Abstract
Hill tribes in Thailand approach 1 million people, about half Karens. We studied isolated Mae Hong Son Province in northwest Thailand near the Myanmar (Burma) border, where demographic research revealed overburdened health resources (938 people per hospital bed, 8721 per physician, 1068 per professional nurse, 4573 per technical nurse, 17,046 per pharmacist, and 5137 per primary care unit [PCU]). We explored the potential for point-of-care testing (POCT) in health care delivery in the mountainous topology of windy roads, with bridges washed out and long transit times to PCUs and community hospitals. We found limited application of POCT in PCUs and community hospitals, which represent the most accessible nodes in the small-world networks (SWNs) of province health care delivery. We surveyed community hospital facilities that lacked blood gas and electrolyte testing, despite serving as network local hubs. We investigated telemedicine, a nodally flexible option to improve SWN connectivity, which is planned to connect 3 PCUs in the southern part of the province where seasonal rains make travel impractical. POC coordinators, social services, and disease-specific testing will reduce errors and improve cultural balance for those who prefer care in or near their villages. We propose an efficiency function and conclude that synergistic POCT, SWNs, and telemedicine will improve health care for mountain hill tribes without sacrificing routine care for other people in rural and urban areas. For distributed clusters of populations, emergency services and care of the critically ill will be improved through enhanced evidence-based decision making when these improvements are implemented.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 199-204 |
| Number of pages | 6 |
| Journal | Point of Care |
| Volume | 5 |
| Issue number | 4 |
| DOIs | |
| State | Published - Dec 2006 |
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Keywords
- Blood gas and pH testing
- Cardiac biomarkers
- Community hospital
- Critically ill
- Demography
- Electrolytes
- Health resource
- Node
- Primary care unit
- Regional hospital
- Standard of care
- Triage
- Whole-blood analyzer
ASJC Scopus subject areas
- Nursing(all)
Cite this
The hill tribes of thailand : Synergistic health care through point-of-care testing, small-world networks, and nodally flexible telemedicine. / Kost, Gerald J; Suwanyangyuen, Audhaiwan; Kulrattanamaneeporn, Shayanisawa.
In: Point of Care, Vol. 5, No. 4, 12.2006, p. 199-204.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The hill tribes of thailand
T2 - Synergistic health care through point-of-care testing, small-world networks, and nodally flexible telemedicine
AU - Kost, Gerald J
AU - Suwanyangyuen, Audhaiwan
AU - Kulrattanamaneeporn, Shayanisawa
PY - 2006/12
Y1 - 2006/12
N2 - Hill tribes in Thailand approach 1 million people, about half Karens. We studied isolated Mae Hong Son Province in northwest Thailand near the Myanmar (Burma) border, where demographic research revealed overburdened health resources (938 people per hospital bed, 8721 per physician, 1068 per professional nurse, 4573 per technical nurse, 17,046 per pharmacist, and 5137 per primary care unit [PCU]). We explored the potential for point-of-care testing (POCT) in health care delivery in the mountainous topology of windy roads, with bridges washed out and long transit times to PCUs and community hospitals. We found limited application of POCT in PCUs and community hospitals, which represent the most accessible nodes in the small-world networks (SWNs) of province health care delivery. We surveyed community hospital facilities that lacked blood gas and electrolyte testing, despite serving as network local hubs. We investigated telemedicine, a nodally flexible option to improve SWN connectivity, which is planned to connect 3 PCUs in the southern part of the province where seasonal rains make travel impractical. POC coordinators, social services, and disease-specific testing will reduce errors and improve cultural balance for those who prefer care in or near their villages. We propose an efficiency function and conclude that synergistic POCT, SWNs, and telemedicine will improve health care for mountain hill tribes without sacrificing routine care for other people in rural and urban areas. For distributed clusters of populations, emergency services and care of the critically ill will be improved through enhanced evidence-based decision making when these improvements are implemented.
AB - Hill tribes in Thailand approach 1 million people, about half Karens. We studied isolated Mae Hong Son Province in northwest Thailand near the Myanmar (Burma) border, where demographic research revealed overburdened health resources (938 people per hospital bed, 8721 per physician, 1068 per professional nurse, 4573 per technical nurse, 17,046 per pharmacist, and 5137 per primary care unit [PCU]). We explored the potential for point-of-care testing (POCT) in health care delivery in the mountainous topology of windy roads, with bridges washed out and long transit times to PCUs and community hospitals. We found limited application of POCT in PCUs and community hospitals, which represent the most accessible nodes in the small-world networks (SWNs) of province health care delivery. We surveyed community hospital facilities that lacked blood gas and electrolyte testing, despite serving as network local hubs. We investigated telemedicine, a nodally flexible option to improve SWN connectivity, which is planned to connect 3 PCUs in the southern part of the province where seasonal rains make travel impractical. POC coordinators, social services, and disease-specific testing will reduce errors and improve cultural balance for those who prefer care in or near their villages. We propose an efficiency function and conclude that synergistic POCT, SWNs, and telemedicine will improve health care for mountain hill tribes without sacrificing routine care for other people in rural and urban areas. For distributed clusters of populations, emergency services and care of the critically ill will be improved through enhanced evidence-based decision making when these improvements are implemented.
KW - Blood gas and pH testing
KW - Cardiac biomarkers
KW - Community hospital
KW - Critically ill
KW - Demography
KW - Electrolytes
KW - Health resource
KW - Node
KW - Primary care unit
KW - Regional hospital
KW - Standard of care
KW - Triage
KW - Whole-blood analyzer
UR - http://www.scopus.com/inward/record.url?scp=33845482718&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33845482718&partnerID=8YFLogxK
U2 - 10.1097/01.poc.0000232580.36762.68
DO - 10.1097/01.poc.0000232580.36762.68
M3 - Article
AN - SCOPUS:33845482718
VL - 5
SP - 199
EP - 204
JO - Point of Care
JF - Point of Care
SN - 1533-029X
IS - 4
ER -