Services In Thailand Research Articles

Responding to media convergence: Regulating multi-screen television services in Thailand

This study examines how Thailand’s convergence regulator, the National Broadcasting and Telecommunications Commission (NBTC), regulates digital television’s transition and new audiovisual services. In addition to document analysis, this study interviewed stakeholders (e.g. NBTC policymakers, broadcaster and cable TV operators). The socio-technical analyses show that the NBTC prioritized digital television transition and imposed substantive government/policy support. Comparatively, Internet Protocol television (IPTV) and mobile TV which are driven by the industry/market subsystem have sluggish regulatory advancements. The interview results show that the NBTC is likely to regulate multi-screen TV services’ contents and platforms separately as a result of complexity. Hence, this study recommends a platform-neutral approach to regulate audiovisual media categorized by socio-cultural impact and content production/aggregation model. It suggests that Thailand’s TV-like services which can reach a mass market and produce/aggregate contents/services via a gatekeeping mechanism should be subject to strict content regulations and licensing schemes. However, light-touch regulations in content and licensing are suitable for governing emerging TV-like services which utilize a participatory content model with less socio-cultural impact. Finally, net neutrality is recommended in facilitating cross-platform content innovations and distribution.

Does harmonization of payment mechanisms enhance equitable health outcomes in delivery of emergency medical services in Thailand?

There are different reimbursement rates by the various insurance schemes in Thailand, which include the Universal Coverage scheme (UCS), civil servant medical benefit scheme (CSMBS) and social security scheme (SSS). Hence, there are concerns about inequitable care standards. Harmonization of the rates of emergency medical services has been started since April 2012. This study analyzed the impact of harmonization on clinical outcomes in private hospitals. Analysis of 22 900 records of the dataset accrued from April 2012 to June 2013 using multiple logistic modelling revealed that beneficiaries under UCS were the worst off [Odds ratio 2.56 95% of confidence interval: 2.35 to 2.80 for non-trauma and 2.19 (1.59-3.0) for trauma, corresponding to 21.26 and 25.09% of bad outcomes, respectively] in terms of not improved or dead outcomes at discharge compared with those under the CSMBS (8.45 and 12.78%, respectively) controlling for age, sex, hospital location, triage priority code, length of stays and adjusted Relative weight (RW) score. Using propensity score, matching analysis found the outcome rates of not improved including dead were highest in UCS 26.27% for trauma and 21.26% for non-trauma patients. Payment mechanism alone is inadequate to ensure equitable distribution of health outcomes in provision of emergency medical care by private providers in urban settings across the country. A secondary finding was that patients accessing hospital services directly showed better improvement or lower in-hospital mortality compared with access through formal pre-hospital means (P < 0.001). Plausible explanations have been discussed with policy implications and recommendations for further studies.

Strategies for Successful Ageing Living Alone

The purpose of this qualitative study, conducted in Thailand, was to identify strategies for older adults to live alone happily, with dignity, security, and independence. Purposive sampling techniques were used to recruit participants from 12 provinces throughout Thailand. The sample included three groups: older Thai people living alone (n = 1,087), clinician who working with Thai older adults (n = 149), and administrators working in aged care and support services in Thailand (n = 83). Data were collected using structured interview guides. Content analysis was used to identify and develop the study findings. Most of the older Thai people living alone were single, widowed or divorced with few wanting to remain living alone. The large majority of participants needed government assistance to manage their activities of daily living including access to health and public services. Participants wanted aged care and support services to assist with their living arrangements, organise community activities, and provide home visits. Moreover, they wanted their families to visit them and provide financial support and care for them when they were ill. These older adults experienced living alone positively and negatively. Some participants felt proud, dignified, and independent. Other participants felt that living alone resulted in poorer health status, particularly emotional problems, especially for those who were not living alone by choice. These participants reported feeling lonely, bored, irritated, sad, and sorrowful. This group of older Thai adults had limited interaction with their families and the wider community. From this study, four strategies were identified to assist older Thai adults to live alone happily, safely and with a sense of dignity, security, and value. These strategies are: ensuring individual choice, maintaining family support, developing community value, and advocating for over-arching government policy support of aged care. A high number of older adults live alone in Thailand and this presents a big challenge for both these individuals and the community in which they live. If this important group in Thai society is to live alone happily and successfully, it needs to be additional assistance to ensure they are supported by families, communities, and government departments.

Factors influencing decisions of Laotian patients to use health care services in Thailand

Abstract Background: Thailand has been facing a gradual increase in use of cross-border health care. Nevertheless, no evidence regarding factors influencing cross-border use of health care by Laotian patients in public Thai hospitals among this group has been established. Objectives: To assess the use of cross-border health care by Laotian patients, and factors that may influence health services in public Thai hospitals along the border. Methods: This study consisted of two parts. (1) Site-visits to 53 Thai public hospitals along the Thai-Laos border during May to July 2011 and collection of data regarding the use of health care services by Laotian patients. (2) A structured questionnaire survey was conducted via face interviews by trained researchers. Findings were analyzed using descriptive statistics and multiple logistic regression. Results: The most common conditions for which treatment was sought were common diseases and basic operative procedures. All hospitals had been facing substantial financial burden, particularly for inpatient care. The analysis of use indicated that a perception of differences in the quality of health services, ability to pay for treatment anywhere, and distance to health services were three major factors affecting the decision of Laotian patients to cross the border to obtain health care in Thailand. Interviews with hospital directors and staff revealed that more financial support and a clear policy for care of Laotian patients was needed. Conclusions: The perception of better quality of health care in Thailand by Laotian patients was the major factor affecting cross-border use of health care services. Assistance to improve healthcare in Laos and financial support for subsidizing care for the indigent Laotian patients is needed.

Understanding Factors Affecting Mobile Services Adoption

Popularity of mobile services is increasing rapidly in Thailand and it is influencing daily life, business, and markets. Recently, more attention has been drawn towards mobile services due to the adoption of 3G in Thailand. This enhanced the competition in the telecommunication industry. Consequently, it became very critical for mobile services providers to better understand users and factors that affect users' adoption of mobile services. This paper aims to identify and study factors that impact mobile services adoption in Thailand. Factors and sub factors were identified and a survey was conducted. Factors were compared using Pairwise Comparison Method (PCM). Results of the analysis show that intermediary factors have the highest impact on users' intention to adopt mobile services followed by service characteristics factors and social factors respectively. The study provides an insight and information about factors influencing users' adoption of mobile services in Thailand.

Understanding Factors Affecting Mobile Services Adoption

Popularity of mobile services is increasing rapidly in Thailand and it is influencing daily life, business, and markets. Recently, more attention has been drawn towards mobile services due to the adoption of 3G in Thailand. This enhanced the competition in the telecommunication industry. Consequently, it became very critical for mobile services providers to better understand users and factors that affect users' adoption of mobile services. This paper aims to identify and study factors that impact mobile services adoption in Thailand. Factors and sub factors were identified and a survey was conducted. Factors were compared using Pairwise Comparison Method (PCM). Results of the analysis show that intermediary factors have the highest impact on users' intention to adopt mobile services followed by service characteristics factors and social factors respectively. The study provides an insight and information about factors influencing users' adoption of mobile services in Thailand.

DEMOGRAPHIC AND HEALTH PROFILES OF PATIENTS SEEN BY PALLIATIVE CARE ADVANCED PRACTICE NURSE IN SONGKHLA HOSPITAL, THAILAND

BackgroundPalliative care services in Thailand had been gradually developed. However, little is known about services provided.ObjectivesThis retrospective study was aimed to describe demographic and medical and health profiles of patients...

An innovative price plan monitoring and advisory system: A case study of mobile telecom service in Thailand

Article history: Received October 23,2013 Received in revised format November 25, 2013 Accepted November 27, 2013 Available online November 27 2013 An innovative price plan monitoring and advisory system simulates subscriber usage consumption for offering suitable price plan. The aim of this paper is to develop the decision support system by using Statistical Process Control (SPC) to identify subscriber usage behavior and provide critical visibility into subscriber consumption to detect their inappropriate usage especially in exceeding usage. To explore subscriber usage behavior, a forecasting model and a regression is employed to identify related factors and predictive usage model. The innovative price plan monitoring and advisory system has been verified and validated with one of the largest telecommunication company in Thailand. Using decision support system with effective control chart and real subscriber behavior pattern help mobile network operator grow their revenues and profits by offering an appropriate price plan as well as improve subscriber experience with more flexible choice to meet their individual usage consumption needs. © 2014 Growing Science Ltd. All rights reserved.

Organised colorectal cancer screening in Lampang Province, Thailand: preliminary results from a pilot implementation programme

ObjectiveColorectal cancer (CRC) is the third-most and fifth-most common cancer in men and women, in Thailand. The increasing CRC incidence and mortality can be reduced by screening and treating adenomas...

Palliative Care Personnel and Services: A National Survey in Thailand 2012

Research on palliative care services in Thailand is incomplete. We conducted a countrywide cross-sectional postal survey to update the situation. We approached hospitals and asked them to respond to a questionnaire. The overall response rate of government hospitals was 61 percent (537 of 882 hospitals). Of these, 59 percent reported that they had personnel trained in palliative care; the majority had received less than a week of such training. In all, 60 percent of the hospitals reported that they offered palliative care services, but 25 percent of these services were delivered by staff who had no palliative care training. The criteria of having at least one trained doctor and nurse on staff was met by 17 percent of the hospitals. Only seven hospitals, most of them associated with medical schools, employed both a doctor and a nurse who had been trained in palliative care for one month or more; these professionals mainly provided hospital and home palliative care team services. Our survey reveals the lack of both health care personnel fully trained in palliative care and specialist palliative care services in Thailand.

Accessibility of health care service in Thasongyang, Tak Province, Thailand.

Accessibility to health care services in Thailand is generally good, but a few areas in the country are difficult to reach. The purpose of this study was to investigate the accessibility of health care services in rural and remote areas of Thailand. It was conducted in 16 remote villages within a catchment area with a primary health care post. The health care post staff interviewed 394 respondents (197 males and 197 females) using a structured questionnaire. Most respondents utilized primary health care posts (98.5%) and medical institutes. Most of the respondents were Karen, had low incomes, and were illiterate. However, they had health insurance. Most of them took more than 30 minutes to travel from home to their primary health care post (60.9%), and took more time in the rainy season than in the dry season. Moreover, it took more than 2 hours for them to travel to the nearest hospital from their residences (64.5% in the dry season and 84.5% in the rainy season). They also paid more for medical services, travelling and food on the way to the hospital. Not only primary health care posts, but also many other medical institutes provided health care services in the villages. In conclusion, based on the results of this study, primary health care posts in remote areas are necessary to ensure the residents' healthy lives. Therefore, improvement of the quality and accessibility of primary health care posts should be considered as the top priority.

An Analysis of Factors Affecting the Adoption of Digital Terrestrial Television Services in Thailand

Digital Terrestrial Television (DTTV) Services is thought to bring many benefits to viewers compared to regular analog televisions. Although many countries around the world introduced DTTV with such benefits in their minds, the rates ofDTTV adoption have been slow and many countries have to postpone the analog switch-off date as a consequence. The objective of this study is to examine and understand factors that contribute to consumer intention to adopt DTTV. In this study we try to evaluate the benefits of consumers’ adoption of DTTV services by analyzing consumers’ valuations on DTTV’s characteristics such as improved video quality, more available TV channels, and other enhanced services against how much they want to pay for a set-top box (STB) or a new digital TV (DTV). We employed a stated preference conjoint analysis method as a way to collect the data from viewers across Thailand. Using such data, we estimate d consumers’ utilities by applying a discrete choice model to determine important factors and measuretheir significance. The willingness to pay (WTP) for each factor by consumers will bealso calculated. The result of the study will helppolicy makers to understand Thai TV viewers and provide suggestions on how to promote efficient DTTV adoption strategies.

Rehabilitation service development for Sub-Acute and Non-Acute Patient (SNAP) under universal coverage scheme in Thailand

The need of rehabilitation in sub-acute and non-acute patients has been continuously increased. Rehabilitation services in Thailand are considered only as part of acute care so that the providers are not motivated to provide intensive services to patients because the payment based on diagnosis related group focuses on acute phase. This study aimed to develop an appropriate model for SNAP Casemix including in-patient, out-patient, and home based care in 4 groups of patients: stroke, brain dysfunction (traumatic and non-traumatic), spinal cord dysfunction (traumatic and non-traumatic) and major multiple trauma. The expected results are improvement of accessibility, continuity, quality of care as well as the proper payment and information of activities, unit costs. Fifty five hospitals in five provinces were recruited voluntarily to develop rehabilitation services both facility-based and home-based care, referral system, structure, payment, information system etc. Three development steps were set up as follows: 1) setting the new desirable system, 2) implementation of the new system (according to context of each province) and 3) evaluation. The effectiveness will be assessed through functional status and quality of life gained compared to set target. The efficiency studies consist of cost per patient, cost per DRG and cost recovery. Barthel Index (assessment of 10 functions: feeding, transfer, grooming, toilet use, bathing, mobility, stairs climbing, dressing, bowels, and bladder) and EQ5D (Assessment of quality of life in 5 dimensions including: mobility, self-care, usual activities, pain/discomfort and anxiety/depression) will be used for functional assessment. The study will go on for 18 months.

Child psychiatric consultation to pediatric inpatient services in Thailand

Children with medical illnesses have significant levels of comorbid psychopathology. To understand the concern, and the area that needs to be addressed, the practice of child psychiatric inpatient consultation at Queen Sirikit National Institute of Child Health, Thailand was examined and appraised. Evaluation of the current practice pattern of psychiatric consultation is a crucial process in determining the next step of improving the quality of mental health care for sick children.

Inlight Optically Stimulated Luminescence for Occupational Monitoring Service in Thailand.

Inlight Optically Stimulated Luminescence for Occupational Monitoring Service in Thailand.

Impact of Universal Health Care Coverage on patient demand for health care services in Thailand

Fully implemented in Thailand in 2002, the Universal Health Care Coverage (UC) Program aimed to provide cheap access to health care services, for 30 baht (less than 1 U.S. dollar) per visit, to all uninsured Thais. In this paper, we studied the impact of the UC in Thailand on the demand for health care services using hospital level data. We found that the UC program was successful in increasing outpatient demand for health care, particularly the demand from the elderly and the poor. However, outpatient demand for health care dramatically increased during the first year of the program and faded away quickly in subsequent years. In contrast to outpatient demand, the number of inpatient visits and the number of days for which the inpatients were admitted at hospitals declined after the UC program was launched. In this paper, we offer our explanation of these phenomena, highlight problems associated with the UC program, and provide policy recommendations to improve the program.

Development Composite Customer Damage Function Using the Customer Survey Based Method for Power System Reliability Planning

The optimization in reliability cost-benefit analysis for distribution investment planning has been more attended on energy delivery services in Thailand. In this research, the reliability costs for the customer point of views represented as the interruption costs are presented. The data for analysis is provided from customer survey-based method during 2008-2009. Due to the direct and indirect impacts for electric customer in each category are different, the concept and methodology for data collecting based on customer survey is described. According to interruption costs are different for each sector, the customer survey results are classified into four customer sectors. In each sector, the individual customer damage function derived from survey is aggregated to develop sector customer damage function. The composite customer damage function utilized in regional reliability investment planning is also presented. In addition, the reliability cost evaluation in term of interrupted energy assessment rate for the selected industrial estate is determined in order to investigate industrial customer impact at the level of microeconomics scale. Application areas of reliability cost indices to enhance the effectiveness planning and operation of power distribution system are also recommended.

Factors involved in recovery from schizophrenia: A qualitative study of Thai mental health nurses

Recovery-oriented services increasingly are being called for around the world. These services do not just consider recovery from mental illness as symptom remission, but as individuals' ability to redefine their self and to "live well", even with enduring symptoms. However, little is known about the views of Thai nurses regarding the conceptualization of recovery. This article presents the findings of a qualitative study that explored the perspectives of 24 Thai nurses regarding schizophrenia and recovery. Semistructured interviews were conducted with nurses who were providing care for persons who were living with schizophrenia in both hospital and community settings. A thematic analysis identified the personal and environmental factors that were related to recovery. Illness acceptance, hope, and adherence to treatment were viewed as the facilitators of recovery, while a low level of self-responsibility and illness-related factors were barriers. Environmental factors, such as the presence of a supportive environment and accessibility to mental health services, were described as facilitators, while stigma towards mental health illness and fragmented health services were barriers. The implications of these results in promoting recovery-oriented mental health services in Thailand are discussed.

Cost analysis for reimbursement-rate setting of hospital pharmaceutical services in Thailand

OBJECTIVES This study aimed to develop a hospital pharmaceutical service model, together with a costing template for unit cost analysis and to analyse unit costs of hospital pharmaceutical services. METHODS The study was designed on the basis of activity-based costing. A model of the services was set up by consensus of the working group. Pharmaceutical services among the study hospitals were standardised. A Microsoft Excel-based costing template was developed. Finally, the costing template was used for the unit cost analysis. Sensitivity analysis and descriptive statistics were used for further analysis. KEY FINDINGS Four general and seven regional hospitals participated in the study. Hospital pharmaceutical services were divided into nine supporting activities and nine patient-service activities. Unit costs of drug dispensing per prescription by regional hospitals were approximately double that of general hospitals. In contrast, the cost of aseptic dispensing per item in regional hospitals was lower than those in general hospitals. In comparing the unit costs from standard labour costs with those from actual labour costs, both increases and decreases were found. CONCLUSIONS Costing and the use of Microsoft Excel can be applied to the development of a costing template for unit cost analysis of hospital pharmaceutical services. This programme can provide accurate unit costs for services. The results can be used when considering pharmacy service reimbursement, efficiency and service development.

Respondent-driven sampling on the Thailand-Cambodia border. II. Knowledge, perception, practice and treatment-seeking behaviour of migrants in malaria endemic zones

BackgroundPopulation movements along the Thailand-Cambodia border, particularly among highly mobile and hard-to-access migrant groups from Cambodia and Myanmar, are assumed to play a key role in the spread of artemisinin resistance. Data on treatment-seeking behaviours, knowledge and perceptions about malaria, and use of preventive measures is lacking as characteristics of this population prevent them from being represented in routine surveillance and the lack of a sampling frame makes reliable surveys challenging.MethodsA survey of migrant populations from Cambodia and Myanmar was implemented in five selected rural locations in Thailand along the Thai-Cambodian border using respondent driven sampling (RDS) to determine demographic characteristics of the population, migratory patterns, knowledge about malaria, and health-care -seeking behaviours.ResultsThe majority of migrants from Myanmar are long-term residents (98%) with no plans to move back to Myanmar, understand spoken Thai (77%) and can therefore benefit from health messages in Thai, have Thai health insurance (99%) and accessed public health services in Thailand (63%) for their last illness. In comparison, the majority of Cambodian migrants are short-term (72%). Of the short-term Cambodian migrants, 92% work in agriculture, 18% speak Thai, 3.4% have Thai health insurance, and the majority returned to Cambodia for treatment (45%), self-treated (11%), or did not seek treatment for their last illness (27%).ConclusionMost highly mobile migrants along the Thai-Cambodia border are not accessing health messages or health treatment in Thailand, increasing their risk of malaria and facilitating the spread of potentially resistant Plasmodium falciparum as they return to Cambodia to seek treatment. Reaching out to highly mobile migrants with health messaging they can understand and malaria diagnosis and treatment services they can access is imperative in the effort to contain the spread of artemisinin-resistant P. falciparum.