Health Research in Thailand: A Gap Analysis

1
Health Research in ThailandA Gap Analysis

• Krit Pongpirul, MD.
• International Health Policy Program
  (IHPP-Thailand)
• doctorkrit_at_gmail.com

2
Outlines for Gap Analysis

• Trend (2544 vs 2546)
• Global Situations
• National Agencies
• Observations
• Proposals

3
Trend (2544 vs 2546)
4
2544 vs 2546
5
Global Situations
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Global Situations

• Methodology
• Medline Search using Medical Subject Headings
  (MeSH) on July 5th, 2005
• Comments from todays expert panel

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Medical Subject Headings (MeSH)

• MeSH is the system designed and used by the
  National Library of Medicine (NLM) for assigning
  subject headings to books and journals articles
  in the medical sciences.

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MeSH Tree Structure 1

1. Anatomy A
2. Organisms B
3. Diseases C
4. Chemicals and Drugs D
5. Analytical, Diagnostic and Therapeutic
   Techniques and Equipment E
6. Psychiatry and Psychology F
7. Biological Sciences G
8. Physical Sciences H
9. Anthropology, Education, Sociology and Social
   Phenomena I
10. Technology and Food and Beverages J
11. Humanities K
12. Information Science L
13. Persons M
14. Health Care N
15. Geographic Locations Z

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MeSH Tree Structure 2

• Diseases C
• Bacterial Infections and Mycoses C01
• Virus Diseases C02
• Parasitic Diseases C03
• Neoplasms C04
• Musculoskeletal Diseases C05
• Digestive System Diseases C06
• Stomatognathic Diseases C07
• Respiratory Tract Diseases C08
• Otorhinolaryngologic Diseases C09
• Nervous System Diseases C10
• Eye Diseases C11
• Urologic and Male Genital Diseases C12
• Female Genital Diseases and Pregnancy
  Complications C13

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MeSH Tree Structure 3

• Health Care N
• Population Characteristics N01
• Health Care Facilities, Manpower, and Services
  N02
• Health Care Economics and Organizations N03
• Health Services Administration N04
• Health Care Quality, Access, and Evaluation N05

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Thai vs Global
Kendalls tau-b -0.19 (p0.04) Spearmans rho
-0.31 (p0.02)
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1.Diseases of the Organs
Kendalls tau-b -0.039 (p0.820) Spearmans
rho -0.036 (p0.887)
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1.Diseases of the Organs
Kendalls tau-b -0.039 (p0.820) Spearmans
rho -0.036 (p0.887)
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1.Diseases of the Organs

• Thai
• Mouth Diseases
• Anesthesiology
• Musculoskeletal Diseases
• Reference Values / Biomedical Research
• Cardiovascular Diseases
• Eye Diseases
• Nervous System Diseases
• Endocrine System Diseases

• Global
• Nervous System Diseases
• Cardiovascular Diseases
• Immune System Diseases
• Respiratory Tract Diseases
• Musculoskeletal Diseases
• Skin Diseases
• Gastrointestinal Diseases
• Endocrine System Diseases

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2.Health Problems
Kendalls tau-b -0.197 (p0.168) Spearmans
rho -0.349 (p0.087)
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2.Health Problems
Kendalls tau-b -0.197 (p0.168) Spearmans
rho -0.349 (p0.087)
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2.Health Problems

• Thai
• Molecular Biology
• Traditional Medicine
• Pharmacology
• Diagnostic Reagent Kits
• Communicable Diseases
• Mental Health
• Nutrition
• Drug Control
• Epidemiology
• Reproductive Health
• Environmental Health
• Substance-Related Disorders
• HIV

• Global
• Neoplasms
• Radiology
• Hereditary Diseases
• Nutrition
• Chronic Diseases
• Rehabilitation
• Substance-Related Disorders
• HIV
• Accidents
• Forensic Medicine
• Primary Health Care
• Pharmacology
• Occupational Medicine

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3.Enabling Mechanisms
Kendalls tau-b 0.297 (p0.160) Spearmans rho
0.432 (p0.141)
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3.Enabling Mechanisms
Kendalls tau-b 0.297 (p0.160) Spearmans rho
0.432 (p0.141)
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3.Enabling Mechanisms

• Thai
• Behavioral Sciences / Health Promotion
• Healthcare Quality Assessment
• Health Facilities / Health Manpower / Health
  Personnel
• Total Quality Management
• Health Economics
• Medical Informatics
• Health Care Evaluation Mechanisms

• Global
• Health Care Evaluation Mechanisms
• Health Services
• Health Facilities / Health Manpower / Health
  Personnel
• Health Economics
• Behavioral Sciences / Health Promotion
• Healthcare Quality Assessment
• Medical Informatics

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National Agencies
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National Agencies

• Sources
• Priority setting report to NRC NHF
• Feedback from expert panel in September 2004
• Academic institutions were not included
• Agencies
• National Research Council (NRC)
• Thailand Research Fund (TRF)
• Health Systems Research Institute (HSRI)
• National Center for Genetic Engineering and
  Biotechnology (Biotec)
• Ministry of Public Health (MOPH)

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Diseases of the Organs
Rank MeSH NRC TRF HSRI Biotec MOPH
1 Mouth Diseases
2 Anesthesiology
3 Musculoskeletal Diseases
4 Reference Values / Biomedical Research
5 Cardiovascular Diseases X
6 Eye Diseases
7 Nervous System Diseases X
8 Endocrine System Diseases
9 Otorhinolaryngologic Diseases
10 Respiratory Tract Diseases
11 Kidney Diseases / Sudden Death
12 Immune System Diseases
13 Hematologic Diseases
14 Gastrointestinal Diseases
15 Urinary Tract Diseases
16 Skin Diseases
17 Liver Diseases
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Health Problems 1
Rank MeSH NRC TRF HSRI Biotec MOPH
1 Molecular Biology X
2 Traditional Medicine X X X
3 Pharmacology X
4 Diagnostic Reagent Kits X X
5 Communicable Diseases X X X
6 Mental Health
7 Nutrition
8 Drug Control X X
9 Epidemiology
10 Reproductive Health
11 Environmental Health
12 Substance-Related Disorders
13 HIV X X
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Health Problems 2
Rank MeSH NRC TRF HSRI Biotec MOPH
14 Neoplasms X X
15 Radiology
16 Occupational Medicine X
17 Human Genome
18 Biomedical Technology Assessment X
19 Accidents X X
20 Rehabilitation
21 Thalassemia X X
22 Primary Health Care
23 Chronic Diseases
24 Hereditary Diseases X
25 Forensic Medicine
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Enabling Mechanisms
Rank MeSH NRC TRF HSRI Biotec MOPH
1 Behavioral Sciences / Health Promotion
2 Healthcare Quality Assessment
3 Health Facilities / Health Manpower / Health Personnel X X
4 Total Quality Management
5 Health Economics
6 Medical Informatics X X
7 Health Care Evaluation Mechanisms
8 Health Services X X X X
9 Health Policy X X X
10 Ethical Issues
11 Legislation
12 Medical Education
13 International Health Problems
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Observations

• Wide many gaps still exist
• Past Present
• Global situation
• Thai situation
• Limitations of quantitative approach
• No systematic research database

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Proposals

• Further qualitative approach
• MeSH-based research database
• Further inter-disciplinary collaboration