plueme/wizJson huggingface dataset:
Logistics management is a useful tool with applicability to many businesses. However, drug distribution
from Klonglan District Hospital to its primary care networks was still in its infancy, resulting in an
excessive drug inventory. This is a quasi-experiment study that monitored 3 Key Performance Indicators
(KPIs) for comparison before and after using the modified vendor-managed inventory (VMI). The KPIs
were 1) inventory efficiency evaluated by ratio analysis, 2) cost-benefit analysis, and 3) stakeholder satisfaction
evaluated through content analysis from focus group discussions. The KPIs were monitored for
eight months at ten primary care units in Klonglan district. The period before using the modified VMI was
from December 2011 - March 2012; the period after using the modified VMI was from April 2012-July 2012
The results showed that KPIs were improved. The average inventory turnover ratio was reduced
from 6.67 months to 1.31 months. The inventory cost saving was 1,006,416.55 baht and the benefit-to-cost
ratio was 80.03. Stakeholders expressed satsifaction with the modified VMI because of the lower workload.
Regular meetings among stakeholders, however, are needed for improvement and maintenances of the
new inventory management system.
The objective of this study was to examine the pattern of drug companies in promoting disease
awareness activities in relation to HPV vaccines through various media channels in Thailand including
television, magazines and the internet. Using content analysis of media content from 1st January 2006 to
31th December 2008, 47 disease awareness activities were found, of which 23 (48.94%) were on the internet,
22 (46.80%) in magazines, and two (4.26%) in television programs. The primary source of information was
from government agencies (36.67%) and the most common presentation pattern was in the form of academic
paper (36.17%). A fear appeal was the most typical communication method (59.57%). Five activities
contained incorrect data about the vaccine (10.64%). On websites, the connection of the disease awareness
activities and the sponsoring drug companies could be identified by the brand logo, the theme color, and
the product packaging linking to specific HPV strands covered by the vaccine. Hotline numbers, sponsored
by the pharmaceutical companies, were also available on the websites and magazines for consumers.
We thus propose that responsible authorities, including the Thai Food and Drug Administration,
regulate the drug advertisement policy more proactively
Overuse of antibiotics for common, self-limited diseases such as upper respiratory infection (URI),
acute diarrhea and simple wound is rampant in Thai community pharmacies. A major reason is a lack of
confidence in the effects of non-antibiotic therapy on patient health and satisfaction. The study aims to compare health outcomes and patients satisfaction between the antibiotic-dispensed group and the non
antibiotic-dispensed group of patients afflicted with three targeted diseases: URI, acute diarrhea and simple
wound. Data collection was conducted in October 2012. Pharmacists from 97 community pharmacies
who attended the Antibiotics Smart Use training session were asked to make a follow-up telephone interview
with their patients 3-7 days after the pharmacy visit. Pharmacists from 54 pharmacies (55.7%)
completed the interviews of 1,021 patients. Responses from 998 patients (97.7%) were usable for data
analysis. The responses were from the patients with URI 71.5%, simple wound 21.2% and acute diarrhea
7.2%. The proportion between the antibiotic-dispensed group and the non antibiotic-dispensed group
were 26.8% and 73.2%, respectively. Interview results showed that 91.2% of patients were fully recovered
or better and 83.9% were satisfied and very satisfied with the treatment. There were no statistical differences
on patients’ health outcome and satisfaction between the antibiotic-dispensed group and the non
antibiotic-dispensed group (p-value > 0.05) and no statistical difference across the three targeted diseases
(p-value > 0.05). The study confirms previous studies that URI, diarrhea and simple wound can be cured without antibiotics.
A mismatch between available antibiotics in the healthcare outlets and limited medical and microbiological
capacities of these outlets can lead to irrational use of antibiotics and subsequently worsens
bacterial resistance situations. The study aims to investigate (a) patterns of antibiotic distribution and
utilization among health promoting hospitals, private medical clinics, and pharmacies; (b) opinions on regulation regarding antibiotic distribution and use; and (c) terminology used by health professionals to
explain to patients about antibiotics. A cross-sectional survey using self-administered questionnaires was
conducted in 27 districts of 9 purposely sampled provinces during April-May 2012. The response rate was
53% (601 questionnaires); 276 of them were from health promoting hospitals, 107 from private medical
clinics and 218 from pharmacies. The results showed that,of the 47 antibiotics surveyed; 25, 35 and 37
items were available at health promoting hospitals, medical clinics and pharmacies, respectively. The
most commonly found antibiotics were amoxicillin (98-100%), norfloxacin (93-99%) and dicloxacillin (85-
99%). Private medical clinics and pharmacies had higher rates of antibiotic utilization for potentially selflimited
diseases than those in health promoting hospitals (40-60% vs. 20-30%, correspondingly). Most
physicians in private medical clinics (77%) agreed with the prescription-only measure for all antibiotics.
Fewer nurses and other health professionals in health promoting hospitals and pharmacists in pharmacies
(24% and 5%, respectively) agreed with such measure. The terms “antimicrobial agents” (36-55%) and
“anti-inflammatory agents” (19-25%) are used more often than the term “antibiotics” (11-28%). The observations
from this study indicate that the regulation of antibiotic distribution should be more restrictive
and such regulatory measures, together with measures to promote rational use of antibiotics, should be
implemented simultaneously.
An increase in antimicrobial drug resistance is a big concern for all hospitals. Thus, effective infection
control (IC) policy and antibiotic stewardship programs (ASP) are crucial to managing the problem.
However, data on such measures in Thai hospitals are limited. This cross-sectional study aims to explore
hospital IC measures, ASP, and barriers to implementation in public tertiary care hospitals (TH), district
hospitals (DH), and private hospitals (PH) in Thailand. The study was conducted during April and May
2012 in nine provinces, purposely selected to represent 5 regions. Among 102 hospitals included (13 TH,
69DH, 6 large PH, 14 small PH), the IC measures were implemented more than the ASP (96% vs. 88%)
with different focus in each hospital group. Non-cooperation from relevant health providers was the
most common barriers to IC and ASP implementation in all groups (38-70%). Inclusion of IC as the
criteria for hospital accreditation had the strongest effect that could introduce IC activities into more than
80% of hospitals. Strengths of the TH were microbiology laboratories and antibiotic susceptibility test.
Concerning ASPs, the TH was a good performer in using antibiograms for the selection of antimicrobials
in hospital formulary. They had IC committee as the core group and tended to implement antibiotic
restrictive strategies. TH’s limitations were staff shortage and disagreement from medical staff towards
some antibiotic guidelines. As for DH, strengths were persuasive measures developed from the
Antibiotics Smart Use program. Plus, DH had Pharmacy & Therapeutics Committee as the core driver.
Limitations were lack of budget, frequent staff rotation and discontinuation of the activities. For PH,
strengths were microbiology laboratories and persuasive measures. In conclusions, hospitals had
different strengths and limitations, thus careful selection of appropriate IC measures and ASP is needed
with participation of stakeholders to tailor the measures to hospital context. Policymakers might start
with activity that raise concern in relevant health providers, support their strengths, alert private
hospitals, and help reducing obstacles that limit further development and sustainability of the IC and
ASP.
Hospital-acquired pneumonia (HAP), one of the most common nosocomial infections, is associated
with a high mortality rate in hospitalized adults. The study aims to determine the prevalence of HAP
pathogens and antibiotic resistance rate at Suratthani Hospital.
We conducted a retrospective study of hospitalized patients aged 15 and over who were diagnosed
with HAP at Suratthani Hospital from January 2011 to December 2012. Data from medical records, including
patient characteristics and results from a sputum culture test, were used to demonstrate etiology and
antibiotic resistance rates.
A total number of 540 HAP cases were identified. The mean age of the sample population was 65
years old, with 54% being male. The median length of the hospital stay was 21 days. The four most common
pathogens were K.pneumoniae (31.2%), A.baumannii (21.9%), P.aeruginosa (14.8%) and S.aureus (4.3%).
Ceftriaxone resistance rates for A.baumannii, K.pneumoniae, K.pneumoniae ESBL and P.aeruginosa were 83.1%,
1.3%, 85.7% and 37.5%, respectively. Imipenem resistance rates for A.baumannii, K.pneumoniae, K.pneumoniae
ESBL and P.aeruginosa were 71.2%, 0%, 6.3% and 23.8%, respectively. All-cause hospital mortality rate was
29.4%.
High mortality and antibiotic resistance rates were observed among adult patients with HAP at
Suratthani Hospital. Information about the etiology and prevalence of antibiotic resistance of HAP in a
local setting may be helpful in the selection of appropriate antibiotics for initial treatment of HAP to
shorten the course of disease and length of hospital stay and reduce antibiotic resistance and mortality
rates.
The purpose of the study was to explore the problems in the caring system of the pediatric CNS
tumor in Thailand. CNS tumors in children need sophisticated diagnosis and treatment, which include
large multidisciplinary care teams. At present, there are many problems in the caring system in Thailand,
including the inadequate number of physicians involved in many aspects of the diseases, equipments for
diagnosis and treatment, and inappropriate referral and payment system, all of which can result in the
delayed diagnosis and treatment leading to an increased rate of morbidity and mortality. Suggestions
derived from the study were made to solve the problems systematically and serve as the basic data for the
improvement of the CNS tumor care in Thailand.
The study aims to identify factors that affect the door-to-needle time for fibrinolytic therapy in patients
with acute myocardial infarction in Buengkan hospital. A retrospective review of medical records
from October 2554 to October 2555 was conducted of all patients receiving thrombolytics for AMI. A total
of 37 patients with acute ST elevation myocardial infarction (STEMI) were identified. Median door-toneedle
time achieved was 30 minutes (range 10 - 180mins). A door-to-needle time of 30 minutes or less
was achieved in 22 (59%) patients. The predominant infarct location on EKG was anterior (35%). The three
factors that can affect door-to-needle time were evaluated: office hours, symptoms and use of care map.
Although the study found no statistical difference in the three factors, the percentage of patients whose
door-to-needle time within 30 minutes was achieved rose among those who came outside of office hours,
presented with typical symptoms, and after the implementation of the STEMI care map, (68, 60.6, and 63
percent, respectively). After implementation, the mean door-to-needle time did not decrease, but the
number of patients whose door-to needle-time within 30 minutes was achieved increased from 50% to
63%. Creating a STEMI network in Buengkan Province could decrease the onset-to-needle time.
Chronic kidney disease (CKD) is an important public health problem due to high volume of patients
and high cost of treatment. Sub-district health promotion hospitals are involved in screening the high risk
group. The aim of this study was to investigate the services provided to CKD patients by the sub-district
health promotion hospitals to understand the problems and limitation in providing health services.
This survey was conducted from March-April 2012. 135 directors of the hospital in Songkhla were
recruited. The questionnaire consisted of 2 parts: 1) general information of the participating directors and
hospitals, 2) services provided by hospitals. 92 (68.1%) of the directors were female. The median age was
45±11. 13/3% of the directors had never participated in the CKD-care workshop. The number of CKDpatients
was 1±2 per hospital. No CKD patients were found in 47.4% of the hospital. CKD services were
not provided in 57.8% of the hospitals. Searching and screening were not conducted in more than 80% of
the hospitals.
Vital statistics provide essential information for monitoring the progress towards achieving the United Nations
Millennium Development Goals (MDGs). Well-functioning and reliable civil registration and vital statistics systems (CRVS
systems) are not only needed for national development, monitoring and evaluation systems, but also for organizations
to plan and manage their operation and programs. Well-functioning civil registration systems are the best data source
for reliable vital statistics. However, more than half of the countries around the world do not have CRVS systems or, if
they do, they do not function well. The United Nations (UN) and the World Health Organization (WHO) recognize and
are aware of this issue and are facilitating member countries to evaluate and improve their CRVS systems.
In 2011, WHO and the University of Queensland, Australia, developed a standard tool called, “Strengthening practice
and systems in civil registration and vital statistics: A Resource Kit ”, in order to strengthen CRVS systems. WHO and
many UN organizations, such as the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP),
encourage and assist member countries to use this tool.
CRVS systems have existed in Thailand for many decades, but have not been systematically evaluated. Therefore,
an assessment was a key step to understanding the status of the current system and identifying areas that need
improvement. The Thai Health Information Standards Development Center (THIS) and other key stakeholders, such as
the Ministry of Public Health, National Statistics Office, and Ministry of Interior, came together to evaluate the CRVS
system using the WHO Rapid Assessment of National Civil Registration and Vital Statistics Systems tool.
This report outlines the methodology and findings from this rapid assessment. It contains three main sections: chapter
one describes the background and history of Thailand’s CRVS system; chapter two describes the assessment objectives,
the tool and evaluation process; and the final chapter provides an analysis of results and recommendations.
It is hoped that the assessment will be informed Thai policy makers, administrators and others involved in CRVS of the
system’s strengths and weaknesses and hope to gain their support for further improvment system.
Vital statistics provide essential information for monitoring the progress towards achieving the United
Nations Millennium Development Goals (MDGs). Well-functioning and reliable civil registration and
vital statistics systems (CRVS systems) are not only needed for national development, monitoring and
evaluation systems, but also for organizations to plan and manage their operation and programs. Wellfunctioning
civil registration systems are the best data source for reliable vital statistics. However, more
than half of the countries around the world do not have CRVS systems or, if they do, they do not function
well. The United Nations (UN) and the World Health Organization (WHO) recognize and are aware of this
issue and are facilitating member countries to evaluate and improve their CRVS systems.
In 2011, WHO and the University of Queensland, Australia, developed a standard tool called,
“Strengthening practice and systems in civil registration and vital statistics: A Resource Kit ”, in order
to strengthen CRVS systems. WHO and many UN organizations, such as the United Nations Economic
and Social Commission for Asia and the Pacific (ESCAP), encourage and assist member countries to use
this tool.
CRVS systems have existed in Thailand for many decades, but have not been systematically evaluated.
Therefore, an assessment was a key step to understanding the status of the current system and
identifying areas that need improvement. The Thai Health Information Standards Development Center
(THIS) and other key stakeholders, such as the Ministry of Public Health, National Statistics Office, and
Ministry of Interior, came together to evaluate the CRVS system using the WHO Rapid Assessment of
National Civil Registration and Vital Statistics Systems tool.
This report outlines the methodology and findings from this rapid assessment. It contains three main
sections: chapter one describes the background and history of Thailand’s CRVS system; chapter two
describes the assessment objectives, the tool and evaluation process; and the final chapter provides an
analysis of results and recommendations.
It is hoped that the assessment will be informed Thai policy makers, administrators and others
involved in CRVS of the system’s strengths and weaknesses and hope to gain their support for further system improvement.
Population-based screening is a large-scale process of identifying apparently healthy people for disease
risks. Some health screening programs in Thailand have been introduced without scientific evidence.
This paper details the experience gained from a systematic and participatory prioritization of health problems
to be screened in Thailand. A consultation meeting with three rounds of anonymous votes was conducted.
Participants included technical officers in the Ministry of Public Health, medical practitioners,
representatives of non-governmental organizations and lay people. We identified the primary list of 31
health problems for their contributions to disability-adjusted life years (DALYs) in Thailand. A set of
information depicting the burden of diseases and availability of screening techniques were provided to
participants prior to the meeting. The prioritization process was conducted with a modified Delphi technique.
The final list of high-priority health problems was determined by researchers using inputs from
round three and overall aspects: ischemic heart disease and stroke, diabetes, alcohol dependence, cirrhosis
and liver cancer, anemia, cervical cancer, HIV/AIDS, asthma, tuberculosis, nephritis and nephrosis,
breast cancer and traffic accidents. They will be investigated further on the appropriate screening program.
Ischemic heart disease and stroke are two major health problems in Thailand. This study aims to
review existing evidence of the screening for cardiovascular diseases at the population level from the
clinical practice guidelines used in selected countries, including Thailand. It is recommended that a global
risk score, known as the Rama-EGAT heart score, should be used for the general Thai population aged 35
years and above to screen for the development of coronary heart disease at 5 year intervals, with a plan to
monitor and evaluate the method at the population level. Further research is also needed for the development
of a global risk score for strokes in Thailand.
Atrial fibrillation is the most common type of cardiac arrhythmia that can cause serious complications.
Guidelines for population-based screening of atrial fibrillation in Thailand have not been reviewed,
nor have the benefits and cost-effectiveness been analyzed. This article aims to conduct a systematic review
and panel discussion on the population-based screening for atrial fibrillation in Thailand. Clinical
practice guidelines recommended checking pulses for 65 years or older. The sensitivity of pulse checking
for at least 20 seconds was 95 (95% CI, 84-97), and the specificity was 72 (95% CI, 69-75). There is no
sufficient data for other methods on a population level. Opportunistic screening is recommended since
the detection rates were similar to that of systematic screening (1.62% and 1.64% for opportunistic and
systematic screening, respectively.) Pulse checking was also found to be cost-effective.
Iron deficiency anemia is associated with long-lasting diminished mental, motor, and behavioral
functioning, especially in infants and toddlers for whom iron is necessary for development. Treatment
with iron can reverse the anemia and restore iron sufficiency, but poor developmental functioning can
persist. Intervention should focus on the prevention of iron deficiency anemia. Since population-based
screening guideline for iron deficiency anemia has not been well established, this study aims to conduct a
literature review on population-based screening for anemia, followed by a panel discussion among experts.
The results support iron deficiency anemia screening with complete blood count (CBC) for all infants
at 9 to 12 months of age who come for their first MMR vaccination. Hematocrit (Hct) can be substituted
where CBC cannot be performed. Further studies on anemia screening for the other groups of population
are warranted
Nephrosis, nephritis and renal stone, commonly found diseases in Thailand, can cause severe chronic
complications. This article thus aims to study the value of a population-based screening for nephrosis,
nephritis and renal stone in Thailand through a systematic literature review and stakeholder discussion.
Urinalysis and blood for renal function tests are widely used in health check-up programs without evidence
of effectiveness and cost-effectiveness. Analysis of the clinical practice guidelines and experts’ opinions
found support for screening in high-risk groups, but not in the general population. Cost-effectiveness
ratio was $282,818 per quality-adjusted life year (QALY), but $53,372 and $18,621 per QALY, in the elderly
and hypertensive patients, respectively. One case would be diagnosed per 800 screened. Incremental costeffectiveness
ratio was $2779. Therefore, renal function tests or urinalysis are recommended for high-risk
groups, whereas the general population should be educated on the disease and risk reduction. Further
studies of the effective and appropriate screening tests for high-risk groups are also needed.
Prostate cancer is a common malignancy in elderly men in western countries. It is the leading cause
of mortality and morbidity worldwide. Two main tools for screening, digital rectal examination (DRA)
and prostate-specific antigen (PSA), are still controversial with regards to effectiveness and cost-effectiveness.
The study aimed to examine whether screening for prostate cancer reduces prostate cancer specific
mortality and all-cause mortality and whether population-based screening for prostate cancer is costeffective.
Literature search of randomized controlled trials (RCTs) and economic evaluation articles was
conducted through Medline and Cochrane library to assess the effectiveness and cost-effectiveness of the
prostate cancer screening. Five RCT with a total of 321,644 participants were included in this review. The
meta-analysis showed no statistically significant differences in prostate cancer-specific mortality and allcauses
mortality between screening and no-screening groups. Relative risks for mortality from prostate
cancer and all cause mortality were 0.99 (95%CI; 0.83-1.17) and 0.98 (95%CI; 0.97-1.00) respectively. Nor
was screening found to be cost-effective.