situation thailand patama_29092012

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Presentation at the "Building collaborative research platform and professional training workshop for cancer treatment, hospic/palliative care and bioethis in SEA countries" National Taiwan university.

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  • 1. T he current situation ofpalliative care in ThailandPatama Gomutbutra MD.Assist Prof. of family medicine Chiang Mai universitypgomutbu@med.cmu.ac.th

2. PurposeProcessPerformance 3. WHAT:PERFORMANCE OF PALLIATIVECARE IN THAILAND 4. 20062012 5. Opioid consumption 3. 96 mg/capitacompare with 693 mg/capita of USA 6. The current situation ofpalliative care service inThailand.THAPS survey 2012Asso.prof. Temsak Phungrassami.Faculty of medicine. University ofSongkla.Rojanasak Thongkhamcharoen .Maesod hospital.Narumol ArkkakulNational health security office (NHSO) 7. Health care unit inThailand 1,002 public hospitals316 registered private hospitals. Level of public hospitals- Primary care (community) hospital- Secondary care (general) hospital- Tirtiary care (regional) hospital- University hospital- Specialized center eg. Cancer center 8. Percentage of palliative care servicein each type of Health care unit Pri. H Sec.H Tir. H U. H Ca.C Private H. 9. Graded system of Palliative care service(European standard)EAPC recommendation: standard and norms for hospice and palliative care 2009http://www.eapcnet.eu/Themes/Organisation/EAPCStandardsNorms.aspx 10. McCain Chiang Mai Nursing home ( so called hospice)One GP (my husband)with 7 nurse: 30 beds 11. Percentage of Morphine availabilityin each type of Health care unit Pri. H Sec.H Tir. H U. H Ca.C Private H. 12. Percentage of Physician got PC trainingin each type of Health care unit 12 physicians !have year long palliative trainingPri. H Sec.HTir. HU. H Ca.CPrivate H. year(s)month (s)week (s) day(s) N/A 13. Percentage of Nurse got PC trainingin each type of Health care unitPri. HSec.H Tir. H U. H Ca.C Private H.year(s)month (s) week (s) day(s) N/A 14. Caveat about the results Response rate 57%(private hospital 19%) Each unit situation may beanswered by who not know allinformation.Dr. Temsak CMU has no pain clinic.REALLY ! 15. Thailand quality ofdeath ???15 16. HOW:PROCESS OF PALLIATIVECAREIN CHIANGMAI UNIVERSITY 17. Patients contact to Follow up bylocal health care phone in someunit themselves case 18. Training physician 4th year MD : Lecture principle 6th year MD : Practice incommunity and sent case report FM resident - ward consultation aka.shared care - Home visit (not home hospice 19. Case report from rural sent viaMoodle e-learning 20. GAP of knowledge & practice dyspneaExample : Management of advance illness Practice in community ( From med students case reports) 5% of in CA lung got opioid/BZD for dyspnea 0% of COPD, CHF 90% non-hypoxia pt. got home oxygen 21. WHY:PURPOSE OF DOING MOREIMPACT RESEARCHIN PALLIATIVE CARE 22. Impact = Support clear massage 23. Indicator of triangle ImageBenefit Right of good deathgetting palliative care Expectation fromoptimal treatment 24. Summary situation of palliative care in Thailand Our palliative care is being in thelag page Initiation/Production is not a bigproblem The problem isCommunication/Distribution 25. Thank you for your attention Welcome for..QuestionSuggestionCollaboration 26. Thank you for Prof.Tai-Yuan Chiu andThe National Taiwan university Suandok palliative care team Dr. Temsak, Dr.SakolDr. Rojjanasak, Dr.Linchong,Dr.Tipaporn

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