plueme/wizJson huggingface dataset:
This study is aimed at providing a detailed analysis of the nursing workforce in Thailand and monitoring
the supply and demand of the nurse workforce. The study was conducted in order to identify the
size, age structure, and the increasing trend of the current registered nurse workforce and to assess the balance between the supply and demand for nurses in order to understand whether there is any current
shortfall or surplus. The research population consisted of 100,671 nurses registered in the Thai Nursing
Council database. The findings led to the following conclusions:
1. There were approximately 97,942 nurses in the active age group (under 60 years) registered in
Thailand by December 2005. Of these, around 88,440 or 90.3 percent participated in the nursing workforce.
At the same time, owing to the impact of the increasing demand for health services and the decreasing
supply of nursing professionals, their numbers remain woefully insufficient for meeting the country’s
health needs, with the total shortage being on the order of 31,260 full-time equivalents.
2. Although total nurse numbers have been relatively constant during the period 2000-2001, between
2000 and 2004 there was also a substantial overall decrease in the net additions to the nurse population of
35.29 percent (from 6,086 to 3,938) because of the decreases in the production of nurses and the increases
in the loss rate, from 2.35 percent in 2000 to 4.15 percent in 2005.
3. The workforce is aging; the average age of Thai nurses has increased to 37.8 years and the average
working life declined to 22 years, which is typical of most Western countries.
The nursing shortage occurring in health systems is bringing in its wake a serious crisis in terms of
their duration of adverse impacts on the health and well-being of the population. This situation poses
unprecedented challenges for policy makers and planners to take effective action in developing and sustaining
an appropriately prepared, equitably deployed, well-motivated and well-supported nurse
workforce.
The objective of this study was to describe the migration and the distribution pattern of pharmacists
in Thailand. A self-administered questionnaire survey was employed. Stratifried sampling by timing of
the compulsory pharmacist project of the Ministry of Public Health was used in the survey. The total
sample included 1,500 registered pharmacists in three sub-units: those who graduated with a bachalor’s
degree before, between, and after the compulsory pharmacist project, i.e. those who graduated between
1975 and 1988, 1989 and 2004, 2005 and 2006, respectively. The response rate was 43.27 percent. The
results showed that 59.78 percent of the samples had moved 1.8 times on average. The mobility patterns
from their first to current workplaces were different among the three sub-groups. According to the distribution, the results indicated that the number of pharmacists was increasingly distributed into regional
areas. Most of them had worked for the government sector, especially in government hospitals. It was
concluded that the compulsory pharmacist project may effect imbalances in the distribution of pharmacists in the public and private sectors. This problem could distort the professional development of pharmacists, particularly in the pharmaceutical industry and drugstores. Therefore, it is necessary to consider
the balance in the distribution of pharmacists between the public and private sectors in Thailand.
Unit cost analysis has often been used as a tool to determine the efficiency of a health-care facility.
Policy makers employ the unit cost of health services in order to make decisions on resource allocation
and for efficiency improvement. This descriptive study was aimed at calculating the unit cost for each cost
center in Mae Sariang District Hospital by collecting financial and accounting secondary data during
fiscal years (FY) 2003 and 2004. The study then evaluated a change in the unit costs of the health services
in each cost center for the two-year period. This study applied the principle of cost analysis and the manual
of unit cost analysis for district hospitals affiliated with the International Health Policy Program (IHPP).
Costs in the study were defined as accounting costs with a provider’s perspective.
The results showed the following proportion of labor costs, material costs, and capital costs in FY
2003 and 2004: 57.73; 27.59; 14.68 and 61.61; 31.61; 6.78, respectively. Average unit costs of all outpatient
departments were Baht 257.01 and 256.33 respectively. Those of all in-patient departments were 4,579.31
and 4,944.22 Baht per case admission, respectively, and the unit costs per adjusted relative weights were
6,575.79 and 7,177.76 Baht, respectively. Compared with the out-patient departments, the unit cost of
dental services was the highest (679.28 baht per visit) in FY 2003 and the counseling service department
had the highest cost (684.39 baht per visit) in FY 2004. Among in-patient wards, the intensive care unit
(ICU) had the highest cost in both years (14,327.40 and 12,338.29 baht respectively per case admission). A
comparison between both years revealed an increase in the number of ambulatory visits and in-patientdays
in most departments. Compared with unit costs in FY 2003, half of the out-patient service centers
had a higher unit cost, but most of the in-patient departments, except for the male ward, could operate at
a cheaper in-patient-day. The data collection methods and the unit cost calculations as described in the Manual of Unit Cost
Analysis for District Hospitals, which were used in the study, were practical and easy. The proportion of
the labor costs to total costs of Mae Sariang Hospital was similar to that of other district hospitals. The
average unit cost of out-patient services was not very different from that of other 90-bed hospitals, but the
average unit cost per in-patient case was higher. Specialists practicing in the hospital and the provision of
ICU services and preterm baby care may explain the more expensive unit cost for in-patient care. In terms
of cost efficiency, an increasing number of patients and the total expenditure in some service centers actually
resulted in an increase in the unit cost; thus, several service centers surprisingly turned out a cheaper
unit cost for visits as well as unit cost of in-patient-days. The findings may indicate greater efficiency of
resource utilization. However, the quality of health services and relative weight of diagnosis-related groups
should be taken into account.
During the period February - August 2005, an outbreak of viral hepatitis A occurred in Wiangpapao
district, Chiang Rai Province. An investigation was promptly carried out in order to determine the source
of disease transmission and provide preventive and control measures. The medical records and investigation
forms of the persons diagnosed with viral hepatitis A during the outbreak were reviewed. An
environmental survey was conducted in those areas. Proportions and attack rates were used to present
the results of the analysis.
A total of 1,308 cases of hepatitis with two deaths were detected during the outbreak. One case with
diabetes mellitus died from hyperglycemia and the other died of scrub typhus. Children aged 5-14 years
had the highest attack rate (7.5 %). The male-to-female ratio was about 1.6:1. The cases were reported
from all subdistricts in Wiangpao district. Only two cases were reported in February 2005 and a number
of cases were found in April and May 2005. Of the 438 cases examined for IgM anti-hepatitis A virus, 361
(82.4%) were positive. Contaminated ice might have been the source of transmission since a lot of cases
reported that they had consumed ice produced by one factory in the district. Samples of ice from that
factory were found it to be harbouring the causative organisms. Preventive and control measures included
the establishment of a war room for planning and supporting the activities, making improvements
in food hygiene and environmental sanitation through good cooperation with local community leaders/
schools/ owners of food, drinking water, and ice-production factories, fostering health education and a
campaign for disease prevention and control, and carrying out surveillance for cases of infection in the
areas concerned. The outbreak was curtailed after intensive preventive and control measures had been
introduced.
Continuous surveillance of food handlers and water, the conduct of health education campaigns
advocating food safety among the public, and improvements in sanitation are essential activities for preventing
or at least reducing the number of future outbreaks of food- and water-borne diseases.
Although effective treatment of and care for some chronic diseases exist nowadays, the majority of
patients with such diseases still do not receive appropriate treatment. This is due to: (a) the rapidly rising
number of patients in parallel with the increasing age structure of the population, which exceeds the
ability of the existing health-care system; (b) the health-care system falling short in its ability to translate
knowledge into routine medical practice; and (c) the health-care delivery system being designed for acute
patient care; it is poorly organized for providing the full complement of services needed by people with
common chronic conditions. The chronic care model (CCM) was developed in the 1990s, based on the
premise that effective chronic illness care can be delivered by prepared provider teams who engage productively
with an activated, informed patient. The six dimensions of CCM that enhance this productive
interaction include the following: (1) self-management support; (2) delivery system redesign; (3) a clinical
information system; (4) decision support; (5) health-care organization; and (6) community policies and
resources. To date, CCM has been applied for patients with diabetes, cardiovascular disease, chronic
respiratory diseases and asthma, depression and HIV infection. Evaluation results, particularly for diabetes,
show that the implementation of CCM improves the process and immediate outcomes of care. However,
its long-term impact on patients’ longevity is still undetermined.
This study was aimed at surveying the distribution of dental hygienists and their job identification
in a primary care unit (PCU) in 2006. Also, a dental health workforce database of the Division of Dental
Health, Department of Health, was updated for 2006, using a questionnaire survey on the working status of dental nurses dispatched to 450 PCUs in Thailand’s 75 provinces. Almost all (94.9%) responded to the
questionnaire. The analysis revealed that 97 percent of the dental nurses in Thailand in 2006 were working
under the Ministry of Public Health and 95.9 percent of their workplaces were outside Bangkok. These
included 55.7 percent working in community hospitals and 32.5 percent in PCUs. The ratio nationwide of
dental nurses increased from 1:21,331 in 2002 to 1:16,883 in 2006, excluding Bangkok. Among those working
in PCUs, the workload of those involved in oral health care to other types of care was 3:1 in terms of
time sharing. The proportion of jobs in curative care, promotion and prevention, and proactive services
was cited as 3:1:1. With regard to workforce in capacity-building, training is required in (1) oral health
promotion and proactive activities, (2) oral health prevention and disease control, (3) health literacy and
communication, (4) project planning, management and evaluation according to local priorities, and (5)
first-aid treatment.
This study was undertaken to determine qualitative data pertaining to the availability, beliefs, attitudes,
and utilization of poisonous plants and animals in a community using group discussion, followed
by an assessment of the efficiency of conveying the knowledge by civil society. The format was a quasiexperimental
research approach in 11 villages in Khukhan district, Sisaket Province. The experiment was
conducted by means of a stratified random sampling procedure; 120 samples were retrieved. The data
obtained were statistically assessed in respect of frequency, percentage, means plus or minute the standard
deviation, and paired t-test for comparison.
The results showed that, among the 23 kinds of poisonous plants and animals studied, jatropha,
tapioca, toad, Copelandia cyaneseens, Russula emetica, and Phaeogyroporus portentosus were present in
every village in the fields, around temples and residences, etc. This finding, together with the traditional
beliefs and attitudes of the villagers regarding poisonous plants and animals, could possibly lead to a
health risk for the community. After utilizing simple civil society communication, the study group had
shown significantly increased knowledge (p <0.05). The factors affecting the result of the learning process
included language and the villagers’ traditional beliefs and attitudes. Although the statistical increase
was not distinctive, the propagation of knowledge on poisonous plants and animals among the community
through a simple civil society was a learning strategy that was related to some extent to the educational
level in the community with regard to the local villagers in their own community. Furthermore, this
type of learning strategy may also be adapted for utilization in other public health-related work.
This study was aimed at assessing the development of the diabetes mellitus clinic of the Jungharn
Hospital’s Outpatient Department. The hospital’s management personnel together with the clinic practitioners
participated in the study in order to analyze and solve service problems, so that the clinic could be
refitted. Seventy-five diabetes patients were included in the study group obtained by systematic random
sampling technique. The data were collected by interviews, questionnaires, group discussions, and observation
in the period from October 2005 to September 2006. The data were subjected to content analysis,
frequency, percentage, means, and paired t-test
In situation analysis, the first step in this kind of study, it was found that the existing service was not
convenient for diabetic patients because too many steps were required, the time consumed was prolonged,
and health education was not at all applicable to the patient’s problems and what was needed to solve them. The following stages were conducted by the groups of managers and care providers who participated
in the planning, implementation, and evaluation of the service. Nurses were prepared for work in
the diabetes mellitus clinic service, and used OPD cards for following up diabetic patients. When such
patients made contact with the diabetes mellitus clinic, their fasting blood sugar level was assessed; they
were treated by a physician, and received drugs. The last step in the service was a group discussion.
Evaluation of each patient’s satisfaction was assessed in terms of whether they had a say and were given
recognition, which were much higher, and the means of fasting blood sugar decreased after the diabetes
mellitus clinic was developed; this was found to be statistically significant at the p-value < 0.01 by paired
t-test.
The study suggested that, clinic development requires staff participation in all processes, team work,
good patient relationships, and the availability of a service center.
This retrospective study involved 470 pregnant women who first attended the antenatal clinic of
Sanpatong Hospital in Chiang Mai Province in the period from October 2005 to March 2007. The objective
was to determine the prevalence and causes of anemia in pregnant women and to study the association
between thalassemia traits and anemic status. All pregnant subjects received screening for hemoglobin concentration, hematocrit level, mean corpuscular volume (MCV), one-tube osmotic fragility test (OF
test), and serology for hepatitis B virus, syphilis and anti-HIV. In anemia cases, a therapeutic trial with
iron supplementation was performed in order to assess iron status. In cases positive for thalassemia
screening tests were taken of hemoglobin electrophoresis, hemoglobin A2 level and PCR for alpha thalassemia-
1 trait. Thalassemia traits and hemoglobinopathies were detected in 97 cases (20.7%). The prevalence
of anemia was 23.2 percent (109/470). Classified by trimester, the prevalence was 19.3, 24.5 and 43.2
percent in the first, second and third trimesters, respectively. In anemic pregnant women, the proportion
of thalassemia traits was 46.3 percent (50/108) and the proportion of iron deficiency anemia was 40.6
percent (28/69). Among the thalassemia traits group, the proportion of anemic status was 51.5 percent,
and anemic status in β-thalassemia trait was 70 percent; in α-thalassemia-1 trait, 68.7 percent; in α-thalassemia-
1 and HbE trait, in 40 percent; and HbE trait 28.2 percent. The overall thalassemia trait was significantly
associated with anemic status (OR 5.7,95%CI 3.5-9.3 ), p<0.00, and the α-thalassemia-1 trait and the
β-thalassemia trait were also statistically and significantly associated with anemic status. In conclusion,
the prevalence of anemia in pregnant women attending Sanpatong Hospital was 23.2 percent. The main
causes of anemia were thalassemia traits and iron deficiency anemia. The prevalence of thalassemia traits
in pregnant women in the present study was high and the subjects with thalassemia traits, α-thalassemia-
1 trait and β-thalassemia trait were associated with anemic status.
This study was carried out to assess the satisfaction with the health services provided under the
Universal Health-care Coverage Scheme (UC) at Pranburi Hospital. The study sample included 369 patients,
i.e., 268 females (72.6%) and 101 males (27.4%), whose general population characteristics varied by
sex, age, income and experience with the hospital services in the period from June 2007 to September 2007.
Statistical analysis of data was represented by percentage, means and standard deviation, t-test and F-test.
The study revealed overall satisfaction with the health-care services provided under the Universal Healthcare
Coverage Scheme; these were rated as good (3.61 ± 0.36). Satisfaction with officials (3.69 ± 0.46),
satisfaction with information (3.65 ± 0.49), satisfaction with servicing processes (3.55 ± 0.42) and satisfaction
with places and materials (3.54 ± 0.36) were all good. The patients differing in terms of sex, age and
income showed no difference under the Universal Health-care Coverage Scheme, but their experiences on
health-care services were different (p < 0.05).
The objective of this study was to determine the effects of diabetic drug adjustment during the Ramadan
period among fasting diabetic residents of Tuyong subdistrict, Nongjik district, Pattani Province, who had received
treatment in Nongjik Hospital during the period from October 1, 2006 to October 12, 2007. Diabetic
complications and changes in glucose levels before and during the Ramadan period were detected among 41
patients with diabetic drug adjustment, compared with 38 patients without drug adjustment. Data on their
blood glucose levels were obtained from OPD cards and from monitoring chart records during the Ramadan
period. SPSS for Windows was used to analyze the data.
The distributions of sex, age, co-morbidity and diabetic drug use were comparable between both groups.
Diabetic complications were found only in patients without diabetic drug adjustment. There were three cases
with hyperglycemia and two with hypoglycemia. Before the Ramadan period, both groups had comparable
mean glucose levels. During the Ramadan period, the mean glucose level was significantly lower in the patients
with diabetic drug adjustment than those without drug adjustment. Patients with drug adjustment were significantly
more likely to control their blood glucose levels than the other group.
Diabetic drug adjustment is useful during the Ramadan period. Before the Ramadan period, good health
education about food intake, diabetic complications, and the benefits of drug adjustment should be given to
diabetic Muslim patients.
Stroke is increasingly found without regard to sex and age in the Thai population. Thus, it is mandatory
that the Occupational Therapy (OT) service be directed at either improvement or maintenance with
regard to individual skills of occupational performance. This OT service was systematically developed in
further support of an increasing number of patients. In section I, Occupational Therapy – Mahidol Clinic
System (OT-MCS) was created as an operational service for the OT Mahidol Clinic. This study was
conducted in order to compare the number of patients who attended the OT Mahidol Clinic in the 30-day
study period, before and after attending the OT-MCS. In section II, the patients studied comprised a group characterized as maintained performance (comparison of repeated therapeutic activities via descriptive
statistics) and a group characterized by improved performance (comparison of levels of activity
approach via Wilcoxon Test in the period of 30 days before and after the use of OT-MCS). After the use of
OT-MCS, the number of patients increased although the number of supervised occupational therapists
remained the same. The therapists also differentiated 40 activity items according to the levels of satisfaction
and importance. Moreover, the maintained performance group had moderate and high levels of
satisfaction with the importance of occupational performance. The improved performance group managed
different levels of activity regarding international concepts of occupational therapy. The patients
could express their existing potentials through meaningful activities, proper activity analysis and synthesis,
learning the importance of occupational performance, and gaining satisfaction with the choices of
occupational performance. The practice may be implemented in the patients’ realistic environment.