plueme/wizJson huggingface dataset:
Background: This study focuses on an evaluation of the universal health care coverage among low
income groups by using four selected characteristics of good governance: equity, efficiency and effectiveness,
participation and transparency.
Methods: The interviews with policy makers and patient representatives were conducted. The purposive
sampling was used to select interviewees. The data was analyzed by a template analysis style, as
the templates are the four selected characteristics of good governance.
Results: After the introduction of universal health care coverage in Thailand, the Thai health care
system has improved. First, equity in Thai health care system is largely improved, which can be seen by
improvement of the accessibility to health services among low income groups. Second, the efficiency of
health care systems has enhanced. Third, people have better opportunity to participate in decision making
process of the health care systems. Fourth, the transparency of health care systems is improved due to
the shift of power to allocate health fund from the Ministry of Public Health to the National Health Security
Office.
Discussion: Despites the improvements in the health care systems, there are still several challenges
that the Thai health care system is facing. For example, the geographical barriers prevent low income
groups from accessing care for chronic conditions, this result showed insufficient allocation of resources
in health care systems. Another challenge for the Thai health care system is a shortage of medical professionals.
Conclusion: the universal health care coverage has improved the accessibility of health care services
among low income groups, efficiency of health care systems and participation of people in decision
making. However, the challenges are still occurring, for example, insufficient of human resources and
geographical barriers.
Since the section 41 of the National Health Security Act B.E.2545 has been enforced, requests for the
preliminary financial assistance under section 41 were increasing every year, but the civil litigation rate is
undetermined. The main purposes of this descriptive research are to examine the relationship between
preliminary assistance and the rate of civil litigation and to study preventable damage from medical errors.
The author retrospectively reviewed all documents related to sub-committee meeting to decide the
request for preliminary financial assistance between the year 2004 and 2010 and interviewed the relevant
personals. Data were analyzed with frequency, percentage, and Fisher’s Exact Test. The results showed
that 37 cases were included in the study, 28 cases were eligible for payment of preliminary assistance. Two
cases in Lamphun and 43 cases (0.93%) in Thailand filed a civil lawsuit against the Ministry of Public
Health. The rate of civil litigation in cases who did not receive money compared to those received in
Lamphun were not different (p-value = 1), but different (p-value = 0.031) at the national level. In conclusion,
the payment of preliminary assistance in Lamphun had no effect on civil litigation, but the filing rate
significantly reduced at the national level owing to this measure. Health care providers should review the
service process, which the most common causes were in the communication and the referral system, to
prevent any damage that may occur repeatedly in the future.
The purpose of this study was to examine the abnormality in Body Mass Index(BMI), lipid profile
and evaluate risk for develop coronary heart disease in 10 years by Framingham Risk Score in Health care
and office workers, aged more than 35 years old, in Health Promotion Center, Region 1, Bangkok at annual
health check up 2010. The results of this study indicate overall prevalence of obesity (BMI ≥ 25 kg/
m2) was 35.5, man 45.5% and woman 34.2%. The most common lipid abnormalities were LDL-Cholesterol
(≥ 100 mg/dl) 78.3%, Cholesterol (≥ 200 mg/dl) 55% and Triglyceride (≥150 mg/dl) 22.2%. Risk for develop
of Coronary heart disease in 10 years by Framingham Risk Score, the study group had low risk
98.4% and no one was in high risk group.
In the past decade, Diabetes Mellitus tends to become more and more important problem in Thailand.
Nowadays, research results clearly indicate that behavioral change strategies can decrease complications
and death among Diabetes patients. Several studies in China, Finland and USA have reported that intensive behavioral modification program focusing on exercise and weight loss certainly decreases the
risk of Diabetes in high risk group by 31-58 percent. Previous related researches in Thailand have found
that giving knowledge alone have led to negative outcome of Diabetes patient care. This research aimed to
test the effectiveness of intensive behavioral modification program for individual at risk of type 2 diabetes.
This Quasi-experimental research is to study effectiveness of intensive behavioral modification model
which focuses on diet and exercise for 24 weeks. Participants who are overweighed person (BMI > 25 kg/
m2) were divided into two groups. Forty-one participants attended the intensive model while 61 participants
received standard care. Effectiveness of the groups was compared at the end of the study. From data
analysis made through changes of both physical and biochemical indicators, there was no significant
difference found between two groups but subgroup analysis in overweight group (BMI > 30 kg/m2)
indicate that the experimental group significantly lost more weight than control group (95%CI= -1.976 - -
0.019, p-value = 0.046). This finding shows that the program is more suitable for overweight person. However,
long term study is still needed.
The purpose of this research was to study the situation and trends of sex crimes in relation to consumption
of alcoholic beverages as well as to explain the types of sexual abuse carried out while under the
influence of adolescents and youth in Thailand. The sources of information were cases related to sex
crimes which appeared in print media over the past 10 years (between B.E. 2541-2551) and from the collection
of qualitative data from in-depth interviews. The sample group consisted of 15 adolescents and youth
at the Central Observation and Protection Center, Nonthaburi who committed sex crimes.
From the research it was found that information from print media portrayed the number, violence,
and complications of sex crimes related to the increased consumption of alcohol in Thailand, at three fold
over the past ten years. The age of victims and perpetrators is greatly varied, with the age of victims
between 4-102 years old and of perpetrators between 15-76 years old. From information on the perpetrators
it was found that the ages are decreasing and are increasingly youth or adolescents. The crimes mostly
take place at night and the abuse reported in print media the most is rape. The majority of the crimes are
carried out by known people, especially family members.
From interviewing youth who carried out crimes, it was found that 13 of 15 drank alcoholic beverages
2-3 hours before committing the crime and ¯ drank with the victims. Drinking alcoholic beverages
plays a role in bringing together groups which lead to planning and thinking of committing crimes. An
interesting point found was that perpetrators did not drink to get drunk (20-30 grams of pure alcohol), but
to become confident and brave enough to carry out the crimes without any consideration.
Recommendations from this study include the need to be more rigorous and strict with using related
laws such as forbidding the sales of alcohol to people under 20 years old according to the Royal Decree on
Control of Alcoholic Beverages, B.E. 2551. Information on sex crimes and other crimes need to be collected
and there information on alcohol consumption of the perpetrators should be collected as well. This is
because alcohol is related to sex crimes and other crimes. There should be measures to publicize and
change attitudes in society regarding alcohol consumption and sex crimes are not a normal aspect in
society.
Objective: The Cigarette Smoking and Alcohol Drinking Behavior survey (CSAD) has been conducted
by the National Statistical Office every 3-4 years. In 2007, this survey added crucial questions for
alcohol policy, including quantity of drinking, binge drinking and untaxed alcohol consumption. In addition,
it has a large sample size which can represent the population at provincial level. The objective of this
study is to report alcohol consumption behaviors of the Thai population.
Methods: The 2007 CSAD was a stratified two-stage sampling. Data were collected from 79,560
households by structured questionnaire, face-to-face interview during July to September 2007. This study
analyzed data of sample aged 15 years or older [N=168,285]. The data were estimated to represent the
population using sampling weights.
Results: Prevalence of 12-month drinkers, 30-day drinkers, regular (weekly) drinkers, high-risk drinkers,
binge drinkers, and drink-driving was 30.0%, 21.1%, 16.4%, 2.8%, 4.9% and 10.1% respectively. 12.9%
of underage people (<20 years) reported consuming alcohol in the last 12 months. Alcohol drinkers were
highly prevalent in a group of people who were male, aged 20-49 years, married, low educated, middleincome
level, agriculture and labor, and living in rural area and the North and Northeast. Among all
provinces, prevalence of alcohol drinkers was highest in North provinces. The most consumed alcoholic
beverage was beer, followed by white spirits and colored spirits. Prevalence of untaxed alcohol drinkers
was 2.4% (2.3% for domestic products drinkers and 0.2% for imported products drinkers). Estimated
untaxed consumption was 4.7% of total alcohol consumption.
Discussion: The findings of this study illustrate situation of alcohol consumption of the Thai population
and critical information to be used for evaluation and monitoring in populations and provinces
with high prevalence of alcohol use.
The current system of pharmacovigilance is mainly responsible to healthcare professionals for reporting
adverse drug reactions (ADRs) which major concerns are underreporting. Many countries had
initiated patient participation to the direct reporting of ADRs resulting in increased the reporting rate
especially possible new ADRs, non- serious ADRs which affect patients’ quality of life or ADRs which
patients could play an important role in drug safety. Those patient reports provided sufficient and thorough
details of the ADR outcome. However, they could be exaggerated, resulting from the ability to
distinguish between their illness and medications that might cause the adverse effects. Therefore, to
increase the report quality and the effectiveness of pharmacovigilance, the information about drugs and
adverse effects, and encouraging the patients’ awareness of ADR reporting are required.
To this research, it is to consider the good practices of pre-hospital emergency medical
service (EMS) system. By an in-depth interview with responsible units, story telling and lessons
learnt can contribute the big picture of their EMS practices in 6 areas (provinces); KhonKhan,
Ubonratchathanee, Lumpang, Petchaburi, Phuket and Songkhla. Initially, the research team has to
choose the modeling framework. Malcolm Baldrige National Quality Award (MBNQA) is chosen;
since it represents wisely for what are key elements in the system and how those are integrated for a
holistic view. Subsequently, the practices of the EMS system in 6 areas are captured. Besides, the
summary of good practices classified by elements of MBNQA is considered prior to shorten the
learning curve or speed-up the practices in other areas.
Respectively, MBNQA is applied as a framework for ascertaining the factors contributing the
success and the key obstacles in the practices of each area. However, it is interesting that the
practices of 6 areas, which have the diverse levels of success, tend to have indifferent obstacles.
Even, the most success area in Thailand encounters the problems in ‘Process Management’,
‘Workforce Focus’ and ‘Customer Focus’, which are similar in other areas. Additionally, the survey of
people who either use or never use the EMS in 6 areas results in the same problems, which are
‘insufficient promotion for the service’ and ‘inefficient service processes’. Besides, the research
team pinpoints that by completing the data collection and analysis, the lesson learnt and practices in
all areas are all remarkable. The differences in success rate are insignificant. In other words, the
practices and lessons learnt should not be limited only the success areas. Every area puts their
attempts to improve the EMS system and their diverse practice should be valued as meaningful
knowledge.
Therefore, the results of this research are concluded as two issues. (1) The guideline for
MBNQA application in the EMS system. The modeling framework enables the responsible units to
analyze the service system for a holistic view. Indeed, the analysis can point out the elements of
underemphasized. (2) The story telling from effective practices. This is an attempt to shorten the
learning curve prior to speed-up the practices in any areas. Significantly, the effective practices,
which are not limited only in the success areas, can cheer up any areas to improve their
performances of practices.
The one of leading non communicable disease burdens around the world including Thailand are Diabetes Mellitus and Hypertension. Health delivery system in Thailand was not proactive enough even having some focal innovative good practicing around country but lack to integration as a system. The management initiative of linking between concepts of Diseases Management, Chronic Care Model (CCM) and Chronic Diseases Management Model was integrated to WHO’s “Chronic disease prevention model”. Our conceptual framework is stress on ‘continuums’ ‘integrations’ and ‘comprehensive’ aiming to developing and testing “The integration of chronic disease management system in Diabetes Mellitus and Hypertension Model: phase I ” in provincial level.
Method : Action research by purposive sampling. Develop assessment tools for assessing the situation in 4 issues.  Field testing those assessment tools was performed in the area of Sakon Nakhon province and participatory develop the provincial strategic plan. 
Results : 1) The situation assessment tools was developed: a) Health service policy and community strengthening.  b) Health service delivery design.  c) Self management and self management support.  d) Performance indicators.  2) Participatory Sakon Nakhon’s provincial strategic plan.
The comprehensive knowledge management in Diabetes/Hypertension
case project is organized to integrate the two existing networks- Toward Clinical
Excellence Network-DM (TCEN-DM) and Diabetes Knowledge Management Network.
The main objective of this project is to combine the comprehensive knowledge
management in Diabetes/Hypertension case in Thai content with the specific objectives
of the followings (1) To collect and synthesize the experience, knowledge and
innovation about diabetes/hypertension prevention and health promotion in or to
develop the clinical excellence system (2) To establish the benchmark measurement in
diabetes/hypertension management and (3) To share the knowledge in comprehensive
diabetes/hypertension knowledge management among network for best practice. The
assumption of this project is that the knowledge can be extracted from the best practice
and staff. So, the knowledge management in this project is to transfer the knowledge
from the person to the others and continuous management to create, share and adapt the
knowledge.
The leader from TCEN and Diabetes KM network from 4 regions of the
Thailand was selected to be the core responsible person (Node). They were trained for
the knowledge management, TCEN indicator and outcome mapping for building the
network, planning and operating the project. The Node was then transferred the
knowledge into their area and provided the knowledge management forum “Synergy
between tacit and explicit knowledge for diabetes and hypertension patient” during Aug
03-04, 2009. Based on the output competency from 11 events of knowledge
management market in each region, the working committee had a conclusion of 9
factors and classified into 5 levels that were used to evaluate and improve the potential
of diabetes/hypertension care team in Thailand context.
For TCEN indicator, it was increased from 17 to 20 indicators to accord
with indicator of the National Health Security Office which was revised to an
appropriate template of each the indicator.
Other than the above activity, this project has published 2 books:-
“Diabetes story: learning through practicing volume 2” and “Diabetes TCEN: Pointing,
Setting the target and Developing”. The synergy tacit and explicit knowledge story was
produced in CD and made the weblog: http://gotoknow.org/blog/dmcop to distribute the
data, story and another summary from this project.
Through a year of the project implementation by using the knowledge
management tool, most of activities were conducted under the positive, friendly,
respective atmosphere with appreciation of all participants of this project. This made the
leader and the members of the network a good relationship and collaboration. It is
confident that the network can be operated in a sustainable way.
The purpose of this research was to develop the Out-Patient Service Quality
Satisfaction Indicators of Community Hospital . Applying research and development was
approached. Analytical statistics were qualtitative research methodology by Multi-Attribute
Consensus Reaching and quantitative research methodology for reliability by Cronbach’s
Alpha-coefficient and Model Validity finding by Confirmatory Factor Analysis:CFA with
LISREL 8.30. The samples were 759 cases from the Out-Patient of 8 community hospitals
in Phitsanulok Province. Eestablishing the standard for the evaluation by normative and
evaluating the handbook.
The finding of this research were as follow ; the Out-Patient Service Quality
Satisfaction Indicators of Community Hospital composed of the 5 domains TICTI 34
indicators ; 1) the Tangibles : T domain composed of 11 indicators 2) Interaction : I domain
composed of 6 indicators 3) the Convenience : C domain composed of 5 indicators 4)
the Trust : T domain composed of 8 indicators ; and 5) the Information : I domain composed
of 4 indicators. Reliability of the Out-Patient Service Quality Satisfaction Indicators of
Community Hospital was 0.77. Model of the Out-Patient Service Quality Satisfaction
Indicators of Community Hospital fit very well with the empirical data (2 =431.55 , df =
522 , p = 0.001 , GFI =0.94 and AGFI = 0.91 and root mean squared residual : RMR =
0.02). The standard for the evaluation employed in three level. The norm statistics were as <
102 scores at poor, 102 to 153 scores at fair and > 153 scores at very good. Evaluating the
appropriate of the Out-Patient Service Quality Satisfaction Indicators of Community Hospital
handbook was at good level .
Since 2005, a national strategic plan aimed at controling and preventing a future avian influenza (AI)
pandemic and/or outbreak of influenza in Thailand was established as a policy measure to tackle these
public health threats. The objective of this paper is to study the formulation process of two policy measures
for AI: vaccination of poultry and stockpiling of antiviral drugs for humans.
We used a qualitative approach with in-depth interviews of 38 key stakeholders from many organizations.
In addition, a literature review was carried out along with the interviews. After collecting data
from the literature and the in-depth interviews, we analyzed the emerging themes relevant to the policy
formulation process in Thailand.
We found that policy formulation concerning poultry vaccination is a very complex and politically
driven process since many stakeholders are involved with different special interests and powerful influences.
Small-scale poultry producers representing rural people are the ones who would rather use vaccine,
because non-vaccine measures, such as culling or using bio-security buildins and measures, are against
their rural culture. However, the majority of key stakeholders were against the use of poultry vaccine.
There are four major reasons: (a) evidence of vaccine effectiveness is not convincing and thus a public
health threat remains possible; (b) the government has confidence in the infrastructure needed to fight AI
outbreaks with non-vaccine measures; (c) the management system of vaccination (acquisition of goodquality
vaccine, finance, logistics, monitoring and exit program) is not fully effective; and (d) the government
implicitly wants to protect the poultry export industry. Thus, the government decided not to use
poultry vaccine.
Contrary to the poultry vaccine policy, building stockpiles of antiviral drugs for use in humans is
determined primarily by experts at the Ministry of Public Health, following World Health Organization
guidelines, but under budget constraints. Other factors relevant to policy analysis are: government leadership,
budget constraints, animal and human health co-ordination, scientific evidence and risk communication
for the public.
Overweight and obesity are associated with several chronic diseases. Economic costs attributable
to overweight and obesity are substantial. In Thailand, the prevalence of overweight and obesity is increasing
rapidly. It was also found that overweight and obesity were the 6th leading risk factor attributable
to Disability-Adjusted Life Year (DALY) loss in Thailand in 2004. However, there had never before
been a study which examined health-care costs due to overweight and obesity in Thailand.
This study is aimed at estimating the health-care costs attributable to overweight and obesity in
Thailand in the year 2009, employing the overweight and obesity-attributable fractions (OAFs), which are
generally defined as the proportion of a disease in a population that is attributable to overweight and
obesity. OAFs were calculated for each disease associated with overweight and obesity. OAFs can be
calculated from the prevalence of overweight and obesity and relative risk of each disease. The number of
patients in each disease category attributable to overweight and obesity was then calculated as the product
of OAFs and the total number of patients with that disease in 2009. The health-care costs of overweight
and obesity were further estimated by multiplying the number of patients in each disease category
attributable to overweight and obesity by the unit cost of treatment.
Health-care costs attributable to overweight and obesity in this study were estimated at 5,580.8 million
baht (i.e. out-patient department = 847.4 million baht and in-patient department = 4,733.4 million
baht). The top three leading causes of health-care costs were diabetes mellitus (3,386.6 million baht),
ischemic heart disease (1,070.5 million baht) and colon and rectal cancer (377.2 million baht), respectively.
The findings clearly confirmed that the economic impacts of overweight and obesity on health-care
costs in Thailand were substantial. More effective policies/interventions aimed at reducing the prevalence
of obesity should be implemented.