Chulalongkorn University Theses and Dissertations (Chula ETD)

Strengthening of the public health care system to improve epilepsy treatment in Nakhonratchasima Province, Thailand : an integrative approach

Year (A.D.)

1999

Document Type

Thesis

First Advisor

Watana S. Janjaroen

Faculty/College

College of Public Health Sciences (วิทยาลัยวิทยาศาสตร์สาธารณสุข)

Degree Name

Master of Public Health

Degree Level

Master's Degree

Degree Discipline

Health Systems Development

DOI

10.58837/CHULA.THE.1999.1400

Abstract

This thesis deals with a strengthening of the Public Health Care Service System in order to improve the quality and effectiveness of care. It consists of: an essay on the problems of caring for epileptic patients in Nakhonratchasima province, Thailand; a proposal for strengthening the health system; a report on reliability testing of the seizure severity questionnaire; a bibliography on the prognosis of epilepsy, the classification and measurement of compliance, the Structural Shared Care Scheme process and the importance and domain of quality of life measurement. The Structural Shared Care Scheme is a health care system, which provides systematic continuity of care for patients with chronic conditions. It was applied to diabetic and hypertensive patients. Even the results of these studies could not improve medical outcomes, the process of care for patients was significantly improved. For epileptic patients, a seizure reduction might have more benefit since these patients have frequent seizures, injuries during seizure attacks, and have to pay more for a seizure occurrence. Under current conventional care, epileptic patients have a very short time to talk with their physicians, use duplicate resources, and sometimes forget their appointments. This Scheme might improve them by the recall system process, shared responsibilities and record medical information, and providing a management guideline. This thesis is an action research, which will measure the reduction of the number of seizures, changing seizure severity and quality of life during a 3 year study.

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