Thailand Country Report on Quality of Dental services Sutha Jienmaneechotchai DDS. MPH. Director,...
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Transcript of Thailand Country Report on Quality of Dental services Sutha Jienmaneechotchai DDS. MPH. Director,...
Thailand Country Report on
Quality of Dental services
Sutha Jienmaneechotchai DDS. MPH.
Director, Bureau of Dental Health, Dept. of Health
ASEAN Chief Dental Officers Meetings 27-28 August 2013
About Thailand
Quality of Dental Services
Patient safety, Effectiveness
Patient centeredness
Timeliness
Efficiency
Equity
People and Society
Population67,448,120 (July 2013) Urbanization
urban population: 34.1% of total population (2011)
rate of urbanization: 1.6%
Life expectancy at birth:(2013)• total population: 74.05 years• male: 71.66 years• female: 76.58 years
Health expenditure3.9% of GDP(2010)
Physicians density:0.3 physicians/1,000 population (2004)Hospital bed density:2.1 beds/1,000 population (2010)
Source: https://www.cia.gov/library/publications/the-world-factbook/geos/th.html#People
School of Dentistry
• Curriculum meets requirements
Dental Students
• Meet school Standards
Thai License Exam
part 1 Written Examination of Basic Biomedical Science
part 2 Written Examination of Clinical Science
part 3 Clinical examination
Input: Dental personnel
Dental Council School Dentistry
CDA-TDC
Dental Safety Goals and Guidelines 2010: Safety Communication, Treatment, Infectious control and Record
Process
Clinical practice Guidelines
Any kinds of Accreditation (HA, ISO, PSO)
Educate consumer
Patient centeredness
• Primary care unit in every sub-district
• Care provide by doctors from local
communities
• Dental Etiquettes
Not much has been done
Long waiting list
Long waiting time
No time point standard
Within the care units under universal coverage
Promote health
rather
than cure
• National level oral health promotion program
• Area based oral health promotion
Fully utilized of equipmen
t
Balance of cost
• Toothbrush’s Labeling (MR 2012)• DOH Tooth brush standard • TSI Committee for oral care product
• No sugar added in follow on formula milk (MR#26)• Ban carbonated drink sale in school Policy
• F in Drinking water (<0. 7mg/L)• F in Bottled Water (MR# 6)• F in Toothpaste ( < 1000 ppm )
• Dental Networks Against Tobacco • Smoking cessation in Dental Clinic
Oral Health Promotion: National Level :
NATIONAL
LEVEL
SUGAR CONTR
OL
TOBACCO
CONTROL
Law enforcement / Regulation / Policy / Standard set up
Fstandard
Oral Care Products
STRENGTHEN NETWORKWHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012
AREA BASE
A
D
B
C
E
Oral Health Promotion : Area base
Elderly
Mothers &Child• Dental Exam in ANC 77 %• Dental Exam in WCC 77 %• F varnish application 42%
Preschool/ Daycare
School Children
• Toothbrush after lunch 96%• Fissure sealant in 1st grade 22.5% • Comprehensive care• Schools Ban on sale of Carbonated drink 77 %
• Elderly Club 365 clubs/year• Dental Prostheses 30,000 /year• Preventive Clinic for the Elderly
Environment/ Community
• Surveillance for F in water in risk area cover 20 province • Dental Fluorosis mitigation project in 10 province
CAPACI TY BUI L DIN
G
STRENGTHEN
NETWORK
Tooth brushing after lunch No sweetened milk Safe sancks • Implement 96.5 %• Oral exam & treatment
WHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012
Source: Bureau of Dental Health, 1994-2012
Result of Oral Health Promotion Program
1994 2001 2007 20120
10
20
30
40
50
60
70 66.5 66.161.4
51.753.9
57.3
56.9
52.3
3 year old12 year old
Year
Dental Caries Prevalence in Thai children (1994-2007)
Equity
20
Percentage of the Thai with health insurance, 2003 and 2011
2003 2011
Social security schemeCivil service welfareUniversal coverage Other schemesNo insurance
Service Utilization of Thai People in 2011
Dental service utilization rate in Thai people increased (7.4 % in 2006 to 9.3 % in 2011)
7.48.4
9.1 9.3
0
2
4
6
8
10
2.3
11 11.19.5
7.6
02468
1012 •The highest utilization rate
were 5-14 and 15-24 yrs each group at 11 %
•The lowest utilization rate was 0-4 years at 2.3 %
Dental service utilization rate (2006-2011)
2011 Service utilization in 12 m, distributed by age
2006 2007 2008 2009
0-4 5-14 15-24 25-59 60+ Source: National Statistic Office, 2011
In 2011
WHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012
Promote health rather than cure Nation
al Health
Act
National Health Act 2007
• Efficient use of resources by good administrative and management practices.
People should be the part of the ownership
• People have the right to choose their health services
expenditure and equity of access to the same quality of health
• An equal sharing of health care services
Health
Health Act, 2007Healthy Public Policy, people
participation
Health Promotion Foundation Act, 2001
Support health promotion action
Health Security Act 2002Health care reform
• Equity• Efficiency• Quality
• Health behavior• Health belief
• Socio-economic• Culture• Community / family
pattern• Politics• Infra structure• Technology