Supaporn Trongsakul, Thapakorn Ruanjai, Wilawan Chaiut, Ratipark Tamornpark and Tawatchai Apidechkul
The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand.
Abstract
Purpose
The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand.
Design/methodology/approach
A cross-sectional study was carried out amongst 459 hill-tribe older people aged 60 years and above. A Mini Mental State Examination (MMSE) Thai 2002 version was used for cognitive screening. A questionnaire and medical records were used for demographic and clinical data collection while descriptive statistics were used to analyze characteristic data. Potential factors related to cognitive impairment were analyzed by using univariate logistic regression analysis.
Findings
The prevalence of cognitive impairment amongst the participants was 49.89 percent (95% CI 45.32%, 53.47 percent). Factors related to cognitive decline included no occupation (OR=1.49, 95% CI 1.10–2.03, p<0.04) and a history of amphetamine use (OR=1.57, 95% CI 1.09–2.33, p<0.04).
Originality/value
Cognitive decline should be a cause for concern amongst Thai hill-tribe older people, especially amongst those in the group with a history of amphetamine use. However, Thai health care professionals need to be aware of the potential cultural bias in the MMSE Thai 2002 version as a cognition test targeted at the hill-tribe population as the questionnaire may not provide a true reflection of their cultural experience and background.
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Keywords
Onn Laingoen, Tawatchai Apidechkul, Panupong Upala, Ratipark Tamornpark, Chaleerat Foungnual and Rattakarn Paramee
The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos.
Abstract
Purpose
The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos.
Design/methodology/approach
A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes.
Findings
In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB.
Originality/value
To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.
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Keywords
Theint Theint Lwin, Tawatchai Apidechkul, Jongkon Saising, Panupong Upala and Ratipark Tamornpark
This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on…
Abstract
Purpose
This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.
Design/methodology/approach
Twenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.
Findings
TB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.
Originality/value
Thailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.