Qualification and needs for self-development of supporting staff in Medical Education Centers.

The Collaborative Project to Increase Rural Doctor Production (CPIRD) of Ministry of Public Health Thailand makes use of a number of supporting staff in facilitating medical teachers delivering clinical teaching at Medical Education Centers (MECs). This study aimed to explore the needs of selfdevelopment of supporting staffs in MECs by the postal questionnaire. The result found that the academic qualifications were diverse and their needs for self-development in medical education were high in all aspects. The survey could be useful for effective individual development plan.

Geographical variation of mortality in Thailand.

OBJECTIVE: To examine geographical variation of mortality in Thailand. MATERIAL AND METHOD: Descriptive ecological study using the national vital registration data in 2000, age-specific mortality rate and cause-specific standardized mortality ratio (SMR) were presented at district geographic level. RESULTS: Overall mortality was highly concentrated in the middle part of the upper north, as well as mortality of the working age. Clustering of cause-specific SMR in a single region was found for liver cancer (in the upper northeast region) and chronic obstructive pulmonary disease (in the upper north region). Clustering in multiple regions was found for renal failure (in the upper north and the upper northeast regions). Dispersed pattern of mortality with no regional clustering was found for leukemia. The geographical pattern of cause-specific mortality might be explained by distribution of incidence and related risk factors. CONCLUSION: Geographical variation of mortality exists and should be used as a target for reducing mortality gap across geographical areas.

Reliability and validity of the Thai version of the Health of the Nation Outcome Scales (hoNOS).

BACKGROUND: Measurement in psychiatric services is important for the development of a psychiatric tool for budget allocation. OBJECTIVE: To translate the Health of the Nation Outcome Scales (HoNOS) into Thai and to assess its psychometric properties. MATERIAL AND METHOD: The HoNOS was translated into Thai, by using the standard of "forward-backward" translation procedure. Two psychiatric nurses interviewed subjects together but independently rated their scores. The subjects were 23 acute inpatients and 23 sub-acute inpatients. The reliability and validity was assessed. RESULTS: The Cronbach's alpha coefficient of the Thai HoNOS was 0.68. It had a high correlation (r > 0.80) with the Brief Psychiatric Rating Scale (BPRS), the Global Assessment of Functioning (GAF) and the Clinical Global Impression (CGI). It suggested high concurrent validity. It had a satisfactory power (p < 0.05) in discriminating overall clinical outcomes between acute and sub-acute psychiatric inpatients. CONCLUSION: The Thai HoNOS fulfils the requirements of a psychiatric outcome scale for routine use in inpatient service.

Benchmarks of Fairness for health care reform in Thailand--combining evidence with opinion of the civic group.

The concept of the Benchmarks of Fairness was tried in Thailand before the big reform of universal coverage policy in 2001. The first phase of the Benchmarks in 1999 involved the analysis of the national health reform proposal as well as the analysis of ongoing field trials of health reforms in two provinces. Though the participants were predominately health personnel, the results suggested the power of combining qualitative viewpoints of participants with the quantitative indicators within the province to move health reforms to more equitable, more efficient and more democratic directions. The second phase of the Benchmarks of Fairness, therefore, tested the possibility of involving wider participation of the civic groups related, and not-related to health, in assessing their provincial health system. The health achievements of the provinces a measured by 81 indicators, in the 9 benchmarks, were provided to the civic groups before focus group discussions in 10 selected provinces to facilitate discussions based on evidence. More qualitative data were obtained from the discussions as well as their judgements on the fairness of their provincial health system. Having completed this second phase, it was recommended that the benchmarks tool could be further endorsed as the basis for monitoring the progress of health reform by province and the effect of health care decentralization. To accomplish this monitoring, the civic groups should have continuous access to evidence, in line with the benchmarks, and they should be provided with the opportunity to express their views, which is helpful in monitoring fairness in the long run.