Abstract
An Integral Study and the Effects of Medical Ethics Toward the Project of Baht 30 All Medical Treatment This study was conducted by the sub-committee of the Medical Council of Thailand in December 2002. It was undertaken to focus the impression towards medical treatment after which could result and affect the morality of medical practitioner in the project of Baht 30 for all treatment throughout Thailand. The subcommittee has distributed pre-test questionnaires to physicians in both the government and private sectors working in the central region and regional areas. Four hundred fifty questionnaires were administered and 125 sets (27.8%) responded. The answered questionnaires were analyzed for the content validity and test the reliability. The reliability of the questionnaires was 27.8% (more than 15%) which is considered to be reliable and valid according to statistical analysis. The subcommittee therefore distributed the questionnaires by using consensus. All questionnaires were delivered to all physicians as shown in the name-list of the Medilcal Council, a total of 25,885 sets. Ninety - four sets of questionnaires were returned for the reason of no recevier or respondents were not at home. Forty-one questionnaires were returned after the data have been analyzed. It was believed that 5,506 of the questionnaires reached the respondents with a total of 25,791 (21.4%) sets which is equally close to the pre-test study.Section 1 : General Information Only 21% of total male physicians (17,095) returned questionnaires and 8,834 (19%) were female physicians. Both of which is proportional. Comparing to the data, the highest number of physician who returned the questionnaires were between the age qroup of 50-59 years (28.3%), 40-49 years (28.1%), 30-39 years(20.4%), more than 60 years(19.5%) and less than 30 years (least returned) or (12.5%) Information obtained from the Medical Council was as follows : general physician (13,976), surgeons including (extended) sub specialty (3,759), internal medicine including extended specialty (3,541), pediatricians (2,188) and obstetricians and gynecologists (1,730). It was noted that general physicians returned most of the questionnaires (29.4%), pediatricians (10.7%) obstetricians and gynecologists (9.7%) internal medicine (8.7%) and surgeons (8.2%) Among 5,465 physicians, who responded the questionnaires, 90% still provide medical treatment of which was considered to be the target group of this survey study. Regarding the places, which provided medical treatment, 39.7% are in the government sectors, only 21.1% worked in private hospitals. Respondents from the central region (22.7%) and in Bangkok (22.7%) answered most of the questionnaires followed by the northeast region (14.0%), northern region (13.2%), the south (8.5%) and eastern region (6.3%) respectively. Part 2 : Sharing Views Among 5,464 physicians who responded agreed in principal and policy of the Baht 30 project all medical treatment. Those agreed most (23.2%), moderately agreed (36.2%), and few agreed (38.4%), Respondents mostly agreed (3.9%) with the present structure, 18.5% moderately agreed and very few agreed of 75.2% respectively. To conclude, 23.2% of respondents mostly agreed in the campaign of Baht 30 all medical treatment but 75.2% did not agreed with its structure. From the Medical Council's point of view, only 2.3% agreed that the Medical Council should stay stagnant while others reflected that the gathered opinions should be forwarded to the government and the Ministry of Public Health. Approximately, 74.6% proposed to forward through the media, 61.6% to members of the Partiament and the Senate and 58.69% to the Economic Council and 53.6% proposed to arrange a seminar for all physicians over the country. Part 3 : Administration of the Baht 30 Project Respondents of 59.6% have received the policy from the management team to reduce the medicine costs and suppiles and 52.9% performed according to the policy given by the administrator. A percentage of 47.8 of physicians did not change the method of treatment towards the patiens and 39.0% admitted their changes of medical treatment does not bring good results to the patient. Only 5.4% agreed the changes were good. For further search for this administration, 50.9% responded the study did not yield good results for further investigation, 31% responded no change and only 6% reponded improved. Regarding the freedom to choose the method of treatment according to medical standards, 54.4% responded lessened, 39.9% answered the same and inquired about the result of the medical treatment, 67.3% responded it was lessened, 13.2% the same and only 6.7% improved.
