Title: Alcohol Consumption and Violence against Women in Khon Kaen Province Researchers: Pongdech Sarakarn*, Yaowaret Kammanat**

* Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University. ** One Stop Crisis Center, Khon Kaen Hospital.

Abstract

: This matched case-study, conducted in Khon Kaen Province, aimed to study two topics: first was to find the relationship between couples alcohol consumption and the violence against the wives. A structured interview questionnaire was used to elicit data from 47 women, who experienced violence and came to seek help at the One Stop Crisis Center of Khon Kaen Hospital and 94 controls, who were women living in the same neighborhood and were in the 5-year age range with the case group. It was found that the women who did not drink alcohol but had husbands who drank were 4.27 times (adjusted OR=4.27, 95%CI=1.10-16.62) as likely to experience violence while those who also drank and had drinking husband were 8.55 times (adjusted OR=8.55, 95%CI=1.75-41.90) as likely, compared to non-drinking couples. Heavy alcohol consumption (more than 5 glasses on a drinking occasion) (adjusted OR=4.17, 95%CI=1.14-15.28) and substance use (adjusted OR=3.97, 95%CI=1.04-15.07) were found to be significantly associated with the increased odds of violence. In conclusion, alcohol consumption is important activate factor for violence against women in family. Keywords: alcohol consumption, violence against women and domestic violence (Published in Journal of Health Systems Research Vol.3 No.4 Oct.-Dec.2009)

Title : Experiences of hospitals on claims for compensation related to adverse events Researchers: Pattapong Kessomboon*, Nusaraporn Kessomboon**, Supasit Pannarunothai***, Amorn Premgamone* * Faculty of Medicine, Khon Kaen University, **Faculty of Pharmaceutical Sciences, Khon Kaen University, ***Faculty of Medicine, Naresuan University

Abstract : When an adverse event has occurred, the patient or relative would bring the case to court or submit a claim for compensation from the National Health Security Office (NHSO). A study on the trend relating to claims for compensation can provide useful information for the design of a new and better system. Objective: To study experiences of hospitals relating to claims for compensation due to adverse events. Method: This was a descriptive study. Two hundred and thirty hospitals were surveyed for their experiences on patient claims for compensation due to adverse events occurred in 2008. Results: The response rate was 70%. It was found that 21.0% of the hospitals had ever experienced patient claims for compensation due to adverse events. Community hospitals have a higher chance of claims than general/regional hospitals (23.4% vs 15.7%, respectively). Most of the cases were related to pregnancy and delivery (43.1%). The median amount of claims was 200,000 Baht. The highest was 15,000,000 Baht. The median amount of the money received was 100,000 Baht. The main source of compensations was from the NHSO (49.0%). Among the claims, 13.3% brought the cases to court. Community hospitals have a higher chance of claims brought to court than general/regional hospitals (14.3% vs 10.0%, respectively). Conclusion: Twenty one percent of hospitals experienced patient claims for compensation. Most were related to pregnancy and delivery. The money received was smaller than claims. Some brought the cases to court lawsuit. Key words: hospital, claim for compensation, adverse event, court lawsuit (Published in Journal of Health Systems Research Vol.3 No.4 Oct.-Dec.2009)

Title: Perspective of the administrators on bringing community pharmacy to provide services under the National Health Security Scheme Researchers: Wiwat Arkaravichien* Jeerisuda Khumsikiew* Duangtip Hongsamoot** Pimolsri Sangkar** Phayom Sookaneknun*** * Faculty of Pharmaceutical Sciences, Khon Kaen University ** Food and Drug Administration, Ministry of Public Health *** Faculty of Pharmaceutical Sciences, Mahasarakham University Abstract Study the concept and the perspective of the administrative person can reflex the direction of development. This research aimed to study the concept and perspective of the administrators regarding the issue of attempt to bring community pharmacy to provide services under the National Health Security Scheme (NHS). The study was conducted by in-dept interview the responsible administrators on the matter of pharmacys status, possibility to recruit pharmacy into the NHS, the direction of development for pharmacy, value of pharmacy in the NHS, stakeholders and factor of success to push pharmacy into the system. Data was gathered and analyzed by content analysis. The results showed that the administrators agreed with the idea of incorporate community pharmacy in to the NHS, but the standard of practice and the quality of service had to fulfill with NHSs criteria first. It had to have a clear status and positioning of the community pharmacy in the system. Reimbursement of the service had to be specified. The administrators saw the value of bringing private pharmacy to join the services as it increased the accessibility of the patients. The accredited pharmacy may be an option to increase patients accessibility to health. To be success, the administrators said that every stakeholder had to take part in his own roles according to the context. However, every partner had to aim the benefit to a patient as patient centered. Key words: Network of accredited pharmacies, Pharmacy in the National Health Security Scheme, Accredited pharmacy (Published in Journal of Health Systems Research Vol.3 No.4 Oct.-Dec.2009)

Title: The outcomes of tuberculosis control in special-high-risk populations in northern Thailand: an observational study Researchers: Attapon Cheepsattayakorn*, Ruangrong Cheepsattayakorn** *10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, 10th Office of Disease Prevention and Control, Department of Disease Control, Ministry of Public Health, Thailand **Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Abstract: Objectives: To evaluate and review the tuberculosis situation in various tuberculosis-high-risk populations, various periods of time and general tuberculosis control outcomes in northern Thailand. Methods: Data of various tuberculosis-high risk populations were analyzed from the DOTS database and special project paper-based record systems for various tuberculosis-high risk populations in the areas of northern Thailand in various periods of time. Results: The 2003 and 2004 reports showed 30% and 60% of multidrug-resistant tuberculosis with cure of less than 60% of the registered cases. The 2004 report revealed that tuberculosis was the most common opportunistic infection (38.9%) among HIVseropositive/AIDS cases. Reports of isoniazid therapy for tuberculosis prevention among HIVseropositive/AIDS population showed that 78% of them had not developed tuberculosis at the end of the 24th month since starting therapy. The 2005 report demonstrated that only 3.2 and 37.1% of the suspected-childhood tuberculosis cases were diagnosed tuberculosis and latent infection, respectively. There was no statistically significant correlations between the types of the patient observers and the cure rates among the general tuberculosis population, analyzed from the 2003 report (Pearson correlation coefficients > 0.01, 2-tailed). There was also no statistically significant changes or improvement of the treatment outcomes(sputum conversion

rates, default rates, death rates, and treatment success rates), compared between 2003 and 2004(p > 0.01). Conclusions: This finding indicates that it still not be well-developed DOTS programme implementation for various tuberculosis-high- risk populations in these areas. Recording and reporting systems for childhood tuberculosis cases in this area still not well-developed contribute to underreporting of this high-risk population. Key words: Tuberculosis, outcomes, high-risk populations, northern Thailand (Published in Journal of Health Systems Research Vol.3 No.4 Oct.-Dec.2009)

Title: The Third Wave of Health Care Reforms in Thailand Researcher: Abstract Health care reform movements in Thailand occur during three main overlapping periods. The first wave of health care reform movements focused on increasing geographical coverage of health care infrastructure while the second wave focused mainly on reform of health care financing mechanisms. The third wave has shifted its focus to strengthening primary care. This paper is aimed to explore the third wave of health care reform movements in Thailand using literature and document review. It was found that among five areas of reform initiatives to strengthen primary care, there was an imbalance of investment in primary care infrastructure and capacity building of health staff. Insufficient number of health centre staff with their limited capacity is the major constraint affecting performance improvement of health centre. Development of referral system has been a neglected development area and could threaten confidence of people in primary care. Although financing reform improves financial status of health centre, it still needs continuous development to promote responsibility and productivity of health centre staff towards their registered population. Finally, there is a need to develop and adapt concept and practice of family medicine to fit with country specific context and to promote it to be well recognized by the general public as well as physicians. New challenges for the development of primary care in Thailand include its governance system under the context of health care devolution and health services provision for chronic patients and the elderly. Key words: health care reform, primary care (Published in Journal of Health Systems Research Vol.3 No.4 Oct.-Dec.2009) Pongpisut Jongudomsuk* *Health Systems Research Institute, Thailand