plueme/wizJson huggingface dataset:
Health financing in Thailand : Technical reportFor the past, Thailand’s health care system has increasingly emphasised more advanced medical technologies and the Thai have been more reliant upon health care providers than self-care. Both public and private expenditures for health services consequently increased in real terms. 75% of health expenditures (the largest portion, 66% from the Ministry of Public Health (MOPH)) was incurred in the public sector compared with 25% in the private. During 1986 to 1996, the MOPH budget increased by 258% in real terms and then dropped since 1997 because of budget constraint caused by economic crisis. From 1995 to 1999, the budget grew about 6% in real terms. In consideration of the MOPH budget in 1998, 42%, 31% and 27% were gone for salaries, recurrent inputs and capital expenditures respectively. The budgeting was based on historical requirement leading to inequity of financing among provinces. Household expenditure became a portion of revenue to public health facilities. Whether the government budget for each public health facility was sufficient remained dubious due to poor cost accounting of public health facilities. Therefore, determining either capitation rates weighted by age, sex or DRGs was inconclusive.Thailand had 5 major health insurance schemes, Civil Servants’ Medical Benefits Scheme (SCMBS), Social Security Scheme (SSS), Voluntary Health Card Scheme (VCS), Low-income Card Scheme (LICS) and Private Indemnity Insurance. Around 76% of the Thai were covered by one of these. The CSMBS covered all government employees, pensioners and their dependents. The program was financed by government tax and managed by the Ministry of Finance. Since the economic crisis, the program did cost control by abolishing reimbursement for private care and imposing co-payment for some services e.g. for non-essential drugs. The SSS was premium-based by collecting 1.5% from the employee, the employer and the Ministry of Social Welfare. Payment to contracted hospitals was on capitation from 700-1000 Baht per head per year.The VHCS was community revolving funds targeting the near poor. The premium was 500 Baht supplementary to 1000 Baht, 500 Baht from the MOPH and 500 Baht from the ADB. The most problem of the program was ineffective targeting measure. The wealthy got the cards while a large number of the near poor were not covered. The LICS basically intended to cover the poor but its objective was enlarged to cover the elderly, children under 12, veterans, religious and community leaders and the handicapped. The program also had a problem of targeting the deserved. On the demand side, the insured often bypassed to their registered hospitals preferable to registered primary care centres or health centres. The paper recommends development of universal health coverage for all.
The problem of substance addiction in communities is a serious increasing social problem at the present time. It has a great impact through families, communities, society and countrywide. The inefficient means on prevention and control of this problem will lead to a great number of social problems in communities very soon. Therefore, the participation of the community to fight with the epidemic of substance addiction is a very crucial mean. The objectives of this study were to explore the situation of addictive substance use and develop a model for prevention and problem solving by emphasizing on the community involvement. The participatory Action Research (PAR) was applied in this study. One hundred and fifty villagers who were community leaders, health volunteers, guardians,  and youths lived in village 5th, 9th, and 11th of Patan, Khuntan district, Chiang Rai province were participated in research activities. The researchers and the community groups analyzed problems and determined the solution means by using the AIC-technique and collected information by using the participatory observation method and focus group discussion technique. The study was conducted between October 2001 and February 2002. 	The result of the study revealed that there were 40 drug users in these villages. The source of substance distribution were found in all 3 villages. Community regulations for prevention and solving the addictive substances use were setup through the village meeting. After the regulations were implemented continuously, the situation of substance addiction was decreased dramatically in these 3 villages. The local organization in each communities played a very important role to solve these social problems. The community participation need to be strengthen and continue to sustain the success of substance control in these villages.
The objectives of the study were (1) to study the situation of Thai-people health promotion (2) to study the role and the development of health promotion in popular sector, and the relationship between government sector and non-government sector (3) to analyze and to suggest the policy recommendation on the contribution of health promotion. The methods of this study were document review method, indepth interview and informal interview. 	The finding of this study was: in general, life expectancy at birth has lengthened substantially, Thai people was facing a changing pattern of health, the pattern of morbidity and motality have changed, non-communicable diseases were increasing. The Thai’s lifestyle was changing to urban lifestyle. Thai people mostly eat Thai food, but they increasingly eat saturated fat and decreasingly eat fiber foods. Thai’s daily activities are 8-9 hours of work, 6-8 hours of sleeping, watching television. Lack of exercise and inappropriate self-medication; and some people drink alcoholic beverages and smoke cigarettes. And, Thai people were coping with the stress problem and lack in the coping skill and the life-skill in the modern society. The study also concluded that Thai people were interested in ill health or illness. For the community-based health promotion, the government have had the policy of the community participation and health development for two decades, but the communities were induced by the health personnel. However, the non-government organizations and some government organization contribute the community’s initiatives, decision-making, control and health development. Some community organizations/groups were initiated the health promotion activities by themselves. If was recommended that (1) MOPH should increase the individual health potential; using the variety of methods and the appropriate methods (2) MOPH should promote community organizations and contribute the community’s initiatives, decision-making and health development (3) MOPH should promote the health personnel skill of mediation, enabling and advocacy in the health promotion process (4) MOPH should formulate the long-term master plan of health promotion.
A quasi experiment was conducted at Lampang Hospital during August 2003 to January 2005 to compare the effectiveness of the pharmacist interventions between using case-based approach and group education in promoting parenteral-oral (IV-PO) drug switching in hospitalized patients. In the mean time, the study measures the satisfaction of health care team and factors affecting physician in switching from IV drug to PO drug. Medical charts of inpatients over one year of age were reviewed prospectively by a clinical pharmacist for two consecutive weeks in three phases for each type of intervention; phase I as baseline period, phase II as intervention period, and phase III as four months post intervention. Candidates for the switching were identified according to the developed guideline. Excess days, durations of IV drug use, length of stay, and potential waste were determined. The generalized linear model was used to adjust age, sex, Charlson index, history of intensive care unit admission, and departments in the multivariate analysis. A descriptive study also was done at Khon Kaen Hospital to determine and compare the incidence of switching candidates with the same switching guideline.The results revealed that the pharmacist intervention using the case-based approach was more effective than using group education, which the case-based approach could reduce (1) the incidences of switching candidates from 36.6% to 19.6%, (2) excess days by 70.2% (p<0.001), (3) durations of IV used by 11.8% (p<0.05) and (4) potential wastes by 60.9% (p<0.001) whereas the group education could reduce only the incidences of switching candidates from 31.3% to 25.5%. No statistically significant change of the studied outcomes including potential waste was found. The case-based approach could save an average of 200,000 Baht a month. However, the majority of physicians and pharmacists preferred the intervention using group education more than case-based approach. During phase II of the case-based approach intervention, the factors affecting physicians in switching from the IV drug to the PO drug were the drug categories A or B (p<0.05) and type of intervention via verbal or written (p<0.01). With the same switching guideline, the incidence of switching candidates at the Lampang Hospital and the Khon Kaen Hospital were comparable at 36.6% and 36.3%, respectively. Thus the case-based approach was the effective strategy in promoting IV-PO switching and it was also a cost-saving program. About one-third of IV drugs in the tertiary care hospitals could switch to oral drugs, which could save drug expenditures. This case-based approach might be applied in order to reduce the incidences of switching candidates and lead to reduce health care costs.
This report is an outcome of the study on how the Health Systems Research Institute (HSRI) obligates and would respond to its 5-year future purposes.  It also is the product of a study process that would be put together to lay a 3-year necessity plans (2005-2007). From trends and driving forces, the researcher has used a ‘Foresight’ strategy to lay future scenarios.  In-depth interviews with 20 public health management and services experts were conducted.  The interviews were integrated and have given 3 summaries.  They are:HSRI is an organization which creates and manages knowledge for the country’s development.Although this role is taken as a systematic organization, but because of changes occurring both inside and outside of the country, HSRI should administrate more on knowledge gained, researches and its management so the information could be converted into policies and actions. Linkage between knowledge found and how they could be implemented must not be separated.  Missing linkage, which is how knowledge and research outcome should be handled so the country’s public welfare is profited, must be handled.  It is important to link and empower scholarly research before they are systematically applied or be made policies.  This links to:2.  HSRI is an organization which manages knowledge systematically. The organization signifies knowledge management by pushing for a public policy, manage its structure and find networks and partnerships along with building knowledge and research.HSRI is an organization built for the public’s strenghten knowledge.  It emphasizes on the public’s self-reliance and participation in knowledge and research buildup.  The three summaries reflect that HSRI is the country’s mechanism and think tank for the health system.  This is an organization which could accurately forecast changes or adjustment in policy.  It could supply information for those provide knowledge and research-result for the public, such as government sectors, networks or institutes so they could create specific and direct research according to the social needs.  It also acts as a well-defined information center to help reduces investment risk for the private sectors thus, could produce or add more value to the country as a whole.Moreover, other organizations could use the knowledge HSRI provides to build up understanding and manage conflicts that might arise among them.
Lessons and Experiences in AIDS Solution of Upper Northern Communities	As Northern communities were highly affected HIV/AIDS, many-years experiences from AIDS takling in such communities were picked up to synthesize lessons learned. This study covered the experiences from 6 upper Northern provinces including provincial administrative bodies involved in AIDS programs in both public, private organizations and NGOs, and community organizations. The study was based on secondary data e.g. project documents and various reports on AIDS programs implementation, data from in-depth interview on a number of key informants, data from group participation processes. 	The study found obvious advantages derived from the development of matrix organizations which were from public, private and NGOs leading to well-cooperative and coordinated system. Core people in communities were the key players to initiate the programs; nevertheless, they must act on their voluntary with sufficient supportive matters like budgets and knowledge either from internal or external communities. Local administrative organizations were the key player while large amount of budgets should be from the public sector via direct allocation to communities or local administrative organizations as the administrative body. Importantly, communities’ knowledge must not be underestimated as they tended to be more practical and acceptable for them.
The relationship of disease of respiratory system, disease of the skin and subcutaneous tissue and air pollution from the industries in Maptaphud Industrial estate conducted by comparing morbidity rate in Maptaphud Municipality to rate in Ban Chang and Wang Chan areas. The comparison revealed that the rate of disease of respiratory system in Maptaphud Municipality was higher 2.8 time and 1.2 time than the rate in Ban Chang and Wang Chan areas respectively. As well, the rate of disease of the skin and subcutaneous tissue in Maptaphud Municipality was 3.1 time higher than in Ban Chang and 1.2 time higher than in Wang Chan areas. And the study in Maptaphud Municipality found that the communities with higher estimated pollutants (NOx, SO2, TSP) had higher rate of disease than the communities with lower estimated pollutants. And the time series analysis also concluded that the rate of disease of disease of respiratory system was related to 3 previous days estimated SO2 (p<0.05) and 3 previous days estimated TSP    (p<0.05). While the rate of the skin and subcutaneous tissue was related to 4 previous days estimated SO2 (p<0.05).
This essay on “Patterns and Meanings of Holism” is the product of a research on “holism”, which is part of a project on “The Synthesis of Knowledge: Thai Society under Reform Currents”.  The research aims at an understanding of and a commentary on holism, a concept widely used in the reform currents in contemporary Thai society.  It relies on the following concepts and theories, namely:-  Gregory Bateson’s metamessage, logical type and ecology of mind, Immanuel Kant’s focus imaginarius or projected unity, Alfred North Whitehead’s abstraction, identity and background, Stephen Rothman’s critique of strong reductionism, Erwin Schrodinger’s objectivation, quantum physics’ non-locality and interrelationship, David Bohm’s implicate order, explicate order and soma-significance interrelationship, Carl Jung’s synchronicity, and discussions of related subjects in Milindapanha (Milinda’s Questions) as well as other major texts such as those of Rene Descartes, Isaac Newton and Martin Heidegger.As a result of the studies, analysis and synthesis of various concepts and theories, the research arrives at the following conclusions.Holism is “a meaningful connecting pattern of all components in a given context”.Holism is a subject concerning with the working process of human thought, which has to rely on a connecting pattern.  Wholes and parts are thus inseparable; and the thing that makes it possible for them to “hang together” in a certain way is a connecting pattern that depends on a certain meaning.Fragmentation and reduction are not the same thing.  And once many ideas, commonly regarded as reductionism, have been seriously considered, it will be found out that they are, in fact, based upon wholes and meanings as well.Various ideas of holism share a common ground in emphasizing the importance of meanings and contexts, and a common attempt to reinstate them in the construction of knowledge.The key issue of holism should thus be an awareness of wholes inherent in contemporary trends in the construction of knowledge; and the emphasis should be on the “meaning” or “value” that defines whole entities, components and contexts of the search for knowledge.  This may be called a “meta-methodology,” which is -- the awareness, selection and application of a type of meaning to define a whole entity, its parts, the context, and to construct a connecting pattern of the thing being mentioned, observed and studied.  This will also include an understanding or argument concerning the choice of meaning.
Sexual knowledge, attitude and behavior of primary and secondary education school studentsThis survey aimed to explore knowledge, attitude and behavior of primary and secondary education school students.  The sampled population was the students from  "pathom"  or  "po"  5 (late primary school-about 11 years old) through "matayom" or "mo" 6 (late secondary school-about 18 years old) at Phanomphrai district, Roi-Et province, Northeast of Thailand,  in academic year 1999. The subjects were stratified into 3 groups, according to education levels, i.e. po 5-6, mo 1-3 and mo 4-6. Two multiple-choice questionaries were, after approved by 4 experts in sexology and in education, used separately, one for po 5-6 and another for mo 1-6 group, for quantitative survey. Three discussion guidelines were developed and used for each group. Among a total of 5956 students, 1073 (18.0) : 	The result of attitude towards who is the most suitable for teaching sexual education reveals that most po 5-6 group prefered a doctor or a nurse. This result corresponds to mo 1-3 (62.1%, 95%Cl: 55.2-69.0)and mo 4-6Z56.9%, 95%Cl:51.5-62.2), and 62.5%Z95%Cl: 58.8-66.3) of all students think so.The attitude towards should school reproductive health services be provided, survey only among mattayom students (mo 1-6), reveals that 53.2 % of mo 1-3, 59.2 % of mo 4-6 and 56.1 % of all mattayom students did not agree. On the other hand, 18.0 % of mo 1-3, 23.6 % of mo 4-6 and 20.7 % of all mattayom students agreed. Most of the students agree that counselling clinic in school by a doctor or nurse or health personnel would be most suitable (64.1 %, 95%CI: 60.5-67.7). The attitude towards what to do first if unwanted pregnancy occurs, survey only among mo 1-6, reveals that 49.7 % of mo 1-3 group would tell their parents and 25.5 % would consult a doctor or a nurse. The same attitude was found among mo 4-6 group, 58.6 % would tell their parents and 23.0 % would consult a doctor or a nurse. For the total of mo 1-6 students, 54.0 % would tell their parents and 24.3 % would consult a doctor or a nurse. The sexual experience was 1.1 % among po 5-6 students, 1.1 % among mo 1-3 and 5.2 % among mo 4-6, and the overall experience was 2.4 %. This study suggests sexual education in school be adjusted according to the student needs. School reproductive health services by means of counselling clinic may be appropriate and there should be a survey for parental readiness in counselling an adolescent with unplanned pregnancy.
Historical dimension has been a missing aspect in studies on medicine and health development in Thailand. This was partly because the interrelation between health and its socio-political contests was not adequately appreciated. History of medicine and public health in Thai society was understood merely as a chronology of medical technological advancement and the growth of state medical service.	This study explores works in the field of Thai medical and public health history both in Thai and English languages. It aims at assessing the state of knowledge and suggesting directions for further studies in medical and public health history in Thailand. The study found that although there were a number of studies in medical and public health history done by physicians, pubic health export, and social scientists, most of the works only compiled and listed the chronologies of events. They didn’t adequately provide historical explanation or interpretation of the events. Such studies failed to create new understanding on the medical history in Thailand. Not only new historical knowledge has been absent, but there was a lacking of the development of relevant methodology in medical historical study.	Historical writings in the early period were mostly done by medical or public health professionals in an  attempt to “construct their own discourses.” The changing of Thai political landscape after October 14, 1973, has led to the new area of historical knowledge. Medical and public health history was no exception. New interpretation of health and medical history was created within the contests of pro-democratic movement. Although various new sociological and historical methodologies were gradually developed and used, it was only in the past decade that greater interest in historical methodology and historiography has gained currency resulting in a building up of new knowledge of the Thai medical past.	The current state of knowledge in Thai medical history focused on two main issues. The first concerned with the evolution and domination of modern medicine. The second issue was in the changes and discontinuity of traditional Thai medicine. The repetitive theme was mainly on the decline of traditional medicine and the success of modern medicine which has become mainstream and increasingly dominant in Thai society. There was a lack of critical scrutiny of medical institutions and historical figures. This was partly because of the adherence to writing history with the framework of the Great Man and the royal nationalism theory. There was a need to put more emphasis on understanding medical history as related to social, cultural, and political circumstances.
TB in some population groups in Thailand : 62 articles reviewed during 1958 to 1998TB has already communicated in community once a TB patient found. Then, number of TB patients is an indicator of TB communication in a community and shows a public burden to control TB infection. According to the review, children living with TB patient who is a family member, are at high risk to infection while those who are health personnel are more prone to get infected than other walks-of-life. Likewise, prisoners are at risk and male prisoners are riskier than female prisoners. Women are less likely to infect than men. Quality of information system which should be accessible and linked to relevant organisations, is recommended in addition to network building for monitoring and evaluation.