause was ill- or un-informed people about health leading to risk living behaviour and poor health. Health system itself particularly lack of health insurance and care quality also jeopardised people’s health. In views of most interviewees, desirable health system should be composed of good cooperation in multi-groups, emphasis on health prevention and promotion, proper structure to support the system, effective political system, response to principles of equity and society’s needs Health system reform needs vision at various levels from top (policy) to individuals. Health reform should be considered as a national goal by having clear policy, strengthening public involvement, creating health insurance, administrative decentralisation, appropriate standard of care, people centred service management, support and supervision by the government, ethical providers and people’s awareness of health
Market exclusivity and drug expenditures: the effects of Thailand New Drug Registration RegulationsThe effects on hospital drug expenditures of the market exclusivity granted to innovator products by means of Thailand regulations on new drug registration were assessed.  Self-administered questionnaires were distributed by mail to 292 public and private hospitals in February 2001 to collect data on purchase volume and value of 11 generic-approval new drugs containing 4 active chemicals, namely fluconazole, clozapine, ondansetron, and ofloxacin (injection form).  The questionnaires were returned by 166 settings (56.9%).     It was found that during the first two years of generic entry, 1999 to 2000, unit prices of generic versions of all products purchased by the hospitals were lower than the prototypes’ but prices of the originals did not change significantly.  Due to lower price of generic products and generic substitution in the hospitals, substantial decreasing in drug expenditures of totally 103.5 million baht has been observed.  Tremendously increased purchase volume of some drugs, particularly fluconazole, among these healthcare settings when generic entered the market while there was no increasing in health needs, indicates significantly improved accessibility to drug.       To potentiate the magnitude of the positive effects of generic entry on drug cost containment among hospitals and the increased accessibility to drugs, promoting drug price competition and encouraging generic substitution are recommended.
Universal Coverage Initiation and Health Care Decentralization in Different Countries	This literature review concerns about the theory and experience on universal coverage initiation that is related to health care decentralization in different countries. The review consists of two important parts. Part one involves the concept of health care decentralization, local government administration, experiences in local government arrangements in some countries, and decentralization situation in Thailand. Part two describes universal coverage initiation in various countries to understand the concept and difficulties in universal health care provision, health care financing, and roles of local government within universal coverage. It is hoped that the obtained knowledge from the review will be the fundamental foundation for policy setting and implementation of universal coverage in Thailand.	From literature review, it can be concluded that universal coverage is very essential for health service welfare. Decentralization has no direct relation to universal coverage initiation. Universal coverage can occurs without decentralization. However decentralization has been viewed as an important strategy to achieve the effective and efficient universal coverage. The obtained knowledge can be synthesized to be some recommendations for universal coverage initiation in Thailand that there should be universal coverage policy at the national level. It should be compulsory system rather than voluntary one to prevent the coming problems such as selection bias. The roles of local governments need to be clearly defined both in health care provision and financing roles. Health sector should be accepted as important as other sectors. The universal coverage should be developed step by step to avoid the opposition from both public and private sectors. Finally, it needs to have more information from additional research studies to fulfill the gap of knowledge particularly in administrative and management aspects. At least, there should be information about the roles of local governments within universal coverage in Thailand.
A survey on antismoking law compliance in Nongkhai municipal area	This  quasi-experimental study  aimed to find a local  preventive-smoking  model  for  the younger  group of  under 18  year-old. The  study  was done in 5 villages at Serm  Sub-district  Ponpisai District, Nongkhai Province, Thailand. Three study-stages  was  organized; (i) surveying  the  locals’ altitude (including  the  group  of  under  18  year-old), as  to  search  critical  smoking  accessibility factor, (ii) establishing a meeting(excluding  the 18  year-old group) as  to  achieve  a  collectively  smoking  prevention  model,  and  lastly(iii)evaluating  such  that  proposed  model.	The survey results showed the critical smoking  accessibility  factor  was “no hazard  understanding”. Only  60.6 %  of  the  younger  understood  health hazard and related smoking  prohibited law. The health volunteers, teachers, cigarette  retailers  sub-district  members, abbots,  polices  and  students  knew  new-enforcement  smoking law and  regulation  by  only  61.5 %, 62.5 %,  78.9 %, 66.7 %, 33.3 %, 61.9 % and  67.2 % respectively.  The  result  also  showed  79.4 % of  the students used  to buy cigarette. Other smoking accessibility factors were “new try”, broken  home,  elder-like smoking, no recreation activity available, no rigorous no-smoking  campaigns  done by local institutions, and lastly, influential from friends. The no-smoking  campaigns  introduced  by  the  study  were  through  education  mediums  as  smoking  causing  health-hazards. These were distributed  via several means. Such those non-smoking campaigns  included “the 18 year-old prohibited” signs adhered  at  the  cigarette  shops,  leaflet,  radio  spots,  local  anti-smoking clubs, playground sport arrangement, healthy student for not smoking competitions, no-smoking  classrooms, smoking-hazards  warning delivered by  abbots, 216 students  swore  for not smoking, monthly cigarette shops’ inspection by polices and  yearly  budget put forward  for no-smoking campaigns  by sub-district  administrative offices.	The achievement by the study campaigns could have the  more  number of students getting to know the non-smoking law increased from 26.6%  to  44.1%. The smoking rate reduced from 31.1% to 20.9%. Persons who gave up  smoking  during  the  campaign  project  were  42.5%, and  buying  cigarette  habits  decreased  from 79.4% to 45.6%. General  public smoking rate from 27.0% could  reduce  to  finally  quit  of  smoking  19.5%.	The  model  applied  by  this  study  was  genuinely  from  grass-root  initiatives,  any achievements was  then  originated  from  community-based  practice.  On-going  activities  following  the  model  applied  remained  next to  be  evaluated.