8 research outputs found
āļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļēāļāļ§āļēāļĄāļĢāļļāļāđāļĢāļāđāļāļāļĢāļāļāļāļĢāļąāļ§ āđāļāļĒāļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļēāļĢāļĄāļĩāļŠāđāļ§āļāļĢāđāļ§āļĄ
This research aims to study domestic violence provisions in community, to develop prevention model, and to investigate effect of prevention model of domestic violence in community by participation process. Setting is a community in Pathumthani province. Research procedures by Participatory Action Research with ten community leaders participation. Research results are: 1) Verbal violence is the highest frequency, followed by physical, mental, and sexual respectively. Family risk violence level is the highest, and the communities with limited area, slum, and low income reveal all kinds of domestic violence. Its causes come from personal and socioeconomic conditions. 2) The prevention method is developed by two cycles. Firstly, community leaders and family mainstays are developed. The results have shown that there is cooperation among many parts of community which makes community leaders gain more knowledge, understanding, and problem analysis thinking skill, and family mainstays change behaviors into positive way. Secondly, at risk families are developed and communication to community. The results have shown that community cooperation is created which makes perception and alerting in community. Moreover, some at risk families understand problem and tend to modify their behavior to prevention. 3) Effects of prevention model are behavior changing in community leaders, family mainstays, at risk families, and also some people. And getting cooperation networking model, and violence prevention model for audiences in each level of community from community-based research method. Keywords : domestic violence, prevention model, participation processāļāļāļāļąāļāļĒāđāļ          āļāļēāļĢāļ§āļīāļāļąāļĒāļāļĢāļąāđāļāļāļĩāđ āļĄāļĩāļ§āļąāļāļāļļāļāļĢāļ°āļŠāļāļāđāđāļāļ·āđāļāļĻāļķāļāļĐāļēāļŠāļ āļēāļāļāļąāļāļŦāļēāļāļ§āļēāļĄāļĢāļļāļāđāļĢāļāđāļāļāļĢāļāļāļāļĢāļąāļ§āļāļāļāļāļļāļĄāļāļ  āđāļĨāļ°āļāļąāļāļāļēāļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļēāļāđāļ§āļĒāļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļēāļĢāļĄāļĩāļŠāđāļ§āļāļĢāđāļ§āļĄ āļĢāļ§āļĄāļāļąāđāļāļĻāļķāļāļĐāļēāļāļĨāļāļēāļĢāđāļāđāļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļēāļāļĩāđāđāļāđāļāļąāļāļāļēāļāļķāđāļ āđāļāļĒāļĄāļĩāļāļļāļĄāļāļāđāļŦāđāļāļŦāļāļķāđāļāļāļāļāļāļąāļāļŦāļ§āļąāļāļāļāļļāļĄāļāļēāļāļĩāđāļāđāļāļāļ·āđāļāļāļĩāđāļĻāļķāļāļĐāļē  āļŠāļģāļŦāļĢāļąāļāļ§āļīāļāļĩāļāļēāļĢāļ§āļīāļāļąāļĒ āđāļāđāļāļāļēāļāļ§āļīāļāļąāļĒāļāļĩāđāđāļāđāļāļļāļĄāļāļāđāļāđāļāļāļēāļāđāļāļāļēāļĢāļāļąāļāļāļē āļāđāļ§āļĒāļĢāļđāļāđāļāļāļāļēāļĢāļ§āļīāļāļąāļĒāđāļāļīāļāļāļāļīāļāļąāļāļīāļāļēāļĢāđāļāļāļĄāļĩāļŠāđāļ§āļāļĢāđāļ§āļĄ āđāļāļĒāļāļ§āļēāļĄāļĢāđāļ§āļĄāļĄāļ·āļāļāļāļāļāļđāđāļāļģāļāļļāļĄāļāļ āļāļģāļāļ§āļ 10 āļāļ  āļāļĨāļ§āļīāļāļąāļĒ āļāļāļ§āđāļē 1) āļāļļāļĄāļāļāļāļĩāđāļĻāļķāļāļĐāļēāļĄāļĩāļŠāļ āļēāļāļāļ§āļēāļĄāļĢāļļāļāđāļĢāļāđāļāļāļĢāļāļāļāļĢāļąāļ§āļāļēāļāļ§āļēāļāļēāļĄāļēāļāļāļĩāđāļŠāļļāļ āļĢāļāļāļĨāļāļĄāļēāļāļ·āļāļāļēāļāļĢāđāļēāļāļāļēāļĒ āļāļēāļāļāļīāļāđāļ āđāļĨāļ°āļāļēāļāđāļāļĻ āļāļēāļĄāļĨāļģāļāļąāļ āđāļāļĒāļāļģāļāļ§āļāļāļĢāļāļāļāļĢāļąāļ§āļāļĩāđāļĄāļĩāļŠāļ āļēāļāđāļŠāļĩāđāļĒāļāļāđāļāļāļēāļĢāđāļāļīāļāļāļąāļāļŦāļēāļĄāļĩāļĄāļēāļāļāļĩāđāļŠāļļāļ āđāļĨāļ°āļāļāļ§āđāļēāļāļļāļĄāļāļāļĒāđāļāļĒāļāļĩāđāļĄāļĩāļāļ·āđāļāļāļĩāđāļāļģāļāļąāļ āđāļāļāļąāļ āđāļĨāļ°āļĄāļĩāļŠāļ āļēāļāļāļēāļāđāļĻāļĢāļĐāļāļāļīāļāđāļĄāđāļāļĩ āļāļ°āļĄāļĩāļāļąāļāļŦāļēāđāļāļāļļāļāļĢāļđāļāđāļāļ āđāļāļĒāļŠāļēāđāļŦāļāļļāļĄāļēāļāļēāļāļŠāļ āļēāļāļ āļēāļĒāđāļāļāļąāļ§āļāļļāļāļāļĨāđāļĨāļ°āļŠāļ āļēāļāđāļ§āļāļĨāđāļāļĄāļāļēāļāđāļĻāļĢāļĐāļāļāļīāļāļŠāļąāļāļāļĄ 2) āļāļēāļĢāļāļąāļāļāļēāļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļē āļāļģāđāļāļīāļāļāļēāļĢāđāļ 2 āļ§āļāļĢāļāļ āđāļāļ§āļāļĢāļāļāđāļĢāļāđāļāđāļāļąāļāļāļēāļāļđāđāļāļģāļāļļāļĄāļāļāđāļĨāļ°āļāļĢāļāļāļāļĢāļąāļ§āđāļāļāļāļģ āļāļēāļĢāļŠāļąāļāđāļāļāđāļĨāļ°āļŠāļ°āļāđāļāļāļāļĨ āļāļāļ§āđāļē āļāļđāđāļāļģāļāļļāļĄāļāļāļĄāļĩāļāļ§āļēāļĄāļĢāļđāđ āđāļāđāļēāđāļ āđāļĨāļ°āļĄāļĩāļāļąāļāļĐāļ°āđāļāļāļēāļĢāļāļīāļāļ§āļīāđāļāļĢāļēāļ°āļŦāđāļāļąāļāļŦāļē āđāļĨāļ°āļāļĢāļāļāļāļĢāļąāļ§āđāļāļāļāļģāļĄāļĩāļāļēāļĢāđāļāļĨāļĩāđāļĒāļāđāļāļĨāļāļāļĪāļāļīāļāļĢāļĢāļĄāđāļāđāļāļāļēāļāļāļ§āļ āļŠāļģāļŦāļĢāļąāļāđāļāļ§āļāļĢāļāļāļāļĩāđ 2 āđāļāđāļāļąāļāļāļēāļāļĢāļāļāļāļĢāļąāļ§āđāļŠāļĩāđāļĒāļāđāļĨāļ°āļĢāļāļĢāļāļāđāđāļāļāļļāļĄāļāļ āļāļēāļĢāļŠāļąāļāđāļāļāđāļĨāļ°āļŠāļ°āļāđāļāļāļāļĨāļāļāļ§āđāļē āļāļāđāļāļāļļāļĄāļāļāļĢāļąāļāļĢāļđāđāđāļĨāļ°āļāļ·āđāļāļāļąāļ§āđāļāļāļąāļāļŦāļē āđāļĨāļ°āļāļĢāļāļāļāļĢāļąāļ§āđāļŠāļĩāđāļĒāļāļāļēāļāļŠāđāļ§āļāđāļāđāļēāđāļāļāļąāļāļŦāļēāđāļĨāļ°āļĄāļĩāđāļāļ§āđāļāđāļĄāļāļĢāļąāļāđāļāļĨāļĩāđāļĒāļāļāļĪāļāļīāļāļĢāļĢāļĄāđāļāđāļāļāļēāļāļāđāļāļāļāļąāļāļāļąāļāļŦāļē āđāļĨāļ°Â 3) āļāļĨāļāļēāļĢāļāļąāļāļāļēāļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļē āđāļāļīāļāļāļēāļĢāđāļāļĨāļĩāđāļĒāļāđāļāļĨāļāļāļĪāļāļīāļāļĢāļĢāļĄāđāļāļāļąāļ§āļāļđāđāļāļģāļāļļāļĄāļāļ āļāļĢāļāļāļāļĢāļąāļ§āđāļāļāļāļģ āļāļĢāļāļāļāļĢāļąāļ§āđāļŠāļĩāđāļĒāļ āđāļĨāļ°āļāļĢāļ°āļāļēāļāļāđāļāļāļļāļĄāļāļāļāļēāļāļŠāđāļ§āļ āđāļĨāļ°āđāļāđāļĢāļđāļāđāļāļāđāļāļĢāļ·āļāļāđāļēāļĒāļāļ§āļēāļĄāļĢāđāļ§āļĄāļĄāļ·āļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļē āđāļĨāļ°āļĢāļđāļāđāļāļāļāļēāļĢāđāļāđāļāļļāļĄāļāļāđāļāđāļāļāļēāļāđāļāļāļēāļĢāļāļąāļāļāļēāđāļāļ·āđāļāļāđāļāļāļāļąāļāļāļąāļāļŦāļēāļāļ§āļēāļĄāļĢāļļāļāđāļĢāļāđāļāļāļĢāļāļāļāļĢāļąāļ§     āļāļģāļŠāļģāļāļąāļ: āļāļ§āļēāļĄāļĢāļļāļāđāļĢāļāđāļāļāļĢāļāļāļāļĢāļąāļ§Â āļĢāļđāļāđāļāļāļāļēāļĢāļāđāļāļāļāļąāļāļāļąāļāļŦāļē āļāļĢāļ°āļāļ§āļāļāļēāļĢāļāļēāļĢāļĄāļĩāļŠāđāļ§āļāļĢāđāļ§
Cost-effectiveness and budget impact analysis of smoking cessation interventions in chronic obstructive pulmonary disease patients in Thailand
Background
To determine the cost-effectiveness of different smoking
cessation interventions in Thailand compared with unassisted cessation in
chronic obstructive pulmonary disease (COPD) patients.
Methods
A cost-effectiveness study was undertaken using a
societal perspective. Cohorts of smokers with COPD: male and female aged 35
years who regularly smoke at least 10 cigarettes per day were simulated in a
markov model. Interventions were counseling with nortriptyline or bupropion or
varenicline. All were compared to counselling in hospital. Incremental cost per
quality-adjusted life years (QALYs) gained was calculated. One-way and
probabilistic sensitivity analyses were also performed. Annually budget
impact analyses were also estimated for five years.
Results
Based on Thai willingness-to-pay threshold (USD 4848), nortriptyline
was the most cost-saving (USD 100) with QALY gained (0.07 QALY). Varenicline is
cost-effective (USD 2181 per QALY) while bupropion was not cost-effectiveness (USD
4917 per QALY) when compared to counselling in hospital alone. Probabilistic
sensitivity analysis revealed that nortriptyline has very high probabilities (96%)
of being cost-saving while varenicline and bupropion are 98% and 90%. The most
influential parameter is efficacy of counseling alone. Average annual budget
for varenicline, bupropion and nortriptyline are 23 MB, 25 MB and 3 MB,
respectively.
Conclusions
Adding pharmacology treatment to conventional
counselling for smoking cessation resulted in cost-saving. The use of
nortriptyline appeared to be the most cost-effective smoking cessation option
for COPD patients. Promoting smoking cessation especially for patient with COPD
will benefit for individual patient and societal perspective. Thai government
may consider including smoking cessation program into national COPD clinic
Effects of medication adherence on hospitalizations and healthcare costs in patients with schizophrenia in Thailand
Background: This study was conducted to determine the impacts of medication adherence on hospitalization and direct healthcare cost in patients with schizophrenia in Thailand. Methods: A retrospective study was undertaken. Patients with schizophrenia aged 18â65âyears who visited a University hospital and received antipsychotics from April 2011 to October 2011 were included. Propensity scoreâadjusted logistic regression was used to determine the impacts of medication adherence on schizophrenia-related and all-cause hospitalizations. Results: A total of 582 patients were included. Three out of 224 patients (1.3%) were hospitalized with schizophrenia in optimal adherence group, while 10 of 140 (7.1%) were hospitalized in under-adherence group, and 7 of 218 (3.2%) were hospitalized in over-adherence group. Based on propensity scoreâadjusted multivariate logistic regression, the adjusted odds ratio was 5.86 (95% confidence intervalâ=â1.53â22.50) for schizophrenia-related hospitalization and 8.04 (95% confidence intervalâ=â2.20â29.40) for all-cause hospitalization. The average annual direct healthcare costs in patients with optimal adherence, under-adherence, and over-adherence were US836, US734, and US2168, respectively. Conclusion: An initiation of interventions to maintain optimal adherence in patients with schizophrenia would significantly impact the healthcare system
Hospitalization and cost after switching from atypical to typical antipsychotics in schizophrenia patients in Thailand
Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics.This study aimed to evaluate clinical and economic impacts of switching from atypical to typical antipsychotics in schizophrenia patients in Thailand.From October 2010 through September 2013, a retrospective cohort study was performed utilizing electronic database of two tertiary hospitals. Schizophrenia patients aged 18 years or older and being treated with atypical antipsychotics were included. Patients were classified as atypical antipsychotic switching group if they switched to typical antipsychotics after 180 days of continual atypical antipsychotics therapy. Outcomes were schizophrenia-related hospitalization and total health care cost. Logistic and Poisson regression were used to evaluate the risk of hospitalization, and generalized linear model with gamma distribution was used to determine the health care cost. All analyses were adjusted by employing propensity score and multivariable analyses. All cost estimates were adjusted according to 2013 consumer price index and converted to US.A total of 2,354 patients were included. Of them, 166 (7.1%) patients switched to typical antipsychotics. The adjusted odds ratio for schizophrenia-related hospitalization in atypical antipsychotic switching group was 1.87 (95% confidence interval [CI] 1.23-2.83). The adjusted incidence rate ratio was 2.44 (95% CI 1.57-3.79) for schizophrenia-related hospitalizations. The average total health care cost was lower in patients with antipsychotic switching (-459 to $332).Switching from atypical to typical antipsychotics is associated with an increased risk of schizophrenia-related hospitalization. Nonetheless, association with average total health care cost was not observed. These findings can be of use as a part of evidence in executing prospective cost-containment policy