ABSTRACT
Background and Objective: Srinagarind Hospital is a tertiary hospital with high potential for medical care of patients with cleft lip and cleft palate so we need to study about statistic and trend of the types of the patients who receive the medical care which depends on the age and illness in order to prepare to be a center of medical care, to have excellent researches in the Northeast and the nearest regions, to plan for giving the medical care and to have complete service which will benefit for patients with cleft lip and cleft palate. This study aim to determine statistics and trend of admitted patients with cleft lip and cleft palate in Srinagarind Hospital regarding types of the disease, distribution, frequency and age of the operated patients.Methods: A retrospective descriptive study was done. All admitted patients with cleft lip and cleft palate in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University during 1984-2007 were included. Results: The study result is found that the most patients is male patients with cleft lip and cleft palate were 56%. There were 32% cleft lip patients, 22% cleft palate patients and 46% cleft lip with cleft palate patients from 1,950 in patient cases that came 3,342 visits, the patient can came to received the treatment many time. The majority of the patients live in Khon kaen, Mahasarakham, and Kalasin were 55%, 25% and 17% respectively. During 1984-1992, the patients to received cheiloplasty treatment age 3-4 months were 14%, to received palatoplasty treatment age 9-12 months were 29%, and during 1993-2001, the patients to received cheiloplasty treatment age 3-4 months were 32%, to received palatoplasty treatment age 9-12 months were 52% and the patients received correction of cleft lip and cleft palate age 4-5 years were 15%. The trend of patients has been increasing by patient’s age; because of the mutidisciplinary team has developed a medical care tendency and work together to the concrete. In 2002, the referral system was developed and the treatment by multidisciplinary team and treatment protocol has absolutely and efficiency. Therefore, a patient to received cheiloplasty treatment aged 3-4 months were increasing 57%, to received palatoplasty treatment aged 9-12 months were 63%, and the patients received correction of cleft lip and cleft palate aged 4-5 year were 11%. Conclusion: The study result is found that cleft lip with cleft palate patients has come to received medical treatment by patient’s age increasing as follows Nation Health Security system plan. However, some patients received medical treatment late, such as to send a patient late, an intervening disease, to be in need a knowledge for the authorities, and the many patients to wait for treatment. This reason might be effect to patients who received the treatment late.Keywords: Cleft lip and cleft palate
ABSTRACT
Rationale: Stroke or the disease of cerebral blood vessel, or paralysis is a prevalent disease and a major public health problem of Thailand. Stroke is a chronic disease with prolonged development at all stages that leads to the paralytic state, the state that prevents the patient from doing their daily routine and thus have to rely on the others. This means an additional expense both from treatment at hospital and home care. The study of Neurological Institute in 1995 reported that the average expense of outpatients which involved transportation cost to receive their treatment at the hospital was 1,400 baht per person per day. Such expense has not been studied at Srinagarind Hospital before.Objective: To study the average direct and indirect expenses of the stroke outpatients at Srinagarind Hospital during the first trimester of 2008. Study design: Descriptive researchSetting: The Outpatient Department, Srinagarind Hospital, Faculty of Medicine, Khon Kaen UniversityMethods: 237 new and former stroke outpatients aged over 20 years old who received treatment from January 1 to March 31, 2008. The research tool was questionnaire.Results: The stroke outpatients in the sample group are from 20 to 91 years old, or an average age of 64+12.8 years. The most diagnosis result reveals cerebral infarction (31.6 percent), with a Modified Rankin Score of 1. Concurrent diseases diagnosed include hypertension, Dyslipidemia, and diabetes, respectively. The result shows the direct and indirect expenses of the outpatients’ final visit to the hospital. For the direct expense, the average cost of food is 172.89 baht, the average two-way transportation cost is 517.68 baht, and the average accommodation cost is 625.50 baht. As for the indirect expense, it was found that the outpatients take a two-day leave from work at a maximum, with a loss of an average of 500 baht of income per day. When the outpatients come to the hospital, they are accompanied by 1-3 relatives or an average of 1.16 persons, causing an average reduction of income of 489.15 baht per day. The average total direct and indirect expense becomes 1,959.85 baht per day per one outpatient.Conclusion: The expense of each stroke outpatient at Srinagarind Hospital is as high as 1,959.85 baht per day. Most of these expenses are accommodation, transportation, and a loss of income from work. It is recommended that community servicing be established in order to lessen the expense of stroke outpatients by not having to travel to the hospital.Keywords: expense of stroke and outpatient