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The use of extra corporeal shock wave lithotripters in Thailand : Efficiency and equity

dc.contributor.authorวิโรจน์ ตั้งเจริญเสถียรen_US
dc.contributor.authorViroj Tangcharoensathienen_US
dc.contributor.authorสุกัลยา คงสวัสดิ์en_US
dc.contributor.authorพินทุสร เหมพิสุทธิ์en_US
dc.contributor.authorนวลอนันต์ ตันติเกตุen_US
dc.contributor.authorงามจิตต์ จันทรสาธิตen_US
dc.coverage.spatialthen_US
dc.date.accessioned2008-12-04T05:22:05Zen_US
dc.date.accessioned2557-04-17T00:46:31Z
dc.date.available2008-12-04T05:22:05Zen_US
dc.date.available2557-04-17T00:46:31Z
dc.date.issued1993en_US
dc.identifier.otherhs0080en_US
dc.identifier.urihttp://hdl.handle.net/11228/1782en_US
dc.description.abstractThe use of extra corporeal shock wave lithotripters in Thailand: efficiency and equityBased mainly on hospital statistics, this study aims to collect(a) financial data from Extra Corporeal Shock Wave Lithotripter (ESWL) to estimate cost of production, cost behaviour, cost recovery, break-even output, (b) patient characteristics eg. domicile, payment status (insurance coverage) in order to assess the two most important societal objectives, namely ; efficiency and equity (equal access for equal needs) In 1994, there are 28 ESWLs throughout the country, of which 11 are in Bangkok (39 percent), 10 (36 percent) are in the Northeast. Of the total 28 ESWLs (39 percent) were owned by public and 17 (61 percent) by private sector. The inappropriate diffusion of ESWLs causes inmigrate patients from upcountry to use services in Bangkok, where by privated cost (in terms of time cost, transportation) is substantial. This leads to inefficiency when urinary tract stone is most prevalent in the Nartheast and the North Region. Twelve ESWL units were included in this study, of with 10 from public and 2 from private. Data from 9,626 patients from 439 momths of opeation by these 12 units were compiled. Unit cost per case is higher than net revenue generated in all ESWL units, except the cases of Ramathibodi and Veteran Hospital when private company rent ESWL to the Hospital. These two units have higher efficiency measured by higher productivities (case load per month), lower unit cost, low capital investments. They are operating at the level higher than the break-even output. We found that most of thecases, 38 percent paid from their own pockets, 35 percent were civil servant or dependants who can be fully reimbursed from the Ministry of Finance, 18 percent were low income card holders, 5 percent were deducted using slidinf scale upon the social worker's discretion. We concluded that the poor and the low income could not access as equal ESWL service as the civil servants and their dependants. This clearly reflects unequal treatment for equal needs. Case studies at Ramathibodi and Veteran hospital were very interesting in terms of efficient management. Several lesson were heavily drawn for the formulation of closer collaboration between the public and private sectors.en_US
dc.description.sponsorshipองค์การอนามัยโลกen_US
dc.format.extent2550086 bytesen_US
dc.format.mimetypeapplication/octet-streamen_US
dc.languagethaen_US
dc.language.isoen_USen_US
dc.publisherสถาบันวิจัยระบบสาธารณสุข ; สำนักนโยบายและแผนสาธารณสุขen_US
dc.subjectLithotripsy -- For Urinary calculien_US
dc.subjectการพัฒนาคุณภาพบริการen_US
dc.titleการใช้เครื่องสลายนิ่วในประเทศไทย ประสิทธิภาพและความเสมอภาคen_US
dc.title.alternativeThe use of extra corporeal shock wave lithotripters in Thailand : Efficiency and equityen_US
dc.identifier.callnoWJ166 ว237ก 2537en_US
dc.subject.keywordExtracorpereal Shockwave Lithotripsyen_US
dc.subject.keywordเครื่องสลายนิ่วen_US
.custom.citationวิโรจน์ ตั้งเจริญเสถียร, Viroj Tangcharoensathien, สุกัลยา คงสวัสดิ์, พินทุสร เหมพิสุทธิ์, นวลอนันต์ ตันติเกตุ and งามจิตต์ จันทรสาธิต. "การใช้เครื่องสลายนิ่วในประเทศไทย ประสิทธิภาพและความเสมอภาค." 1993. <a href="http://hdl.handle.net/11228/1782">http://hdl.handle.net/11228/1782</a>.
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