plueme/wizJson huggingface dataset:
One of the factors that contribute to obesity in children is food advertisement because it can influence
the eating behaviour of children. Advertising is a marketing strategy to build brand recognition of food. The goals are to promote the product and increase children’s food consumption. . The objectives of
this survey research were to assess the recognition of brand logos among students in primary 6and to
examine the relationship between individuals’ abilities to recognize brand logos and their demographic
eating behaviour. Methods: There were 453 children from two primary schools in Bangkok and in
Phetchaburi joined in this study by purposive sampling. A self-administered questionnaire survey was
administered to gather demographic characteristics, nutrition, and their abilities to recognize brand logos.
This study found that 64.7% (239 students) of the children demonstrated a high brand logos recognition
recognizing 14 food brand logos in the questionnaire. Among these children, the number of children who
ate unhealthy food; consumption of snack, fast foods, and soft drinks was higher than those who ate
vegetables and fruit. In addition, BMI, parent’s educational level, mother’s occupation, habit of eating
breakfast every day, eating snacks and, fast foods were associated with the abilities to recognize brand
logos. To conclude, there is a correlation between poorer eating behaviours and brand logos recognition
ability of school children. However, health promotion campaign should be emphasized among school
children to increase their awareness of how unhealthy eating habit can affect obesity
This study was conducted to learn of the changes that had occurred during the five-year period of
the transfer of subdistrict (tambon) health centers to Tambon Administrative Organizations (TAOs) and
municipalities. Both quantitative and qualitative data were collected from primary and secondary sources;
and then data were processed and policy recommendations were synthesized for submission to highlevel
administrators of the Ministry of Public Health (MoPH) and other relevant agencies in the next phase. Documentary review was conducted on program implementation documents of agencies concerned,
various evaluative research papers, and reports on program monitoring and evaluation carried out continuously
by administrators of the local government organizations (LGOs), the transferred health officials,
and the people who had received health services from the health centers before and after the transfer,
and the participatory observation of the transfer process especially to the LGOs as the management
agencies. The results in the three dimensions are as follows: (1) The progress of the transfer, over the past
five years, have shown positive changes in most of the local health programs as their services are responsive
to the needs of the communities. Of all 26 transferred health centers, only 2 health centers had only 1
health official transferred to each of them, which was too few and the recruitment of additional staff by the
local agencies was constrained by the local context. (2) The lessons learned from transfer with regard to
specific cases and overall common lessons are the information that can be used for consideration for
policy and operation improvements. (3) The policy recommendations for MoPH and the Office of the
Decentralization to Local Government Organizations Committee (DLOC) regarding the options of transfer
are: (a) transfer in the old pattern, but with the revision of criteria, conditions, and process to prevent
negative effects; and the roles and responsibilities of relevant agencies have to be made clearer by an
independent mechanism; (b) the new model of transfer, i.e. MoPH has to take this matter seriously especially
in the pilot-scale decentralization and the synthesis of lessons learned; and the DLOC has to have a
strong and adequate support mechanism and procedures; and (c) non-transfer but working together
collaboratively by MoPH and LGOs with clearly specified roles and responsibilities.
Role of community pharmacies for caring chronic disease patients together with primary care units is still new in Thailand. The objective of this study was to compare clinical outcomes of providing pharmaceutical
care in patients with diabetes mellitus and hypertension who got prescriptions refilled between
two accredited community pharmacies (the intervention group) and two primary care units (the
control group). The study was quasi-experimental design with a control group. The duration of the study
was between September 2008 - July 2011. The intervention group received the individual care each month
for 5 months by the community pharmacists and PharmD students. In the fifth month at the community
pharmacies, the patient medication record of each patient was reported back to the primary care units.
Blood pressure, blood sugar, drug related problems and patients’ satisfaction were recorded. There were
totally 59 eligible patients (28 and 31 patients in the intervention and the control group, respectively). The
proportions of patients who achieved target goals of blood pressure control and blood sugar control were
1.242 (OR 1.242; CI: 0.458-4.312) and – 0.675 (OR 0.675; CI: 0.174-2.653) when compared with the control
group. There was not different between groups. The community pharmacists mostly solved the drug
related problem of non-adherence in the treatment group (81.8 %) and made a referral to the primary care
units due to an adverse drug event (bradycardia was probably from atenolol). The treatment group was
highest satisfied with the relax feeling to talk to the pharmacists. The control group was highest satisfied
with the willing to comply for the next schedule. In conclusion patients received prescriptions refilled
from accredited community pharmacies have potential clinical benefits as received from the primary care
units. Patients in the treatment group had a high satisfaction to the pharmacists’ service
Cold weather is one of causes that can be effected to higher morbidity and mortality in Thai citizens.
Hypothermia condition can lead to a dangerous of the brain and heart. A cross-sectional study aimed to
monitor trend, described characteristics of the deaths, identified risky behaviors and risk factors of coldrelated
to death for future planning in assistance to the victims. The guidance, definition of cold-related
deaths and reporting form have been developed for the surveillance system. The results showed that total
number of 30 deaths and suspected cases related to the cold weather had been reported from 21 provinces.
Out of these, 2 from Lei and Chiangrai province were confirmed for cold-related deaths. Most of them
were male (86.7%), mean age was 49 years, 30.1% were elderly (> 60 years). 40.0% were indoor deaths
whilst the others were outdoor deaths. The major risk factors were exposure to cold weather combined
with alcohol drinking, having underlying diseases and wearing clothing that could not prevent cold weather
(60.0%, 53.3% and 83.3% respectively). The above results can be beneficial to the health care guidance,
providing appropriate assistance to the risk group such as children, elderly or people with underlying
diseases including health service, referral system and provide warm clothing in order to decrease coldrelated
mortality.
The study is part of continuous review of the Ethics Committee. The objective of the study is to
follow up the adherence of the research proposals approved by the Ethics Committee of the Institute for
the Developments of Human Research Protections (IHRP). Methods: All the studies approved during the
year 2008-2010 were randomized by stratified random sampling. The sample size is 20 from the total of
197 studies. The relevant documents were revised and the researchers were interviewed. The data were
analysed by percentage. Findings: Majority or almost all of the studies adhered to the approved protocol,
i.e., volunteer recruitment, information provision and consent process, submission for protocol amendments,
documentation in case of protocol deviation, keeping and control of studied drugs, provision of
compensation for the volunteers, keeping of confidentiality, data record and the operating procedure in
case of termination of the study. Conclusion: The studies that strictly adhere to the research protocol are
those drug studies, including both new drugs and bioequivalent studies. The main reason for good adherence
is to maintain the credibility of the data, otherwise it will not be accepted for drug registration. Some
studies that were not fully adhere to the practice guidelines for drug studies were social science studies.
Since there was no appropriate guidelines available. The operational guidelines for social science studies
should be developed.
Back ground: Valvular heart disease, a chronic illness with high mortality rate, is difficult to treat
and prone to complications, especially from warfarin. In 2009, before implementing the network of care in
Health region 13, we found that about 50 cases of total 217 cases (23.04%) had been brought back to the
hospital due to warfarin using. Because of this problem, the network of care for warfarin use has been set up in January 2010 to look after these patients for continuity of care and to maintain wafarin level. Objective:
To study the result of implementing network of care for post-operative valvular heart disease patients
who use warfarin. Setting: Health region 13 Method: The study is divided into 3 phases;1) situation
analysis 2) developing network of care guideline and 3) implementing and evaluation. The data were
collected during January to March 2009 by questionnaire, depth interview, observation and focus group
discussion. A descriptive statistic and content analysis were used to analyze the data.
Result: During January to March 2009, only 9 patients (8.11 % & 0.48% of post operative patients & of
1,881 patients who use warfarin during that time respectively) came back to the hospital due to warfarin
using ( 5 due to overdose & 4 due to valve dysfunction ). From 15 committed hospitals, 13 hospitals were
ready for implementation, 9 & 4 were community hospitals & general hospitals respectively. Conclusion:
The network of care with guideline, monitoring and supervisioon can improve the quality of life by decreasing
the complication of warfarin use.
Drug price control is one of the measures to contain health care costs. This paper briefly reviewed
the price control methods that have been commonly employed in developed countries. Experience in controlling drug prices by government agencies in Thailand was analyzed and recent findings from the
Research Projects on Drug Prices (B.E. 2553-2555) that have been supported by the Health Systems Research
Institute were summarized. Policy recommendations for the control of both purchased and reimbursed
prices were additionally proposed. The National Lists of Essential Medicines should be strategically
mobilized as an indirect measure of price control. To control the purchased prices of new drugs,
innovative strategies of pool purchasing and price negotiation should be implemented under collaboration
with health insurance funds. Routine monitoring of the hospital-purchased prices should be supported
so as to obtain the regular and update information on drug pricing. The reimbursed price of a
generic drug that is covered by the National Lists of Essential Medicines should be set at an adequately
high rate that can incentivize the use. An agency for the development and maintenance of standardized
drug databases should be established. The long-run development should include the price monitoring
infrastructure in every step, from essential drug selection, drug purchasing, utilization and reimbursement.
People living in urban areas are growing; therefore, urban primary medical care is more crucial.
Studying urban primary care systems in various countries will make us learn from best practice in each
country which may be applied to Thai urban medical system. Objectives of this study were to analyze and
compare urban primary care systems among each country. Study design was documentary research about
urban primary care systems in 14 countries including Brazil, Canada, Spain, Cuba, Republic of Korea,
Japan, Taiwan, Hong Kong, Denmark, Sweden, Belgium, United Kingdom, United States of America, and
Australia. Primary Care Evaluation Tool (PCET) of WHO European Region was used as a framework for
analysis. From this study, countries with gatekeeper system (patients were screened by general practitioners
or family physicians ) had good continuous, collaborative, and coordinate care with appropriate
health care costs. Most of countries which governments spent budget for people’s medical care expenses
had provided general practitioners or family physicians as gatekeepers acting in patients screening. There
was no gatekeeper system in countries which people were responsible for their own medical care expenses
but co-payment system was involved to reduce unnecessary service uses.
This study focused on a review of the national system for drug price policy. Methods including
interviewing key persons in various organizations, meetings with experts, studying related documents
and literatures, were used. The study revealed that Ministry of Public Health (MOPH hospitals) had several
indirect drug price control mechanisms for government sector especially for the MOPH hospitals themselves. Drug price control has been started in the process of national essential drug list (ED) selection.
Cost effectiveness and budget impact analyses were parts of the consideration criteria. After drugs
were selected as the ED, median price would be set as the price control measure for procurement process
of MOPH hospitals. In addition, central negotiation was used for controlling price of single source nonessential
drugs in MOPH hospitals. National Health Security Office takes the leading role in price negotiating
of high cost ED to ensure accessibility for their beneficiaries. However, limited items were negotiated
in each year. Group purchasing in level of provinces and regions was not much expanded from the
past.
There exists no autonomous body and no regulation for controlling of manufacturer price setting
before drug registration processes. No regulation and system for controlling mark up in private sector
have been implemented. Selling price was controlled to not more than price list. For drug price monitoring,
only voluntary reporting of MOPH hospital purchasing price was available under the Drug and
Medical Supply Information Center (DMSIC).
As the ways to improve drug price control system in Thailand, manufacturer production cost structure
should be submitted as the condition for national essential drug list consideration. In terms of negotiation,
knowledge management of negotiation and purchasing strategies, expanding of items for central
negotiation for all three health insurance schemes are encouraged. Drug price setting for procurement
and a monitoring system should be improved. Moreover, a study on adverse effects of drug price control
system on domestic pharmaceutical industries is necessary.
Rational drug use would lead to sustain health care financing. Currently, most hospitals have prescribing
data recorded in standard electronic databases. However, an analysis of these electronic data-bases providing a performance feedback on quality of prescribing is limited. The analysis algorithms to
assess prescribing indicators for 18 standard files on out-patient services using SQL program were developed.
Pharmacists and computer staff from 134 hospitals voluntarily attended the 3-day training sessions.
We reported the results of analyses of fiscal year 2553 data of the 88 attending hospitals. The information
presented could be used to guide not only health care settings, but also health policy makers, in terms of
rational antibiotic prescribing for common cold and diarrhea, inhaled coticostroid (ICS) prescribing for
asthma patients, and angiotensin converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers
(ARBs), and statins prescribing for diabetes patients.
More than half of hospitals had greater than 50% of oral antibiotic prescriptions in common cold,
and quinolones prescriptions in non-infected diarrhea. ICS prescriptions in asthma patients, and ACEIs/
ARBs and statins in diabetes patients were moderately prescribed. However for the latter two conditions
high variations across hospitals were found. The findings urge that all hospitals should promote analysis
of the hospital electronic database to obtain the feedback information, which in turn can guide the implementation
of activities to increase quality of prescribing, at least for the reported conditions.
Background: There are many effective drug pricing systems which Thai Government should employ
to solve drug pricing problems especially at the reimbursement level. This research focuses on a
comparison of budget saved by the payer after the application of different drug pricing measures at the
reimbursement level.
Methods: This was a quantitative research. The budget impact analysis modeling to estimate the
budget saved from the pricing policy implementation was employed.
Drugs belonged to the group HMG-CoA reductase inhibitor (statins) were purposive sampling to be
the sample for the budget impact analysis. They were divided into 3 groups and the sample of each group
was shown in the bracket: 1) Innovative drug with therapeutic improvement (Rosuvastatin), 2) Innovative
drug with technical improvement (Amlodipine+Atorvastatin), and 3) Innovative drug with Generic
drug (Atorvastatin).
Drug pricing measures assigned for each drug groups were 1) Price Volume Agreement, 2) Value
Based Pricing, 3) Maximum Allowable cost, and 4) Reference pricing.
Results: In terms of budget saving for: 1) Innovative drug with therapeutic improvement group:
Reference Pricing measure saved more budget than Price Volume Agreement. 2) ) Innovative drug with
technical improvement group: Value Based Pricing measure saved more budget than Price Volume Agreement.
3) Innovative drug with Generic drug group: Reference Pricing measure saved more budget than
Maximum Allowable Cost.
Discussion: The magnitude of saving in each measure depends on the factors such as percentage of
drug rational use, numbers and prices of drugs available in the market, and availability of local made
drugs.
Conclusion: There are many effective drug pricing measures which can be used to reduce the reimbursement
budget. The government should place the right measure to each drug to gain its most benefit.
Total drug expenditure for Civil Servant Medical Benefit Scheme (CSMBS) has rapidly increased.
Reference pricing (RP, or maximum reimbursable limit) for drugs is proposed as a means to control drug
expenditure. The objectives of this study were to determine the RP of five high expenditure drug groups
and estimate the budget impact of RP implementation. Prescription records of 29 public hospitals in 2010
were collected. Drug utilization and several RP’s of each drug product were determined. Then, overall
budget impact was determined for RP under three different scenarios.
Results showed that there were 1.7 million prescriptions, accounted for 2.5 billion baht. By drug
group, total number of prescriptions were 39.96%, 26.25%, 16.57%, 13.68% and 3.55% while total expenditures
were 44.65%, 20.43%, 20.59%, 4.47% and 9.85% for statins, Proton Pump Inhibitors (PPI), Angiotensin
Receptor Blockers (ARB), Angiotensin-Converting Enzyme Inhibitors (ACEI), and Bisphosphonates
(BIS) respectively. Brand name drugs accounted for 94.8% of expenditures but 50.6% of prescriptions. If
RP was implemented, the highest savings (50.39% of expenditure) would be from pharmacological substitution
(eg. price of Atorvastatin is equal to median price of generic Simvastatin). Generic substitution
(median price of generic for brand Simvastatin) would result in 20.56% savings while 15.91%-17.26%
savings would be achieved if brand drugs were reimbursed at cost plus 50 or 30 baht dispensing fee per
item respectively.
Use of high price, brand drugs has burdened the overall drug expenditure of government hospitals.
Reference pricing would encourage generic drug use and thus, help not only to control overall expenditure,
but also strengthen the local manufacturing drug industry.
This qualitative research used purposive sampling through in-depth interviews from main caregivers
whose severe ex-thalassemic children underwent successful hematopoietic stem cell transplantation (HSCT). Participated caregivers were interviewed using a semi-structured questionnaire based on openended
questioning and tape-recorded after receiving their informed consent. Transcripts of the interviewed
were created verbatim and examined using content analysis.
Results revealed that HSCT treatment procedure requires comprehensive understanding and cooperation
from patients and their families. Economic household burden is the main hindrance for accessibility
toward this service owing to its high direct non-medical costs as well as service charges although
HSCT can be reimbursed from all Thai health insurance schemes.
It is very crucial to prevent new thalassemic cases in order to alleviate the impact on the resource
allocation for treating a preventable disease in both household and public sectors. Therefore, public health
policy makers should consider creating a disease awareness campaign among citizens as well as healthcare
personnel who should have the comprehensive understanding about potential obstacles of the patients or
families and should commit to perform more effective thalassemia screening and prevention both in policy
and routine practice aspects.
The Statue on National Health System B.E 2552 section 7, the health system must promote human
value and dignity and attach importance to fairness and equity in society. This concept leads to an attempt
to capture interaction between providers and users in order to improve and develop the health service
system. Every person should be treated equally even though he/she accesses to care under different health
insurance schemes and hospital types. The purpose of this research was to assess the responsiveness of
Thai health care service system according to different types of national health insurance schemes and
health care facilities in 9 provinces. An exit survey of 6,507 out-patients covered by 3 health care schemes:
Civil Servants Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS) and Universal Coverage
Scheme (UCS), was conducted. The health care settings included 4 hospital types: regional/general hospital,
community hospital, university hospital and private hospital. The field survey period was from April
to June 2011.
The study revealed that there were significant difference between median scores, both overall and
hospital-type based, of responsiveness to users among three schemes in some domains and responsiveness
scores under the CSMBS was higher than those from the SSS and UCS. Nevertheless, results from
logistic regression show that, when 75 percentile of score of each component was adopted as cut point for
high responsiveness, health insurance scheme was not significantly associated with all responsiveness
components, except choice: the scores of the CSMBS was significantly higher than those of the UCS. On
the other hand, type of hospital was significantly associated with responsiveness in all components. Overall,
the score of private hospital was significantly higher than those of the others, whereas that of the
university hospital was significantly lower than the scores of the other hospitals, except choice, which was
significantly higher than in the university hospital than in the regional/general hospital.