4 research outputs found
āļāļēāļĢāļāļāļą āļāļēāđāļāļĢāļ·āļāļāđāļēāļĒāļāļĢāļīāļāļēāļĢāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļāļŠāļģāļŦāļĢāļāļą āļāļđāđāļāđ āļ§āļĒāđāļāļēāļŦāļ§āļēāļāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨāđāļāļāļēāļĢāļēāļĄ
AbstractObjectives: This quasi-experimental study aimed to develop the primarycare network model of Photharam hospital. Method: The patients weredivided into control group (n = 48) receiving regular service at the hospitaland treatment group (n = 50) receiving services at the Primary Care Unit(PCU). Clinical outcome of stable patients at baseline and after 6 monthswere compared and healthcare providersâ and patientsâ satisfaction wereobtained during the period from November 4, 2009 to August 15, 2010.Data collection was performed using clinical data and questionnaire. Thepercentage and mean were calculated and independent t-test wasperformed.Results: The differences in fasting blood sugar, hemoglobinA1c, systolic blood pressure and diastolic blood pressure, cholesterol,triglyceride, low density lipid and high density lipid level between the twogroups were not statistically significant at P = 0.05. Most patients (95.5%)were very satisfied with overall services. They reasoned that PCU serviceswere faster and more convenient than those at the hospital whilemaintaining similar level of disease control. Acceptability among PCUpatients was high and most patients (95.5%) agreed to continue to receivecare at the PCU. Healthcare providers were also satisfied with providingcare at PCU since this would be a direct benefit for the patients.Conclusion: Healthcare services for diabetic patients at the PCU were aseffective as those at the hospital. A primary care network service was oneof the models for developing quality services for diabetic patients.Keywords: primary care network, diabetes mellitus, effectiveness,satisfactionāļāļāļāļąāļāļĒāđāļāļ§āļąāļāļāļļāļāļĢāļ°āļŠāļāļāđ: āļāļēāļĢāļĻāļķāļāļĐāļēāļāļķāđāļāļāļāļĨāļāļāđāļāļ·āđāļāļāļąāļāļāļēāđāļāļĢāļ·āļāļāđāļēāļĒāļāļĢāļīāļāļēāļĢāļŠāļģāļŦāļĢāļąāļāļāļđāđāļāđāļ§āļĒāđāļāļēāļŦāļ§āļēāļāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨāđāļāļāļēāļĢāļēāļĄ āļāļĩāđāļĒāļąāļāļāļāđāļ§āđāļāļķāđāļāļāļļāļāļ āļēāļāđāļāļāļēāļĢāļĢāļąāļāļĐāļēāđāļĨāļ°āļāļ§āļēāļĄāļāļķāļāļāļāđāļāļāļāļāļāļđāđāđāļŦāđāđāļĨāļ°āļāļđāđāļĢāļąāļāļāļĢāļīāļāļēāļĢ āļ§āļīāļāļĩāļāļēāļĢāļĻāļķāļāļĐāļē: āđāļāļĒāđāļāļĢāļĩāļĒāļāđāļāļĩāļĒāļāļāļĨāļāļēāļāļāļĨāļīāļāļīāļāļāļāļāļāļđāđāļāđāļ§āļĒāļāļĩāđāļĄāļĩāļŠāļ āļēāļ§āļ°āļāļāļāļĩāđāļāđāļāļāđāļĨāļ°āļ āļēāļĒāļŦāļĨāļąāļ 6 āđāļāļ·āļāļ āļĻāļķāļāļĐāļēāļāļ§āļēāļĄāļāļķāļāļāļāđāļāļāļāļāļāļđāđāđāļŦāđāļāļĢāļīāļāļēāļĢāđāļĨāļ°āļāļđāđāļāđāļ§āļĒ āļĢāļ°āļŦāļ§āđāļēāļāļ§āļąāļāļāļĩāđ 4 āļāļĪāļĻāļāļīāļāļēāļĒāļ 2552 āļāļķāļ 28 āļāļĢāļāļāļēāļāļĄ 2553 āđāļāđāļāļĢāļ§āļāļĢāļ§āļĄāļāđāļāļĄāļđāļĨāļāđāļ§āļĒāđāļāļāļāļąāļāļāļķāļ āđāļāļāļŠāļąāļĄāļ āļēāļĐāļāđāđāļĨāļ°āđāļāļāļŠāļāļāļāļēāļĄ āđāļāđāļāļāļđāđāļāđāļ§āļĒāđāļāđāļāļāļĨāļļāđāļĄāļāļ§āļāļāļļāļĄāļāļģāļāļ§āļ 50 āļāļ āļāļķāđāļāļĢāļąāļāļāļĢāļīāļāļēāļĢāļāļĩāđāļāļĨāļīāļāļīāļāđāļāļēāļŦāļ§āļēāļ āđāļĢāļāļāļĒāļēāļāļēāļĨāđāļāļāļēāļĢāļēāļĄ āđāļĨāļ°āļāļĨāļļāđāļĄāļāļāļĨāļāļāļāļģāļāļ§āļ 48 āļāļ āļāļķāđāļāļĢāļąāļāļāļĢāļīāļāļēāļĢāļāļĩāđāļĻāļđāļāļĒāđāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļ āļ§āļīāđāļāļĢāļēāļ°āļŦāđāļāđāļāļĄāļđāļĨāļāļēāļāļŠāļāļīāļāļīāđāļāļĒāđāļāđāļāđāļēāļĢāđāļāļĒāļĨāļ° āļāđāļēāđāļāļĨāļĩāđāļĒ āđāļĨāļ° t-test āļāļĨāļāļēāļĢāļĻāļķāļāļĐāļē: āļāļāļ§āđāļēāļĢāļ°āļāļąāļāļāđāļģāļāļēāļĨāļāļāļāļāļđāđāļāđāļ§āļĒāļāļāļ°āļāļāļāļēāļŦāļēāļĢ āļŪāļĩāđāļĄāđāļāļĨāļāļīāļāđāļāļ§āļąāļāļāļĩ āļāļ§āļēāļĄāļāļąāļāđāļĨāļŦāļīāļāļāļąāļ§āļāļāđāļĨāļ°āļāļąāļ§āļĨāđāļēāļ āļāļĨāļāđāļĢāļŠāđāļāļāļĢāļāļĨ āđāļāļĢāļāļĨāļĩāđāļāļāđāļĢāļāđ āđāļāļāļāļĩāđāļāļĨ āđāļĨāļ°āđāļāļĨāļāļĩāđāļāļĨ āļāļāļāļāļđāđāļāđāļ§āļĒāļāļąāđāļ 2 āļāļĨāļļāđāļĄāđāļĄāđāđāļāļāļāđāļēāļāļāļąāļāļāļĩāđāļĢāļ°āļāļąāļāļāļąāļĒāļŠāļģāļāļąāļ 0.05 āļāļđāđāļāđāļ§āļĒāđāļāļ·āļāļāļāļąāļāđ āļŦāļĄāļ (91.3%) āļāļķāļāļāļāđāļāļāđāļāļāļĢāļīāļāļēāļĢāđāļāļĒāļĢāļ§āļĄāđāļĨāļ°āđāļŦāđāļāļ§āđāļēāļāļĢāļīāļāļēāļĢāļāļĩāđāļĻāļđāļāļĒāđāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļāļŠāļ°āļāļ§āļāđāļĨāļ°āļĢāļ§āļāđāļĢāđāļ§āļāļ§āđāļēāļāļĩāđāđāļĢāļāļāļĒāļēāļāļēāļĨ āļāļāļ°āļāļĩāđāļāļēāļĢāļāļ§āļāļāļļāļĄāļŠāļ āļēāļ§āļ°āđāļĢāļāļāļāļāļāļđāđāļāđāļ§āļĒāđāļĄāđāđāļāļāļāđāļēāļāļāļąāļ āđāļĨāļ°āļāļđāđāļāđāļ§āļĒāđāļāļ·āļāļāļāļąāđāļāļŦāļĄāļ (95.5%) āļāļĒāļēāļāđāļāđāļēāļĢāđāļ§āļĄāđāļāļĢāļāļāļēāļĢāļāđāļāđāļ āļŠāđāļ§āļāļāļđāđāđāļŦāđāļāļĢāļīāļāļēāļĢāļāļķāļāļāļāđāļāļāđāļāđāļāļĢāļāļāļēāļĢāđāļāđāļāļāļąāļāđāļĨāļ°āđāļŦāđāļāļ§āđāļēāđāļāđāļāļāļĢāļ°āđāļĒāļāļāđāđāļāļĒāļāļĢāļāļāđāļāļāļđāđāļāđāļ§āļĒ āļŠāļĢāļļāļ: āļāļēāļĢāļĻāļķāļāļĐāļēāļāļĩāđāđāļŠāļāļāđāļŦāđāđāļŦāđāļāļ§āđāļēāđāļĄāđāļĄāļĩāļāļ§āļēāļĄāđāļāļāļāđāļēāļāļāļĒāđāļēāļāļĄāļĩāļāļąāļĒāļŠāļāļīāļāļīāļāļāļāļāļĢāļ°āļŠāļīāļāļāļīāļāļĨāđāļāļāļēāļĢāļāļđāđāļĨāļāļđāđāļāđāļ§āļĒāđāļāļēāļŦāļ§āļēāļāļĢāļ°āļŦāļ§āđāļēāļāļĻāļđāļāļĒāđāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļāļāļąāļāļāļĨāļīāļāļīāļāđāļāļēāļŦāļ§āļēāļāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨāļāļđāđāļĢāļąāļāļāļĢāļīāļāļēāļĢāđāļĨāļ°āļāļđāđāđāļŦāđāļāļĢāļīāļāļēāļĢāļĄāļĩāļāļ§āļēāļĄāļāļķāļāļāļāđāļāđāļāļĢāļđāļāđāļāļāļāļĢāļīāļāļēāļĢāļāļĩāđāļāļąāļāļāļēāļāļķāđāļ āļāļąāļāļāļąāđāļāđāļāļĢāļ·āļāļāđāļēāļĒāļāļĢāļīāļāļēāļĢāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļāđāļāđāļāļĢāļđāļāđāļāļāļŦāļāļķāđāļāļāļāļāļāļēāļĢāļāļąāļāļāļēāļāļļāļāļ āļēāļāļāļĢāļīāļāļēāļĢāđāļāļāļēāļĢāļāļđāđāļĨāļāļđāđāļāđāļ§āļĒāđāļāļēāļŦāļ§āļēāļāļāļāļāđāļĢāļāļāļĒāļēāļāļēāļĨāļāļģāļŠāļģāļāļąāļ: āđāļāļĢāļ·āļāļāđāļēāļĒāļāļĢāļīāļāļēāļĢāļŠāļļāļāļ āļēāļāļāļļāļĄāļāļ, āđāļāļēāļŦāļ§āļēāļ, āļāļĢāļ°āļŠāļīāļāļāļīāļāļĨ, āļāļ§āļēāļĄāļāļķāļāļāļāđ
Can knowledgeable experts assess costs and outcomes as if they were ignorant? : An experiment within precision medicine evaluation
Objectives The purpose of this study is to evaluate the validity of the standard approach in expert judgment for evaluating precision medicines, in which experts are required to estimate outcomes as if they did not have access to diagnostic information, whereas in fact, they do. Methods Fourteen clinicians participated in an expert judgment task to estimate the cost and medical outcomes of the use of exome sequencing in pediatric patients with intractable epilepsy in Thailand. Experts were randomly assigned to either an âunblindâ or âblindâ group; the former was provided with the exome sequencing results for each patient case prior to the judgment task, whereas the latter was not provided with the exome sequencing results. Both groups were asked to estimate the outcomes for the counterfactual scenario, in which patients had not been tested by exome sequencing. Results Our study did not show significant results, possibly due to the small sample size of both participants and case studies. Conclusions A comparison of the unblind and blind approach did not show conclusive evidence that there is a difference in outcomes. However, until further evidence suggests otherwise, we recommend the blind approach as preferable when using expert judgment to evaluate precision medicines because this approach is more representative of the counterfactual scenario than the unblind approach
The health utility of Graves' disease treatments at Damnoensaduak hospital
The objectives of this cross-sectional study were to compare the utility of anti-thyroid drug and radioactive iodine in patients with Graves' disease (GD) at Damnoensaduak hospital, Ratchaburi, Thailand. This study included all patients who were diagnosed with Graves' disease during September 1, 2011 to January 31, 2012. There were 114 patients with Graves' disease in whom 80 patients were treated with anti-thyroid drug and 34 patients were treated with radioactive iodine. The utility was measured by using the EuroQol (EQ-5D) in Thai version. The health utility of patients treated with anti-thyroid drug or radioactive iodine were compared by using t-test independent. The results showed that the utility of GD was 0.698 ¹ 0.22. The utility of anti-thyroid drug and radioactive iodine patient were 0.675 ¹ 0.23 and 0.754 ¹ 0.18 respectively. The utility of anti-thyroid drug was not significant different from the utility of radioactive iodine (p-value=0.07)