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Purpose@#Minimally invasive surgery (MIS) offers patients several benefits, such as smaller incisions, and fast recovery times. General surgery residents should be trained in both open and MIS. We aimed to examine the trends of minimally invasive and open procedures performed by general surgery residents in Thailand. @*Methods@#A retrospective review of the Royal College of Surgeons of Thailand and Accreditation Council for Graduate Medical Education general surgery case logs from 2007 to 2018 was performed for common open and laparoscopic general surgery operations. The data were grouped by three time periods, which were 2007–2010, 2011–2014, and 2015–2018, and analyzed to explore changes in the operative trends. @*Results@#For Thai residents, the mean number of laparoscopic operations per person per year increased from 5.97 to 9.36 (56.78% increase) and open increased from 20.02 to 27.16 (35.67% increase). There was a significant increase in the average number of minimally invasive procedures performed among cholecystectomy (5.83, 6.57, 8.10; p < 0.001) and inguinal hernia repair (0.33, 0.35, 0.66; p < 0.001). Compared to general surgery residents in the United States, Thai residents had more experience with open appendectomy, but significantly less experience with all other operations/procedures. @*Conclusion@#The number of open and minimally invasive procedures performed or assisted by Thai general surgery residents has slowly increased, but generally lags behind residents inthe United States. The Thai education program must be updated to improve residents’technical skills in open and laparoscopic surgery to remain competitive with their global partners.
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Background: Purchasing price will be changed soon, from hospital charge to price calculated by Drug Related Group (DRG).Objective: To compare DRG adjusted price and hospital chargeMethods: Based on raw data of the previous study “Comparison of unit cost and charge of medical care for common diseases in Srinagarind Hospital during year 2003” price of medical care was calculated from DRG. Each Relative Weight (RW) was multiplied by 10,300 baht. Finally, the price was compared with the hospital charge.Design: Retrospective descriptive study.Setting: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.Samples: In-patients who were admitted with the ten most common diseases in each of 8 clinical departments.Measurement: Value and percentage.Results: Price of each disease may lower or higher than the hospital charge, but the average DRG adjusted price of each department is lower. Department of Medicine has the lowest ratio (59.42%), while Department of Ophthalmology has the highest ratio (96.55%).Conclusion: The DRG adjusted price is around 74% of the hospital charge for the common diseases in Srinagarind Hospital.Keywords: DRG, hospital charge
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Background: Each year, the budget committee is difficult to choose which of the high-cost machine should be bought. There are very few data about installed high-cost machine, especially cost-effectiveness.Objective: To study the cost-effectiveness in usage of high-cost machine.Methods: Data of 223 high-cost machines (more than 500,000 Baht), which were bought between 2001 and 2005, was collected. Data included buying price, using time, charge, cost and maintenance. Cost-effectiveness of all machines was analyzed.Design: Retrospective descriptive study.Setting: Faculty of Medicine, Khon Kaen University.Samples: Machines which were bought between 2001 and 2005 with buying price of more than 500,000 Baht.Measurement: Value and percentage.Results: Excluded depreciation, cost of the machine included installed area (44.57%), material (35.59%), public utilities (16.58%) and maintenance (3.16%). Most of the medical machines (65.05%) were used more than 50% of standard using time, however more than one-fourth of them were used less than 20% of standard using time. On contrary, most of the studying machines (58.63%) were used less than 20% of standard using time.Conclusion: Most of the high-cost machines were used more than 50% of standard using time. If depreciation was included, cost of all medical machines was more than charge.Keywords: cost-effectiveness, high-cost machine
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Eighty-six rats were divided at random into 3 groups of 40,40 and 6. Intrahepatic injection were performed with 0.5 cc. of ethyl alcohol in group I, saline in group II, and no injection in group III. On the post injection day 3:10 rats each of group I and II and all of group III were sacrificed. The gross and microscopic pathology of livers were recorded. Five cc. of whole blood were sent for biochemical study. The same procedures were then repeated on post injection day 7, 14 and 21 on the first two groups. The results were found on gross pathology were areas of whitish plaque representing parenchymal necrosis on histological examination at the injected site, followed by inflammatory reaction, fibrosis and eventually regeneration. No changes were detected on the last two groups. Significant biochemical changes were noted:SGOT and ALP in saline group (p
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Objective: 1. To audit the management of surgical patients by computer system. 2. To collect the problems of data analysis for auditing the management of surgical patientsDesign: Retrospective, descriptive study.Setting: Department of surgical, Faculty of Medicine, Khon Kaen UniversitySubject: All in-patients of Department of Surgical within 1998.Data collection: Review from computer database.Measurement: Descriptive statistics.Result: Important factor, which can be retrieved from computer database, include age, sex, diagnosis, operation, result, hospital stay, and mortality rate. A total of 6,821 patients was admitted in Department of Surgery during January and December 1998. The male: female ratio was 0.98:1 (3,375:3,446). The mean age of male and female patients was 43.17 and 43.76 years, respectively. The average hospital stay was 9.53 days. There were 1,224 patients (17.94%) who had complications and 6,048 patients (88.67%) had good discharge status. The average hospital mortality was 1.92%Conclusions: Computerized audit of surgical patients can be done much faster than manual audit. The result is highly accurate but may have some mistakes. Misunderstanding, inappropriate coding, unclear wording and input error cause mistakes in the computerized patient records. Some important factors for auditing are not collected in the computer system.Keyword: (1) Computer (2) Audit (3)Surgical patients