plueme/wizJson huggingface dataset:
The COVID-19 pandemic situation has affected health workforce in the public health system, health personnel could not provide care to all infected people. The situations led to home isolation equipped with volunteer health workforce in a telehealth care model. The objectives of this qualitative research were: 1) to analyze the roles and operating procedures of health workforce; 2) to analyze success factors, problems and obstacles in the implementation of home isolation telehealth care model; and 3) to synthesize the home isolation telehealth care model in terms of health workforce in Health Region 12 of Thailand. Data were collected through semi-structured in-depth interviews and online group discussions with 30 volunteers and 50 home isolated patients. Data were triangulation verified at every step of data source check, investigator, and methodology. Content analysis was carried out till interpretation, and conclusions reached. The results revealed that 1) the home isolation telehealth care model was staffed by the combined workforces of health workers and volunteers who helped take care of COVID-19 patients. The volunteers were recruited from lay people, people who had contracted COVID-19 and their relatives. 2) The combined workforces built up shared common goals through group meetings to clarify the objectives and goals of the voluntary work. 3) Training sessions began with forming volunteers’ care attitude ready to be giver to others; followed by the use of language in good communication; knowledge on COVID-19 prevention, care and rehabilitation; tele-patient assessment using information technology and patient database systems to achieve continuity of care. And 4) online patient consultations were operated to reinforce confidence of the combined health workforce. The roles and operating procedures were confined to 4 teams: 1) The central team designed patient database system to assign patients with COVID-19 to patient care team. The databases coordinated and kept track of patients’ symptoms whether they faced severe symptoms, crises, or emergency conditions that required necessary medical equipment support. 2) Patient monitoring team took responsibilities of the assigned patients, making phone calls to assess symptom changes, providing advice, encouraging mental support. This team recorded patient progress in the database. If severe symptoms of COVID-19 were detected, the team needed to notify doctor or pharmacist for appropriate action. 3) The community team was responsible for delivering the actions of the monitoring team to COVID-19 patients, such as providing medical equipment, medicines and food to their homes. And 4) the funeral volunteer team provided necessary ritual ceremony if the patient died. The key factors for success of home isolation telehealth care model included attitude, mindset, and belief in volunteer work, which conveyed peace of mind, complacent feeling and fulfilling in merit making. Problems and obstacles included difficulties of access to the database, communication and tools and the Internet system.
Background and Rationale: COVID-19 control measures impacted on stress, alcohol, and tobacco consumption, including physical inactivity and sedentary lifestyle among populations. As age is a factor in the health belief model that affected individual beliefs throughout life-course, this study aimed to explore health-related behaviors by age groups during the COVID-19 pandemic, compared to the pre-pandemic. Methodology: A cross-sectional study was done among 7,731 Thai people aged 15 years and older, through multistage sampling of the total 13 health regions and proportionate to population size of selected provinces by three age groups (adolescent: 15-24 years, working age group: 25-59 years, and elderly: 60 years and older). Face-to-face interview captured changes in health-related behaviors (increase, no change, and decrease) then analyzed by ordinal logistic regression. Results: During the COVID-19 pandemic 33.3% of Thai people were current drinker, 18.3% were current smoker, 73.5% had sedentary behavior, 6.8% were physical inactive, more than 70% had vegetable and fruit in some meal/day, 77.0% had sugar drink, and 57.7% ate fast-food. Compared to pre-pandemic, 3 out of 8 behaviors were going in positive direction - alcohol consumption (27.0%), sugar drink (11.1%), and fast-food eating (12.7%) - whereas tobacco consumption, sedentary life, physical activity, and eating vegetable and fruit were going in the opposite direction. Negative directions happened among age group 15-24 years the most, followed by the 60 years and older. Taking the 15-24 years as the reference group, the working age and the elderly had less sedentary and physical inactivity, the working age ate fast-food more frequently and the elderly even more than among adolescent group. Also, elderly group had higher risk of eating less vegetable and fruit compared to adolescent group. The 15-24 years had the most 4 highest negative health behavior changes compared to pre-pandemic including sedentary life, less physical activity, more sugar-drink (p < 0.01), and more fast-food. Conclusion: During the COVID-19 pandemic, the adolescent had most negative health-related behaviors, whereas the working age and the older persons had higher risk of having fast-food than the adolescent. Government should further develop interventions specific to age groups. New interventions should create enabling healthy environments to adolescent and the vulnerable groups during the pandemic.
This lesson learned study aimed to review documents and experiences gained from story-telling of 50 executives and practitioners involving with international sports events during COVID-19 pandemic. Key informants were from government and private organizations who agreed to participate in phone and video conference interviews or discussions with an open-ended questionnaire conducted in September 2021. According to research findings, the operations of international sports events with no audiences during the COVID-19 pandemic used quarantine measures called “organizational quarantine type B” provided an opportunity for athletes to be eligible to participate in the Tokyo 2020 Olympic and Paralympic Games. All the authorities involved expressed concerns on challenges of the management of sports events under quarantine. Even though the accomplishments did not have direct economic worth, Thailand had shown the potential of controlling the COVID-19 pandemic internationally. The sports events during COVID-19 with appropriate preventive measures had proved that they promoted social and economic mobility. Combined with other quarantine facilities, the contracted souvenir shops, restaurants and other recreation facilities with disease prevention and control standards, could help decrease stress and distribute profits to the community.
This research is an international collaboration among three organizations: the National Science and Technology Development Agency, the Pharmaceutical Organization, and the University of Oxford. Its purpose is to study the potential use of temperature sensor technology in pharmaceutical and medical applications. Temperature sensor technology can measure Thermal Product (TP), a heat property that is specific to each type of substance, and varies with the substance's density, specific heat capacity, and thermal conductivity. The University of Oxford has developed this technology for commercial use in the aerospace industry, specifically for detecting metal contamination in engine oil. We performed a feasibility study for commercial applications in various aspects in this project. The technology is tested in three areas: quality control of pharmaceuticals and raw materials, detection of counterfeit drugs or substandard drugs, and production processes related to medical cannabis. Collaborative research has been conducted to improve the sensor system for more appropriate use. From preliminary experiments, it was concluded that the current sensor system works well with liquid substances and has high sensitivity to detect changes in substance proportions. Therefore, it is suitable for use in quality control processes that require accurate measurement of substance proportions. The system is feasible both technically and commercially for use in quality control processes for drug production and pharmaceutical raw materials. It can help increase efficiency in production by adding real-time quality inspection and control processes during production stages, as the current quality control mainly relies on final product testing. The research team has proposed to install and test the system in the production process of Deferasirox, a pharmaceutical raw material product developed by the Governmental Pharmaceutical Organization (GPO), which is entering the commercial production stage in the middle of 2024. This will be the practical application of research results for commercial use which can also be expanded in the future.
The 2019 coronavirus outbreak has forced many industrial plants to shut down, then negatively affecting to the industrial sector and the economy of Thailand. Serial testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proposed as a measure for safe factory reopening. This study examines the efficacy of detecting the pathogenic SARS-CoV-2 infection by detecting antigens in saliva samples. It compares the results obtained from the automated machine with the results of the manual antigen detection. The samples used in the study were saliva samples obtained from industrial workers in Bangkok and Nonthaburi provinces between March 2022 and May 2022. A total of 4,364 participants attended the study, of which 85 were confirmed to be infected with SARS-CoV-2. An automated antigen detection using Lumipulse G1200 SARS-CoV-2 Ag detection and manual antigen test kit were compared with RT-PCR. The test results showed that The Lumipulse G1200 SARS-CoV-2 Ag is effective in detecting SARS-CoV-2 infection and results were comparable to confirmation method by RT-PCR with the sensitivity and specificity of SARS-CoV-2 as 87.0% (95% CI 78.0%–93.4%) and 99.0% (95% CI 96.6%–99.9%) respectively. In conclusion, the Lumipulse G1200 SARS-CoV-2 Ag is a capable tool for screening pathogens for SARS-CoV-2 and provide accurate test results when ccompare to the standard test method. The instrument is therefore suitable for use in epidemic situations where large volumes of samples are required to be tested, such as factory or school samples.
At present, the importance of data-driven policy in healthcare is paramount, especially with the emergence of Big Data. Thailand can benefit from diverse data channels to enhance efficiency in primary healthcare services. This study aimed to assess the feasibility of developing a big data system for primary healthcare in Thailand. This includes exploring access and feasibility of relevant data, resource allocation, and assessing potential collaborations among stakeholders. For data feasibility, we reviewed literature and interviewed various data sources. The analysis focused on environmental factors, health resources, individual factors, and behavioral patterns that affect health data. Regarding resource feasibility, we outlined several scenarios for data aggregation from in-depth interviews with experts and relevant organizations, providing direction for maximum benefit from the big data system. Furthermore, focus group discussions were held to discuss collaborative strategies among different agencies. The study results showed the feasibility of important data in environmental, health, and behavioral health aspects. It was found that there is potential data that could be beneficial and comprehensive. Additionally, interviews and focus group discussions emphasized the enthusiasm of organizations to collaborate effectively. However, challenges in data standardization and system interoperability remain. Yet, there's a consensus on the massive benefits of big data. In conclusion, establishing a big data system for primary healthcare in Thailand is not only appropriate but also feasible with robust data. Nevertheless, this challenge hinges on the collaboration of key stakeholders, driven by a shared vision and understanding of its transformative potential.
This project aims to (1) search for early warning signs or risk factors related to health impacts associated with the transfer of tambon health promoting hospitals (THPHs), (2) study changes in resource management, health service provision, and public health operations of THPHs that have been transferred to provincial administrative organizations (PAOs), including necessary systemic management approaches, and (3) analyze and synthesize financial, treasury, information, and legal tools to establish an environmental public health system framework for the transferred PHFs to respond to post-transfer health impact situations. The study employs a mixed methods approach, consisting of (1) a qualitative case study conducted in 12 areas across 6 provinces, and (2) a retrospective cohort study with a focus on the first-year post-transfer (fiscal year 2566). It emphasizes baseline data analysis from fiscal years 2561 to 2565 to identify risks and develop measurement sets and information for monitoring future impacts. The project's duration is from September 1, 2022, to August 31, 2023. Key findings from the study reveal that the evaluation framework for health impacts of the THPH transfer should include (1) health outcomes, (2) costs of care, (3) public health outcomes, (4) primary care access, (5) effectiveness or adherence to medical guidelines and timely care, (6) alignment with public health activity frameworks and goals, and (7) resources and management models. This framework can serve as early warning indicators for monitoring post-transfer health impacts. Furthermore, statistical indicators on various aspects of operational differences, trends, and post-transfer changes were identified between transferred THPHs and those that were not transferred, or areas having varying proportions of the transfer. However, it should be noted that certain indicators in the proposed framework lacked data readiness due to limitations in data collection. The surveys with low response rate, despite being conducted by district health officers, might reflect the challenges in executing their existing duties under the new context of decentralized health systems. Additionally, changes in resource management of THPHs transferred to PAOs led to health service reductions, including public health activities. The Ministry of Public Health, the National Health Security Office, the Local Administration Organization Empowerment Committee, the Prime Minister's Office, and the Department of Local Administration, along with relevant agencies, should collaborate to review, plan, and design a monitoring and response system to prevent and address health impacts on the public resulting from the transfer of THPHs to PAOs. This also includes reviewing and re-designing a system for supervising the area-based public health system.
Background: Chronic kidney disease (CKD) is prevalent in Thialand that incure high healthcare expenditure. Screening for high risk CKD is recommended to contribute benefit. Aging is one of a CKD risk factor, though this service is yet excluded from the Universal Coveragre Benefit Package (UCBP). Objective: To propose a recommendation for elderly CKD screening to be included in the UCBP by performing economic evaluation, budget impact analysis, and feasibility of delivery such a service. Methods: A cost-effectiveness analysis (CEA) of six screening methods was carried from societal and provider perspective. Decision-tree and markov model were used to simulate screening and CKD health states. Screening methods included Serum creatinine (Scr), Proteinuria dipstick (Pro), Microalbuminuria dipstick (Micro), Albumin-to-creatinine ratio (ACR) dipstick (ACRdip), combined Pro+Scr, and combined Micro+Scr. Parameters were reviewed and analysed by meta-analysis. Sensitivity and threshold analysis were performed to identify uncertaintity of the CEA results. Budget impact analysis was conducted to estimate 5-year budget for NHSO. Feasibility of service delivery was explored by qualitative approach using telephone interview. Results: Under Thailand’s willingness to pay of 160,000 baht/QALY, the six screening methods were cost-effective. CKD screening incurred additional cost and effectiveness. ICER of the six methods were between 16,878.73 - 24,245.37 and 13,844.74-20,503.14 baht/QALY for societal and provider perspective, respectively. Protienuria dipstick had the lowest ICER and exhibited a 5-years-budget of 5,653 million baht for screening and treatment, however treatment budget was the major proportion of the budget (97-99%). Primary care practitioners agreed the benefit of CKD screening and suggest to implement a screening method that ease to use. Preparing for CKD screening before implementation should concern: human resources, training about screening, CKD related services and referral system, educate elderly about CKD to increase compliance to screening and treatment. Conclusion: Annual CKD screening for elderly is cost-effective. Although protienuria dipstick incures the lowest budget to NHSO for screening and treatment. However microalbuminuria dipstick should be selected because of its highest cost-effectiveness. Elderly CKD screening is feasible for primary care but need some prepations regarding healthcare resources: human resources, CKD related services and referral system. This study recommends that CKD Annual CKD screening for elderly should be included in the UCBP.
Objectives: (1) to examine prevalence of medication non-adherence (2) to investigate the factors contributing to non-adherence to medication treatment among elderly patients with non-communicable diseases receiving treatment as outpatients. (3) To evaluate the value of unused medication resulting from non-adherence to medication treatment among elderly patients with non-communicable diseases. Methods: This was a cross-sectional descriptive study. Participants were selected from the electronic hospital database using random sampling. Data will be collected through a developed interview questionnaire based on the study objectives. Study setting in rural area was NongPhra district Health Promotion Hospital, Phitsanulok; in urban area was Rajvithi hospital, Bangkok. Data analysis was performed using descriptive statistics, employing SPSS version 21. Results: In rural area, from 214 participants, overall prevalence of medication non-adherence in older adults with non-communicable diseases patients was 98.1%. Prevalence of non-adherence patients for each step were as followed; refill 43 (20.1%) understand 185 (86.4%) organize 174 (81.3%) take 175 (81.8%) monitor 181 (84.6%) sustain 175 (81.8%). The total of unused medicine was 11,007.5 pills. The economic impact of unused medicine was 10,027.63 Baht and average 63.07 Baht per person. Medication for treating cardiovascular diseases were mostly involved in medication non-adherence. In urban area, from a sample of 286 elderly patients with non-communicable diseases, the prevalence of medication non-adherence in elderly patients with non-communicable diseases was 29.72%. For the factors associated with non-adherence using chi-square and Fisher exact tests, no significant differences were found between the two sample groups. When calculating the quantity and value of unused medication for the entire sample group, it was found that there were 11,341 remaining medication units with a total value of 46,339.14 Baht, averaging 545.16 Baht per patient. Atorvastatin 40 mg was the medication with the highest value of unused medication, amounting to 12,337.50 Baht, while Metformin 500 mg was the highest quantity of unused medication with 11,141.50 medication units. Conclusions: Medication non-adherence is prevalent, especially in rural area. Effective and easy interventions should be in place for dealing with medication non-adherence.
Background: The previous study, entitled “The Development of Multi-Sectoral Approaches to End TB in Municipality and Central District (year 1)" was conducted in Chiangrai province in 2019 and 2020 revealed private pharmacies and clinics contributed to 25% tuberculosis (TB) detection rate (6 of 24 referred cases). Subsequently, this project was extended and implemented in 8 provinces of the Health Region 1 amid the Covid-19 pandemic. The project was coordinated by 8 operational researchers (OR) who are government health staff in provinces. The study aimed to develop a model involving pharmacies/clinics to screen and refer persons with TB risks and to investigate factors contributing to the implementation outcomes among 8 provinces. Methods: Developing two digital innovations, i.e. TB-Refer, a web-application for TB screening and referral and a TB online training course. The data were collected for 9 months and analyzed database of TB-Refer. The qualitative methods included in-depth interviews with OR, provincial TB administrators (Mr.TB), hospital staff and the pharmacies/clinics with and without referral cases. Results: The participation rate of pharmacies in 8 provinces is 50.4% (143/284) with a range of 12.7%-100% participation. Participation from clinics is only 4.6% (11/240) with no-participation in 2 provinces. Of the 143 pharmacies, 19 (13.3%) pharmacies screen and referred 37 persons with TB risk to the hospitals, while 2 out of 11 clinics screen and referred 2 cases made up to a total of 39 referred cases (38 symptomatic cases and 1 asymptomatic contact case). Only 19 referred persons arrived the hospitals and received TB screening and one pulmonary TB with sputum positive (AFB 3+) was detected. Fifty-seven pharmacists and five clinics doctors/staff enrolled and completed this training. The median scores of drug stores were increased from 16 (IQR = 4) to 23 (IQR = 2) (p < 0.001) while the mean scores of clinics were increased from 17.8 (SD 4.5) to 21.8 (SD 2.3) (p = 0.034). Drug stores and clinics completing the course had higher proportion of TB screening and referral cases to the hospitals than those without training (22.6% vs 7.6%, p=0.008). Among 8 provinces, only one province demonstrated regular referral and continuity of communications between OR and pharmacies/clinics. The OR of this province is a staff of disease control department who received excellent support from the department of consumer protection and public health pharmacies (CPHP), including supports from Mr.TB of the hospital and the provincial health office, particularly establishing a hospital’s fast track for referred patients. Conclusion and recommendations: It is feasible to involve drug stores and private clinic to screen and refer persons with TB risks to the hospital. The best model is the project’s coordinator should be a staff of disease control with good support of CPHP and provincial health authorities. Personals of drug stores and clinic should attend the TB online training course.