Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy.

Purpose: This study was proposed to evaluate factors predicting a successful vaginal delivery following labor induction and develop induction prediction model in term pregnancy among Thai pregnant women.

Patients And Methods: We conducted a retrospective cohort study using electronic medical records of 23,833 deliveries from April 2010 to July 2021 at tertiary care university hospital in Bangkok, Thailand. Univariate regression was performed to identify the association of individual parameters to successful vaginal delivery.

Intervening alcohol marketing to reduce harmful alcohol use and lessons learned from the theory of changes: Case studies in Thailand.

Objectives: Globally, the burden of disease caused by alcohol use has been steadily increasing, including in Thailand. In this study, we aim to test the effectiveness of Anderson et al.'s suggested three approaches to change the collective social norms, which comprise of: (1) providing information and an understanding about alcohol use behaviour, its causes and distribution; (2) focusing strategies on groups rather than individuals; and (3) strengthening supportive laws, regulations and approaches.

Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients' perspectives.

Background: To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation.

Methods: We conducted a cross-sectional survey of 4071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces.

Paradox of sustainability in tobacco control in Thailand: A comprehensive assessment of three-decade experiences.

Background: Over the past 3 decades of tobacco control, Thailand has gained international recognition as a middle-income country with sustained achievement of declining smoking prevalence. However, the number of key Framework Convention on Tobacco Control measures implementation is still far away from the highest-level implementation. As a result, we aim to explore explanatory factors for the paradoxical phenomenon of sustainability in tobacco control in Thailand, to understand what the paradox means, why it happens, and how to take further steps in minimizing the paradox.

Trend analysis of smoking-attributable hospitalizations in Thailand, 2007-2014.

Introduction: Tobacco use is a major preventable risk factor for many noncommunicable diseases. Smoking-attributable mortality has been well described. However, the prevalence of smoking-attributable hospitalization (SAH) and associated costs have been less documented, especially in low- and middle-income countries.

Assessing system-based trainings for primary care teams and quality-of-life of patients with multimorbidity in Thailand: patient and provider surveys.

Background: Strengthening primary care is considered a global strategy to address non-communicable diseases and their comorbidity. However, empirical evidence of the longer-term benefits of capacity building programmes for primary care teams contextualised for low- and middle-income countries is scanty. In Thailand, a series of system-based capacity building programmes for primary care teams have been implemented for a decade.

Prehospital prediction of severe injury in road traffic injuries: A multicenter cross-sectional study.

Background: To develop and validate a risk stratification model of severe injury (SI) and death to identify and prioritize road traffic injury (RTI) patients for transportation to an appropriate trauma center (TC).

Methods: A 2-phase multicenter-cross-sectional study with prospective data collection was collaboratively conducted using 9 dispatch centers (DC) across Thailand. Among the 9 included DC, 7 and 2 DCs were used for development and validation, respectively.

Assessment of nationwide emergency systems in Thailand, a middle-income country setting with UHC.

Background: Evidence has been limited regarding broader emergency systems assessment in low- and middle-income countries. The aim of the present study was to provide the empirical evidence of Thai emergency department (ED) workforce vis-à-vis workload on a national scale, the availability of services for selected high-priority health burdens, and the governance obstacles in addressing the workforce management.

Method: One hundred thirty public Thai EDs that provide 24-hour emergency medical care were identified across Thailand as meeting the inclusion criteria.

Relevance of using length of stay as a key indicator to monitor emergency department performance: Case study from a rural hospital in Thailand.

Objective: The present study explores factors related to length of stay (LOS) in a rural public hospital in Thailand and assesses the feasibility of using LOS as an ED key performance indicator.

Methods: Using a mixed-methods approach, qualitative methods (in-depth interviews, patients' chart review and participatory observations) were used to guide and elaborate findings from quantitative analysis of 555 electronic ED records.

Results: Multivariate analysis revealed that age, Emergency Severity Index score and number of laboratory tests were significantly associated with LOS.

Closing the Equity Gap of Access to Emergency Departments of Private Hospitals in Thailand.

Background: Previous policy implementation in 2012 to incentivize private hospitals in Thailand, a country with universal health coverage, to provide free-of-charge emergency care using DRG-based payment resulted in an equity gap of access and copayment. To bridge the gap, strategic policies involving financial and legal interventions were implemented in 2017. This study aims to assess whether this new approach would be able to fill the gap.

Payment Reforms for Prehospital Care Services in a Middle Income Country: Assessing Implementation and Patient Outcomes Using a Mixed-Methods Approach.

Introduction: Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems.

Copayment and recommended strategies to mitigate its impacts on access to emergency medical services under universal health coverage: a case study from Thailand.

Background: Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death.

Methods: Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001.

Results: The copayment poses a barrier of access to emergency care delivered by private hospitals despite the policy proclaiming free access and payment.

A Participatory Randomized Controlled Trial in Knowledge Translation (KT) to Promote the Adoption of Self-Monitoring of Blood Glucose for Type 2 Diabetes Mellitus Patients in An Urban District of Thailand.

Objective: To examine effectiveness of self-monitoring of blood glucose (SMBG) in glycemic control for poor control diabetes patients, and test whether the glycemic outcome for those with the 7-point SMBG was better than those with 5-point SMBG or usual care.

Material And Method: Randomized-controlled trial (RCT) of patients with type 2 diabetes mellitus aged 30 years or older HbA1c > 7. Patients were randomly allocated to one of three groups; 7-point SMBG 5-point SBMG and control group.

Effectiveness of Self-Monitoring Blood Pressure in Primary Care: A Randomized Controlled Trial.

Objective: To examine the effectiveness of self-monitoring blood pressure (SMBP) in a randomized controlled trial with 12 months of follow-up in a community hospital.

Methods: A total of 224 eligible patients with hypertension were randomly allocated to the SMBP (n = 111) and usual care groups (n = 113). Each patient in the SMBP group was provided with a blood pressure (BP) monitor for home BP measurement.

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.

A Thailand case study based on quantitative assessment: does a national lead agency make a difference in pre-hospital care development in middle income countries?

Background: Emergency Medical Institute of Thailand (EMIT) has been established as a national lead agency to improve emergency medical service systems since December 2008. However up to now, there has not been any published systematic assessment of its performance to guide further policy decisions.

Methods: This study assesses the 4-year pre-hospital care coverage and performance in Thailand after EMIT establishment.

Risk prediction score for death of traumatised and injured children.

Background: Injury prediction scores facilitate the development of clinical management protocols to decrease mortality. However, most of the previously developed scores are limited in scope and are non-specific for use in children. We aimed to develop and validate a risk prediction model of death for injured and Traumatised Thai children.

Safety riding program and motorcycle-related injuries in Thailand.

A retrospective cohort study was conducted in Thailand from 2007 to 2009 to evaluate the efficacy of a safety riding program in preventing motorcycle-related injuries. A training group of motorcyclists were certified by the Asia-Pacific Honda Safety Riding Program in either 30-h instruction (teaching skills, riding demonstration) or 15-h license (knowledge, skills, and hazard perception) courses. The control group consisted of untrained motorcyclists matched on an approximately 1:1 ratio with the training group by region and date of licensure.

An assessment on Thai emergency medical services performance: the patient perspective.

Background: Emergency medical services (EMS) have been steadily developed in Thailand. However the patient perspective has not been explicitly considered in performance assessment thus far although it is a key consideration for quality improvement in public organizations.

Objective: To investigate the Thai patient experience in EMS and emergency departments (ED) and help Thai leaders guide future improvements.

Prevalence of metabolic syndrome defined by the International Diabetes Federation and National Cholesterol Education Program criteria among Thai adults.

This study determines the prevalence of metabolic syndrome (MetS) according to the International Diabetes Federation (IDF) and National Cholesterol Education Program III (NCEP) criteria in Thai adults. Data from a national representative sample, InterASIA study, including a total of 5305 Thai adults 35 years and older were analyzed. Overall, the age-standardized prevalence of MetS by IDF and NCEP criteria were 24.

Comparison of cardiovascular risk factors in five regions of Thailand: InterASIA data.

Background: Age- and sex- standardized mortality rate of cardiovascular disease (CVD) was high in Bangkok and central Thailand in the year 2000. This may partially be related to differences in risk factors.

Objective: To compare prevalence of CVD risk factors among regions in Thailand in the same period.

Different risk magnitudes of femoral neck and intertrochanteric fractures in Thai women.

Objective: To study the risk factors associated of femoral neck and intertrochanteric fractures in Thai women.

Material And Method: A case,control study was conducted in Bangkok and its vicinity between 1997 and 1998 to compare factors related to each type of hip fracture in Thai women. Cases, aged > or =51 years old, were diagnosed as intertrochanteric or femoral neck fracture and were matched with controls by age and sex.

A comparative study of risk factors of femoral neck and intertrochanteric fracture in Thai men.

Objective: The objective of this study was to compare the risk factors related to hip fracture between intertrochanteric fracture and femoral neck fracture in Thai men.

Material And Method: The study was conducted in Bangkok and its vicinity from July 1997 to September 1998. The cases were recruited and matched with the controls by age and sex.

Alcohol, illicit and non-illicit psychoactive drug use and road traffic injury in Thailand: a case-control study.

The objective of this study was to determine the relationship between alcohol use, psychoactive drug use and road traffic injury (RTI). A case-control study was conducted among drivers in Bangkok, Thailand. Two hundred cases and 849 controls were enrolled between February and November 2006.

Prevalence of psychoactive drug use among drivers in Thailand: a roadside survey.

The objective of this study was to determine the prevalence of psychoactive drug and alcohol use among general drivers and predictors of the drug use in Thailand. One thousand six hundred and thirty-five motor vehicle drivers were randomly selected from five geographical regions of Thailand between December 2005 and May 2006. The prevalence of psychoactive drugs was determined using urine tests by gas chromatography/mass spectrometry (GC/MS).