Abstract:BackgroundThis study forecasts physician supply between 2012 and 2030 using cohort analysis, based on future production capacity and losses from the profession, and assesses if, and by when, the projected numbers of physicians would meet the targets of one doctor per 1,500 population, as proposed by the 7th National Conference on Medical Education in 2001, and one per 1,800, proposed by the Ministry of Public Health (MoPH) in 2004.MethodsWe estimated the annual loss rate that best reflected the dynamics of exi… Show more
“…This corresponds to the guidelines recommended by WHO in 2010 and also various international reports and studies [10-15]. The most clearly targeted programmes are the ‘Collaborative Project to Increase Production of Rural Doctors (CPIRD)’, launched in 1995, and ‘One District One Doctor (ODOD)’ which was launched in 2005 [6,8,16,17]. These provide a special admission mode (special track) in parallel to the existing methods of national entrance examination and direct admission.…”
Section: Introductionsupporting
confidence: 63%
“…This contract system was then expanded to other professions such as nurses and dentists; however, working in public facilities remained voluntary for pharmacists. More recently, the past two decades have seen the founding of a number of new health professional schools, mostly outside Bangkok and the vicinity [5,6]. Civil servant posts and financial incentives have been provided, on top of the regular salary, to offset the opportunity loss of working in remote areas [5,8].…”
Background: Inequity in health workforce distribution has been a national concern of the Thai health service for decades. The government has launched various policies to increase the distribution of health workforces to rural areas. However, little is known regarding the attitudes of health workers and the factors influencing their decision to work in rural areas. This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas. Methods: A cross-sectional survey was conducted, using self-administered questionnaires, with a total of 1,225 medical, dental and pharmacy graduates. They were participants of the meeting arranged by the Ministry of Public Health (MOPH) on 1-2 April 2012. Descriptive statistics using mean and percentage, and inferential statistics using logistic regression with marginal effects, were applied for data analysis. Results: There were 754 doctors (44.4%), 203 dentists (42.6%) and 268 pharmacists (83.8%) enrolled in the survey. Graduates from all professions had positive views towards working in rural areas. Approximately 22% of doctors, 31% of dentists and 52% of pharmacists selected 'close proximity to hometown' as the most important reason for workplace selection. The multivariable analysis showed a variation in attributes associated with the tendency to work in rural areas across professions. In case of doctors, special track graduates had a 10% higher tendency to prefer rural work than those recruited through the national entrance examination. Conclusions: The majority of graduates chose to work in community hospitals, and attitudes towards rural work were quite positive. In-depth analysis found that factors influencing their choice varied between professions. Special track recruitment positively influenced the selection of rural workplaces among new doctors attending the MOPH annual meeting for workplace selection. This policy innovation should be applied to dentists and pharmacists as well. However, implementing a single policy without supporting strategies, or failing to consider different characteristics between professions, might not be effective. Future study of attitudes and factors contributing to the selection of, and retention in, rural service of both new graduates and in-service professionals was recommended.
“…This corresponds to the guidelines recommended by WHO in 2010 and also various international reports and studies [10-15]. The most clearly targeted programmes are the ‘Collaborative Project to Increase Production of Rural Doctors (CPIRD)’, launched in 1995, and ‘One District One Doctor (ODOD)’ which was launched in 2005 [6,8,16,17]. These provide a special admission mode (special track) in parallel to the existing methods of national entrance examination and direct admission.…”
Section: Introductionsupporting
confidence: 63%
“…This contract system was then expanded to other professions such as nurses and dentists; however, working in public facilities remained voluntary for pharmacists. More recently, the past two decades have seen the founding of a number of new health professional schools, mostly outside Bangkok and the vicinity [5,6]. Civil servant posts and financial incentives have been provided, on top of the regular salary, to offset the opportunity loss of working in remote areas [5,8].…”
Background: Inequity in health workforce distribution has been a national concern of the Thai health service for decades. The government has launched various policies to increase the distribution of health workforces to rural areas. However, little is known regarding the attitudes of health workers and the factors influencing their decision to work in rural areas. This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas. Methods: A cross-sectional survey was conducted, using self-administered questionnaires, with a total of 1,225 medical, dental and pharmacy graduates. They were participants of the meeting arranged by the Ministry of Public Health (MOPH) on 1-2 April 2012. Descriptive statistics using mean and percentage, and inferential statistics using logistic regression with marginal effects, were applied for data analysis. Results: There were 754 doctors (44.4%), 203 dentists (42.6%) and 268 pharmacists (83.8%) enrolled in the survey. Graduates from all professions had positive views towards working in rural areas. Approximately 22% of doctors, 31% of dentists and 52% of pharmacists selected 'close proximity to hometown' as the most important reason for workplace selection. The multivariable analysis showed a variation in attributes associated with the tendency to work in rural areas across professions. In case of doctors, special track graduates had a 10% higher tendency to prefer rural work than those recruited through the national entrance examination. Conclusions: The majority of graduates chose to work in community hospitals, and attitudes towards rural work were quite positive. In-depth analysis found that factors influencing their choice varied between professions. Special track recruitment positively influenced the selection of rural workplaces among new doctors attending the MOPH annual meeting for workplace selection. This policy innovation should be applied to dentists and pharmacists as well. However, implementing a single policy without supporting strategies, or failing to consider different characteristics between professions, might not be effective. Future study of attitudes and factors contributing to the selection of, and retention in, rural service of both new graduates and in-service professionals was recommended.
“…Although Thailand has 18 public medical schools and one private one – that together produce about 2500 new graduates annually, 34 there remains a shortfall in doctors. It has been estimated that at the current rate of training, Thailand will not achieve its targeted physician density – of one per 1500 people – until 2020 34 . The situation is compounded by the distribution of doctors, with an acute shortage in rural areas.…”
ObjectiveTo investigate the magnitude and characteristics of medical tourism in Thailand and the impact of such tourism on the Thai health system and economy.MethodsIn 2010, we checked the records of all visits to five private hospitals that are estimated to cover 63% of all foreign patients. We reviewed hospital records of foreign patients and obtained data on their countries of origin, diagnoses and interventions. We surveyed 293 medical tourists to collect demographic characteristics and information on their expenditure and travelling companions. To help understand the impact of medical tourism on the Thai health system, we also interviewed 15 hospital executives and 28 service providers from the private hospitals.FindingsWe obtained 911 913 records of hospital visits, of which 324 906 came from 104 830 medical tourists. We estimated that there were 167 000 medical tourists in Thailand in 2010. Of the medical tourists who attended our study hospitals, 67 987 (64.8%) came from the eastern Mediterranean region or Asia and 109 509 (34%) of them were treated for simple and uncomplicated conditions – i.e. general check-ups and medical consultations. The mean self-reported non-medical expenditure was 2750 United States dollars. According to the hospital staff interviewed, medical tourism in 2010 brought benefits to – and apparently had no negative impacts on – the Thai health system and economy.ConclusionWe estimate that the total number of medical tourists visiting Thailand is about 10% of previous national government estimates of 1.2 million. Such tourists appear to bring economic benefits to Thailand and to have negligible effects on the health system.
“…Their production capacity increased from less than 35% of the country's medical graduates in 2002 to nearly 44% in 2012. 10,11 A temporary laddered nursing programme was introduced in 1982 in response to the rapid expansion of district health systems. Students received a diploma as technical nurses after a two-year course of study.…”
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