Health situation analysis of Thai population 2010: implications for health education and health service reform.

BACKGROUND: Between 1990 and 2010, many national and international factors converged to both beneficially and antagonistically affect people's health and the Thai healthcare system. Moreover Thailand is moving to aged society and a low birth rates. OBJECTIVE: To analyze Thailand's health issues for baseline information for changing medical education, services and researches. MATERIAL AND METHOD: Information on illness of in-patients, out-patients and casualties came from hospitals nationwide and from hospitals withdrawals from the three health insurance schemes in fiscal 2010. The data included 96% of the population. Research literature was also extensively reviewed. The data were analyzed by age groups and burdensome diseases. RESULTS: Out-patients were treated 326,230,155 times and in-patients 6,880,815 times at Community Hospitals (44%), Provincial Hospitals (22%), Central or University Hospitals (26%) and Private Hospitals (8%). Infants and elderly were the patients most commonly treated in hospital. Among pediatric patients, perinatal disease, intestinal infection, respiratory tract infection, injury and poisoning and teenage pregnancy predominated; while among adults, it was accident, non-communicable and chronic disease. CONCLUSION: Thailand is faced with the dual burden of infection and non-communicable diseases. Risky behavior and changing social structure are underlined this epidemiological transition. Medical schools and health service systems need to be recalibrated to response proactively to these challenges.

Geriatric hospitalizations due to fall-related injuries.

BACKGROUND: Fall is a preventable condition associated with disability and mortality in elders. The overall data regarding admission rates and its impact in Thai elderly are lacking. OBJECTIVE: To identify admission, mortality rates of older persons with fall, its causes and consequences. MATERIAL AND METHOD: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data included 96% of the population. The data were analyzed by age groups in older patients with fall. RESULTS: There were 311,132 falls of all admissions; accounting for admission and mortality rates of 423.4 and 11.1/100,000 older persons. The number rose with age. Slipping, tripping were the major causes. The average length of stay (LOS) of fallers with and without fractures was 8.1 and 6.4 days. The average hospital costs in these same groups were 25,728 and 19,419.3 Baht. CONCLUSION: The increasing age is related to an increased admission and mortality rates of fall. Slipping, tripping was the frequent causes. Greater LOS and hospital charges were found in fallers with fractures. Allied-healthcare workers should routinely implement a fall assessment and educate modifiable factors to elders to prevent future fall.