Bowornsilp Chowchuen - Academia.edu (original) (raw)

Papers by Bowornsilp Chowchuen

Journal of the Medical Association of Thailand, Jun 1, 2019

PubMed, Aug 1, 2016

Objectives: To report the treatment expenses of the congenital malformations of craniofacial of i... more Objectives: To report the treatment expenses of the congenital malformations of craniofacial of in-patients of Srinagarind Hospital between 2010 and 2014 Material and method: The expenses of congenital malformations of craniofacial in-patients of Srinagarind Hospital were studied by analyzing the actual amount charged and the reimbursement of treatment expenses. Results: One thousand eight hundred forty five in-patients were treated 2,144 times. The average treatment was about once or twice per person. Male patients were 54.1% and female were 45.9%. About 84% of the patients were under the universal coverage, with an average Relative Weight (RW) between 2010 and 2014 of 1.6988, 1.7059, 1.4847, 1.4165, and 1.5096, respectively. The average of the RW and the treatment expenses differentiated by the patients’ eligible medical expenses for self-paid, Government or State Enterprise Officer (OFC), Social Security Scheme (SSS), and universal coverage (UC) were 1.0398, 1.1596, 1.2759, 1.3477, respectively. The average RW calculated under diagnosis-related group (DRG) for each patient was 1.3148. The estimated RW of OFC at 13,378 and UC at 9,600 baht per RW were 18,081, 14,535, 14,259, and 17,118 baht, for an average of 16,842 baht. The average of the treatment expenses charged by the hospital to the OFC was 14,535 baht and to the UC was 17,118 baht for each treatment. The treatment expense under DRG was lower than the cost under the hospital charge by 2,051,072 baht. Conclusion: The present study analyzed the treatment expense by patients’ eligible medical expenses between 2010 and 2014. The universal coverage and government or state enterprise officer’s charges were reimbursed to the hospital under DRG system for 32,257,000 baht while the hospitals actual charges were 34,308,072 baht. This indicated that Srinagarind Hospital must set up the fund to support congenital malformations of craniofacial patients for a minimum sum of 410,214 baht per year. This is likely to increase in the future.

PubMed, Aug 1, 2015

Background: Cleft lips and cleft palates have the most incidences in the Northeast of Thailand (2... more Background: Cleft lips and cleft palates have the most incidences in the Northeast of Thailand (2.49/1,000 newborns). Cleft lips and cleft palates (CLP) can affect patients and families both physically and mentally. It takes critical long-term medical treatment starting when prenatal, newborn, and fully grown until 19 years old by a multidisciplinary team; therefore, it was effective to have collaboration with patients, families, and a multidisciplinary team in order to build up the same objective and create key performance index to monitor the treatment outcome also to develop the quality of care. Objective: 1) to create the key performance index and 2) to develop the index system by using information technology. Material and method: After the research received ethics approval from Khon Kaen University, qualitative and quantitative data were collected. There were two periods in this study. The 1st period as following list below: 1) Field research was performed by conference meetings and problem-learning process, which participants participated in each step. There were two example groups: (1) Patients and families cooperated 2 times and (2) Nursing care cooperated 4 times in October-December 2013 (3) Combining the conclusions to set the key performance index and develop the index system in January-February 2014 (4) Recording the system in March-June 2014. Content analysis and percentage were used in this study. Results: Nine organizations were engaged in this study; eight key performance indexes were established and the research recorded continuously for 4 months. There were three key performance indexes, which performed successfully: 1) Patients/caregivers received follow-up treatment continuously, 92.06%, 2) Patients/caregivers reported 89.69% satisfaction after asking the information, 3) Patients/families reported overall satisfaction of 92.11%. Conclusion: It is shown that recording the key performance index for the 1st period covered every quality of care. The Tawanchai Center and Out-patient Surgical Room under Srinagarind Hospital applied eight key performance indexes and found that three key performance indexes were feasibly implemented. For the 2nd period, the 1st outcome of key performance indices will be analyzed and developed including improving the software in order to record data and analyze the percentages automatically.

PubMed, Aug 1, 2016

Background: The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate ... more Background: The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate has not been systematically assessed. Objective: To assess the evidence in the literature for the prevalence of 22q11.2 deletion in patients who were presenting with isolated cleft palate. Material and method: A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion AND cleft palate. Results: Of the six prospective studies reported, 328 patients with isolated cleft palate had been screened with FISH (Fluorescence In Situ Hybridization) test for 22q11.2 deletion. Among the 328 patients, there was one (0.3%) patient with positive FISH test for 22q11.2 deletion. This patient was clinically assessed and did not have an associated malformation or clinically recognized syndrome. Conclusion: The prevalence of 22q11.2 deletion among patients with isolated cleft palate is rather low. Of more than 400 genetic disorders involving occurrences of isolated cleft palate, FISH testing for 22q11.2 deletion in a patient with isolated cleft palate is recommended on clinical suspicion of additional clinical presentations of 22q11.2 deletion syndrome such as conotruncal congenital heart diseases, dysmorphic facies, velopharyngeal insufficiencies, immune deficiencies, hypoparathyroidisms, and neuropsychiatric disorders.

PubMed, Oct 1, 2010

Objective: To use a Geographic Information System (GIS) approach to study the distribution and st... more Objective: To use a Geographic Information System (GIS) approach to study the distribution and statistics of patients with cleft lip/palate in Thailand's Northeast region who get treatment at Srinagarind Hospital, Khon Kaen University. Material and method: Using a GIS approach, the researchers reviewed every case with cleft lip/palate treated at Srinagarind Hospital between 1984 and 2007 to study the distribution of cleft lip/palate in Northeast Thailand. Results: Of the 1,950 patients, there were more male patients (56.3%) with cleft lip/palate than females (43.7%). One-third (31.8%) of the patients had cleft lip only, while 22.5% had cleft palate only and 45.7% had both cleft lip and cleft palate. Most of the patients (55.1%) lived in Khon Kaen, 24.9% in Mahasarakam and 16.9% in Kalasin provinces. Since 2002, more patients have had surgical treatment at the ages and intervals recommended by our centre's protocol. Discussion and conclusion: Most of the patients who have got treatment at The Tawanchai Center lived in central and northern Northeast Thailand: most lived in Khon Kaen province. More of the patients tended to get surgery on time, according to the establishment of The Tawanchai Center's interdisciplinary protocol for cleft lip and cleft palate care; however some were still getting the surgery late. The GIS data was very useful for the Cleft Center for planning outreach, community-based interdisciplinary treatment, referrals, preparing a schedule for follow-up and follow-on treatments; thus, improving care for the patients with cleft lip/palate.

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Objectives To report the treatment expenses of the congenital malformations of craniofacial of in... more Objectives To report the treatment expenses of the congenital malformations of craniofacial of in-patients of Srinagarind Hospital between 2010 and 2014 Material and Method The expenses of congenital malformations of craniofacial in-patients of Srinagarind Hospital were studied by analyzing the actual amount charged and the reimbursement of treatment expenses. Results One thousand eight hundred forty five in-patients were treated 2,144 times. The average treatment was about once or twice per person. Male patients were 54.1% and female were 45.9%. About 84% of the patients were under the universal coverage, with an average Relative Weight (RW) between 2010 and 2014 of 1.6988, 1.7059, 1.4847, 1.4165, and 1.5096, respectively. The average of the RW and the treatment expenses differentiated by the patients’ eligible medical expenses for self-paid, Government or State Enterprise Officer (OFC), Social Security Scheme (SSS), and universal coverage (UC) were 1.0398, 1.1596, 1.2759, 1.3477, ...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Background The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate h... more Background The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate has not been systematically assessed. Objective To assess the evidence in the literature for the prevalence of 22q11.2 deletion in patients who were presenting with isolated cleft palate. Material and Method A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion AND cleft palate. Results Of the six prospective studies reported, 328 patients with isolated cleft palate had been screened with FISH (Fluorescence In Situ Hybridization) test for 22q11.2 deletion. Among the 328 patients, there was one (0.3%) patient with positive FISH test for 22q11.2 deletion. This patient was clinically assessed and did not have an associated malformation or clinically recognized syndrome. Conclusion The prevalence of 22q11.2 deletion among patients with isolated cleft palate is rather low. Of more than 400 genetic disorde...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Background A birth prevalence of chromosome 22q11.2 deletion syndrome among population-based repo... more Background A birth prevalence of chromosome 22q11.2 deletion syndrome among population-based reports has been documented to vary, however, a systematic assessment is lacking. Objective To assess the evidence in the literature for the birth prevalence of chromosome 22q11.2 deletion syndrome. Material and Method A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion and prevalence. Results Of the six studies reported, there were 156 patients with 22q11.2 deletion syndrome found in total study populations of 1,111,336 live births. According to countries, the birth prevalence of this deletion syndrome (95% confidence interval) from United States, Belgium, Sweden, United Kingdom, France, and Singapore were 1.68 (1.22-2.26), 1.56 (1.33-1.72), 1.36 (0.91-2.08), 1.30 (0.45-2.15), 1.03 (0.53-2.23), and 1.02 per 10,000 live births, respectively. Estimates of minimum prevalence rates on the basis of the pr...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2015

BACKGROUND Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incid... more BACKGROUND Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incidences in the Northeast of Thailand. These birth defects can affect patient's quality of life. CLP patients need crucial and long-term treatments by a multidisciplinary team starting from prenatal stage to late adulthood. Patients and their families should involve in their own care, and their care objectives should correspond with healthcare providers. Besides the clinical outcome of interdisciplinary team, key performance indicators (KPIs) need to be developed in the hospital service unit in order to improve quality of care and treatment outcomes. OBJECTIVE 1) to establish KPIs in hospital service units, and 2) to develop the information system to collect, analysis and improve the quality of CLP care. MATERIAL AND METHOD A nurse coordinator was appointed in the Tawanchai Center to coordinate care. The three periods were conducted for the nurse coordinator to work with nine service un...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014

The study ofcost management with regard to cleft lip patients under the Universal Health Coverage... more The study ofcost management with regard to cleft lip patients under the Universal Health Coverage Program at Tawanchai Cleft Center Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, was conducted in order to provide fundamental information for the administrative team on how best to administrate and manage the organization. To study the cost management of cleft lip patients under the Universal Health Coverage Program. To compare individual patient management costs and costs from the National Health Security Office (NHSO), and to offer proper guidelines for cost management to the organization. The study was performed retrospectively. The data were collected by reviewing secondary sources of information from patients with cleft lips who consistently underwent treatment at Tawanchai Cleft Center. As for the provider prospects, the cost management did not address the other expenses. The study analyzed the comparison between cost management and income from the Universal Hea...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014

To determine the levels of dental caries, periodontal disease and oral health-related quality of ... more To determine the levels of dental caries, periodontal disease and oral health-related quality of life in children with cleft lip and/or cleft palate compared to non-cleft controls. This cross-sectional study was conducted in Khon Kaen, Thailand. Subjects included 68 oral cleft and 118 non-cleft individuals aged 10-14 years, who were interviewed using the Child-Oral Impacts on Daily Pemformance (Child-OIDP) index and received oral examinations. Decayed, missing and filled teeth (DMFT) index in permanent teeth, plaque index (PI), and gingival index (GI) scores were significantly higher in the children with cleft than in the controls. However, there was no significant difference in caries prevalence and decayed, missing and filled teeth (dmnft) index inprimaly teeth between comparison groups. The prevalence of oral impacts on Speaking and Smiling was significantly higher in the cleft children than non-cleft controls. The mean impact score between both groups were not significantly diff...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for the management of patients with fronto-ethmoidal meningoencephalocele (FEEM) i... more The challenges for the management of patients with fronto-ethmoidal meningoencephalocele (FEEM) include: classification, assessment and analysis of the deformities, craniofacial reconstruction and long-term management. To present experience of the Tawanchai Craniofacial Center of long-term integrated management and outcome of patients with FEEM. Medical records were reviewed of 32 patients with FEEM treated by the authors between 1993 and 2011 at the Tawanchai Center, Srinagarind Hospital; the referral center for Northeast Thailand. Geographic Information System (GIS) analysis was used to examine the incidence and pattern of referrals to our Center. Most of the patients had the nasoethmoidal type (12 patients) followed by the combined naso-ethmoidal/-orbital type (8 patients). The surgical procedures included craniofacial reconstruction with medial canthopexy, orbital translocation, external repair and nasal reconstruction. Ultimately, most patients were satisfied with their remedie...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for the management of Pierre Robin Sequence (PRS) are the evaluation and managemen... more The challenges for the management of Pierre Robin Sequence (PRS) are the evaluation and management of airway and feeding difficulty from glossoptosis and associated cleft palate. To present the clinical findings, management, outcome and the role of early distraction osteogenesis in patients with PRS. The medical records were reviewed of patients with PRS seen and managed by the authors at Srinagarind Hospital, Khon Kaen University between 2001 and 2011. Fifteen patients with PRS were seen and managed. The female-to male ratio was 1.8 to 1 (9 girls, 5 boys). All of the patients presented with a small mandible, retrodisplaced tongue and upper airway difficulty. One patient had cleft lip only and one patient had cleft lip with cleft palate. Patients were primarily from the provinces of Khon Kaen and Mahasarakham. Conservative management was successful in 12 patients while the 3 with tracheostomy required distraction osteogenesis and the tracheostomy was subsequently successfully decanu...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for management of Treacher Collins Syndrome (TCS) are the analysis of deformities ... more The challenges for management of Treacher Collins Syndrome (TCS) are the analysis of deformities and staged soft tissue and bony reconstruction. To present clinical and radiologic findings, the evaluation methods and the concept of staged reconstruction for patients with TCS. The authors reviewed the clinical and radiologic findings, the evaluation methods, the staged reconstruction and early surgical outcome of three patients with TCS treated at Srinagarind Hospital, between 1994 and One patient underwent evaluation by CT scan for planning, reconstruction of the zygoma and orbit, correction of the lower eyelid coloboma, bilateral staged ear reconstruction with costal cartilage. At the age of 8 years, he had acceptable initial outcome with planned middle ear management and staged facial reconstruction. Palatoplasties of a cleft palate were performed in two patients, TCS is a rare craniofacial deformity but poses challenges in evaluation, management and reconstructive surgery. The de...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2010

Review the clinical presentation and treatment of buccal carcinoma and compare it to the results ... more Review the clinical presentation and treatment of buccal carcinoma and compare it to the results of treatment as per survival rate. The authors reviewed the medical records of newly diagnosed seen between 1995 and 2005 at the Division of Plastic Surgery and the Department of Radiotherapy, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University Patients previously treated elsewhere or those whose lesions secondarily involved the buccal mucosa were excluded. The authors reviewed the medical records of 107 buccal carcinoma patients (94 females and 13 males) averaging 67 years of age. The 5-year survival rates of patients with Stage I (5.6%), 11 (6.5%), III (12.1%), and IVa (75.7%) were 67%, 43%, 47%, and 26%, respectively. A combined modality treatment (surgery and radiation or chemotherapy) was used to treat the advanced stage (III and IV) patients. The rate of incomplete therapy was high (47.78%). In the group that completed the protocol (i.e., neoadjuvant, surgery, and post ...

PubMed, Oct 1, 2014

Background: The study ofcost management with regard to cleft lip patients under the Universal Hea... more Background: The study ofcost management with regard to cleft lip patients under the Universal Health Coverage Program at Tawanchai Cleft Center Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, was conducted in order to provide fundamental information for the administrative team on how best to administrate and manage the organization. Objective: To study the cost management of cleft lip patients under the Universal Health Coverage Program. To compare individual patient management costs and costs from the National Health Security Office (NHSO), and to offer proper guidelines for cost management to the organization. Material and method: The study was performed retrospectively. The data were collected by reviewing secondary sources of information from patients with cleft lips who consistently underwent treatment at Tawanchai Cleft Center. As for the provider prospects, the cost management did not address the other expenses. The study analyzed the comparison between cost management and income from the Universal Health Coverage Program, which it receivedfrom the National Health Security Office (NHSO). The study was conducted over 2 years (October 1, 2010 to 30 September, 2013). There were 21patients in this study. Microsoft excel was the instrument used to calculate the cost ofmanagement. Results: (1) Total costs were lower than real payments because this cost did not take into account the total cost of the operation room, patient room, common bed, and costs of the medical equipment. Moreover the information regarding the building's price and the facility were not clear enough. The database of materials and equipment was also not yet complete. (2) The average cost ofpatient management was 12,025.14 Bahtperperson, but the compensation receivedfrom the National Health Security Office (NHSO) averaged 10,527.63 Bahtperperson, which was 87.55% ofthe total cost management. The department with the largest expenses was Anesthesia (36.42%). Conclusion: This study indicated that the cost of patient management is lower than usual due to the lack of clear cost information. The cost of medical care, which was received from the National Health Security Office (NHSO), was only 87.55%; the department with the highest costs was Anesthesia (36.42%).

Journal of the Medical Association of Thailand, Jun 1, 2019

Journal of the Medical Association of Thailand, May 1, 2018

Journal of the Medical Association of Thailand, May 1, 2018

Journal of the Medical Association of Thailand, Jun 1, 2019

PubMed, Aug 1, 2016

Objectives: To report the treatment expenses of the congenital malformations of craniofacial of i... more Objectives: To report the treatment expenses of the congenital malformations of craniofacial of in-patients of Srinagarind Hospital between 2010 and 2014 Material and method: The expenses of congenital malformations of craniofacial in-patients of Srinagarind Hospital were studied by analyzing the actual amount charged and the reimbursement of treatment expenses. Results: One thousand eight hundred forty five in-patients were treated 2,144 times. The average treatment was about once or twice per person. Male patients were 54.1% and female were 45.9%. About 84% of the patients were under the universal coverage, with an average Relative Weight (RW) between 2010 and 2014 of 1.6988, 1.7059, 1.4847, 1.4165, and 1.5096, respectively. The average of the RW and the treatment expenses differentiated by the patients’ eligible medical expenses for self-paid, Government or State Enterprise Officer (OFC), Social Security Scheme (SSS), and universal coverage (UC) were 1.0398, 1.1596, 1.2759, 1.3477, respectively. The average RW calculated under diagnosis-related group (DRG) for each patient was 1.3148. The estimated RW of OFC at 13,378 and UC at 9,600 baht per RW were 18,081, 14,535, 14,259, and 17,118 baht, for an average of 16,842 baht. The average of the treatment expenses charged by the hospital to the OFC was 14,535 baht and to the UC was 17,118 baht for each treatment. The treatment expense under DRG was lower than the cost under the hospital charge by 2,051,072 baht. Conclusion: The present study analyzed the treatment expense by patients’ eligible medical expenses between 2010 and 2014. The universal coverage and government or state enterprise officer’s charges were reimbursed to the hospital under DRG system for 32,257,000 baht while the hospitals actual charges were 34,308,072 baht. This indicated that Srinagarind Hospital must set up the fund to support congenital malformations of craniofacial patients for a minimum sum of 410,214 baht per year. This is likely to increase in the future.

PubMed, Aug 1, 2015

Background: Cleft lips and cleft palates have the most incidences in the Northeast of Thailand (2... more Background: Cleft lips and cleft palates have the most incidences in the Northeast of Thailand (2.49/1,000 newborns). Cleft lips and cleft palates (CLP) can affect patients and families both physically and mentally. It takes critical long-term medical treatment starting when prenatal, newborn, and fully grown until 19 years old by a multidisciplinary team; therefore, it was effective to have collaboration with patients, families, and a multidisciplinary team in order to build up the same objective and create key performance index to monitor the treatment outcome also to develop the quality of care. Objective: 1) to create the key performance index and 2) to develop the index system by using information technology. Material and method: After the research received ethics approval from Khon Kaen University, qualitative and quantitative data were collected. There were two periods in this study. The 1st period as following list below: 1) Field research was performed by conference meetings and problem-learning process, which participants participated in each step. There were two example groups: (1) Patients and families cooperated 2 times and (2) Nursing care cooperated 4 times in October-December 2013 (3) Combining the conclusions to set the key performance index and develop the index system in January-February 2014 (4) Recording the system in March-June 2014. Content analysis and percentage were used in this study. Results: Nine organizations were engaged in this study; eight key performance indexes were established and the research recorded continuously for 4 months. There were three key performance indexes, which performed successfully: 1) Patients/caregivers received follow-up treatment continuously, 92.06%, 2) Patients/caregivers reported 89.69% satisfaction after asking the information, 3) Patients/families reported overall satisfaction of 92.11%. Conclusion: It is shown that recording the key performance index for the 1st period covered every quality of care. The Tawanchai Center and Out-patient Surgical Room under Srinagarind Hospital applied eight key performance indexes and found that three key performance indexes were feasibly implemented. For the 2nd period, the 1st outcome of key performance indices will be analyzed and developed including improving the software in order to record data and analyze the percentages automatically.

PubMed, Aug 1, 2016

Background: The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate ... more Background: The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate has not been systematically assessed. Objective: To assess the evidence in the literature for the prevalence of 22q11.2 deletion in patients who were presenting with isolated cleft palate. Material and method: A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion AND cleft palate. Results: Of the six prospective studies reported, 328 patients with isolated cleft palate had been screened with FISH (Fluorescence In Situ Hybridization) test for 22q11.2 deletion. Among the 328 patients, there was one (0.3%) patient with positive FISH test for 22q11.2 deletion. This patient was clinically assessed and did not have an associated malformation or clinically recognized syndrome. Conclusion: The prevalence of 22q11.2 deletion among patients with isolated cleft palate is rather low. Of more than 400 genetic disorders involving occurrences of isolated cleft palate, FISH testing for 22q11.2 deletion in a patient with isolated cleft palate is recommended on clinical suspicion of additional clinical presentations of 22q11.2 deletion syndrome such as conotruncal congenital heart diseases, dysmorphic facies, velopharyngeal insufficiencies, immune deficiencies, hypoparathyroidisms, and neuropsychiatric disorders.

PubMed, Oct 1, 2010

Objective: To use a Geographic Information System (GIS) approach to study the distribution and st... more Objective: To use a Geographic Information System (GIS) approach to study the distribution and statistics of patients with cleft lip/palate in Thailand's Northeast region who get treatment at Srinagarind Hospital, Khon Kaen University. Material and method: Using a GIS approach, the researchers reviewed every case with cleft lip/palate treated at Srinagarind Hospital between 1984 and 2007 to study the distribution of cleft lip/palate in Northeast Thailand. Results: Of the 1,950 patients, there were more male patients (56.3%) with cleft lip/palate than females (43.7%). One-third (31.8%) of the patients had cleft lip only, while 22.5% had cleft palate only and 45.7% had both cleft lip and cleft palate. Most of the patients (55.1%) lived in Khon Kaen, 24.9% in Mahasarakam and 16.9% in Kalasin provinces. Since 2002, more patients have had surgical treatment at the ages and intervals recommended by our centre's protocol. Discussion and conclusion: Most of the patients who have got treatment at The Tawanchai Center lived in central and northern Northeast Thailand: most lived in Khon Kaen province. More of the patients tended to get surgery on time, according to the establishment of The Tawanchai Center's interdisciplinary protocol for cleft lip and cleft palate care; however some were still getting the surgery late. The GIS data was very useful for the Cleft Center for planning outreach, community-based interdisciplinary treatment, referrals, preparing a schedule for follow-up and follow-on treatments; thus, improving care for the patients with cleft lip/palate.

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Objectives To report the treatment expenses of the congenital malformations of craniofacial of in... more Objectives To report the treatment expenses of the congenital malformations of craniofacial of in-patients of Srinagarind Hospital between 2010 and 2014 Material and Method The expenses of congenital malformations of craniofacial in-patients of Srinagarind Hospital were studied by analyzing the actual amount charged and the reimbursement of treatment expenses. Results One thousand eight hundred forty five in-patients were treated 2,144 times. The average treatment was about once or twice per person. Male patients were 54.1% and female were 45.9%. About 84% of the patients were under the universal coverage, with an average Relative Weight (RW) between 2010 and 2014 of 1.6988, 1.7059, 1.4847, 1.4165, and 1.5096, respectively. The average of the RW and the treatment expenses differentiated by the patients’ eligible medical expenses for self-paid, Government or State Enterprise Officer (OFC), Social Security Scheme (SSS), and universal coverage (UC) were 1.0398, 1.1596, 1.2759, 1.3477, ...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Background The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate h... more Background The prevalence of 22q11.2 deletion in patients presenting with isolated cleft palate has not been systematically assessed. Objective To assess the evidence in the literature for the prevalence of 22q11.2 deletion in patients who were presenting with isolated cleft palate. Material and Method A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion AND cleft palate. Results Of the six prospective studies reported, 328 patients with isolated cleft palate had been screened with FISH (Fluorescence In Situ Hybridization) test for 22q11.2 deletion. Among the 328 patients, there was one (0.3%) patient with positive FISH test for 22q11.2 deletion. This patient was clinically assessed and did not have an associated malformation or clinically recognized syndrome. Conclusion The prevalence of 22q11.2 deletion among patients with isolated cleft palate is rather low. Of more than 400 genetic disorde...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2016

Background A birth prevalence of chromosome 22q11.2 deletion syndrome among population-based repo... more Background A birth prevalence of chromosome 22q11.2 deletion syndrome among population-based reports has been documented to vary, however, a systematic assessment is lacking. Objective To assess the evidence in the literature for the birth prevalence of chromosome 22q11.2 deletion syndrome. Material and Method A systematic literature search was conducted through PubMed between 1992 and June 2016 using search terms of 22q11.2 deletion OR 22q11 deletion and prevalence. Results Of the six studies reported, there were 156 patients with 22q11.2 deletion syndrome found in total study populations of 1,111,336 live births. According to countries, the birth prevalence of this deletion syndrome (95% confidence interval) from United States, Belgium, Sweden, United Kingdom, France, and Singapore were 1.68 (1.22-2.26), 1.56 (1.33-1.72), 1.36 (0.91-2.08), 1.30 (0.45-2.15), 1.03 (0.53-2.23), and 1.02 per 10,000 live births, respectively. Estimates of minimum prevalence rates on the basis of the pr...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2015

BACKGROUND Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incid... more BACKGROUND Congenital deformities, such as cleft lips and/or cleft palates (CLP), have high incidences in the Northeast of Thailand. These birth defects can affect patient's quality of life. CLP patients need crucial and long-term treatments by a multidisciplinary team starting from prenatal stage to late adulthood. Patients and their families should involve in their own care, and their care objectives should correspond with healthcare providers. Besides the clinical outcome of interdisciplinary team, key performance indicators (KPIs) need to be developed in the hospital service unit in order to improve quality of care and treatment outcomes. OBJECTIVE 1) to establish KPIs in hospital service units, and 2) to develop the information system to collect, analysis and improve the quality of CLP care. MATERIAL AND METHOD A nurse coordinator was appointed in the Tawanchai Center to coordinate care. The three periods were conducted for the nurse coordinator to work with nine service un...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014

The study ofcost management with regard to cleft lip patients under the Universal Health Coverage... more The study ofcost management with regard to cleft lip patients under the Universal Health Coverage Program at Tawanchai Cleft Center Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, was conducted in order to provide fundamental information for the administrative team on how best to administrate and manage the organization. To study the cost management of cleft lip patients under the Universal Health Coverage Program. To compare individual patient management costs and costs from the National Health Security Office (NHSO), and to offer proper guidelines for cost management to the organization. The study was performed retrospectively. The data were collected by reviewing secondary sources of information from patients with cleft lips who consistently underwent treatment at Tawanchai Cleft Center. As for the provider prospects, the cost management did not address the other expenses. The study analyzed the comparison between cost management and income from the Universal Hea...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014

To determine the levels of dental caries, periodontal disease and oral health-related quality of ... more To determine the levels of dental caries, periodontal disease and oral health-related quality of life in children with cleft lip and/or cleft palate compared to non-cleft controls. This cross-sectional study was conducted in Khon Kaen, Thailand. Subjects included 68 oral cleft and 118 non-cleft individuals aged 10-14 years, who were interviewed using the Child-Oral Impacts on Daily Pemformance (Child-OIDP) index and received oral examinations. Decayed, missing and filled teeth (DMFT) index in permanent teeth, plaque index (PI), and gingival index (GI) scores were significantly higher in the children with cleft than in the controls. However, there was no significant difference in caries prevalence and decayed, missing and filled teeth (dmnft) index inprimaly teeth between comparison groups. The prevalence of oral impacts on Speaking and Smiling was significantly higher in the cleft children than non-cleft controls. The mean impact score between both groups were not significantly diff...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for the management of patients with fronto-ethmoidal meningoencephalocele (FEEM) i... more The challenges for the management of patients with fronto-ethmoidal meningoencephalocele (FEEM) include: classification, assessment and analysis of the deformities, craniofacial reconstruction and long-term management. To present experience of the Tawanchai Craniofacial Center of long-term integrated management and outcome of patients with FEEM. Medical records were reviewed of 32 patients with FEEM treated by the authors between 1993 and 2011 at the Tawanchai Center, Srinagarind Hospital; the referral center for Northeast Thailand. Geographic Information System (GIS) analysis was used to examine the incidence and pattern of referrals to our Center. Most of the patients had the nasoethmoidal type (12 patients) followed by the combined naso-ethmoidal/-orbital type (8 patients). The surgical procedures included craniofacial reconstruction with medial canthopexy, orbital translocation, external repair and nasal reconstruction. Ultimately, most patients were satisfied with their remedie...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for the management of Pierre Robin Sequence (PRS) are the evaluation and managemen... more The challenges for the management of Pierre Robin Sequence (PRS) are the evaluation and management of airway and feeding difficulty from glossoptosis and associated cleft palate. To present the clinical findings, management, outcome and the role of early distraction osteogenesis in patients with PRS. The medical records were reviewed of patients with PRS seen and managed by the authors at Srinagarind Hospital, Khon Kaen University between 2001 and 2011. Fifteen patients with PRS were seen and managed. The female-to male ratio was 1.8 to 1 (9 girls, 5 boys). All of the patients presented with a small mandible, retrodisplaced tongue and upper airway difficulty. One patient had cleft lip only and one patient had cleft lip with cleft palate. Patients were primarily from the provinces of Khon Kaen and Mahasarakham. Conservative management was successful in 12 patients while the 3 with tracheostomy required distraction osteogenesis and the tracheostomy was subsequently successfully decanu...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The challenges for management of Treacher Collins Syndrome (TCS) are the analysis of deformities ... more The challenges for management of Treacher Collins Syndrome (TCS) are the analysis of deformities and staged soft tissue and bony reconstruction. To present clinical and radiologic findings, the evaluation methods and the concept of staged reconstruction for patients with TCS. The authors reviewed the clinical and radiologic findings, the evaluation methods, the staged reconstruction and early surgical outcome of three patients with TCS treated at Srinagarind Hospital, between 1994 and One patient underwent evaluation by CT scan for planning, reconstruction of the zygoma and orbit, correction of the lower eyelid coloboma, bilateral staged ear reconstruction with costal cartilage. At the age of 8 years, he had acceptable initial outcome with planned middle ear management and staged facial reconstruction. Palatoplasties of a cleft palate were performed in two patients, TCS is a rare craniofacial deformity but poses challenges in evaluation, management and reconstructive surgery. The de...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2010

Review the clinical presentation and treatment of buccal carcinoma and compare it to the results ... more Review the clinical presentation and treatment of buccal carcinoma and compare it to the results of treatment as per survival rate. The authors reviewed the medical records of newly diagnosed seen between 1995 and 2005 at the Division of Plastic Surgery and the Department of Radiotherapy, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University Patients previously treated elsewhere or those whose lesions secondarily involved the buccal mucosa were excluded. The authors reviewed the medical records of 107 buccal carcinoma patients (94 females and 13 males) averaging 67 years of age. The 5-year survival rates of patients with Stage I (5.6%), 11 (6.5%), III (12.1%), and IVa (75.7%) were 67%, 43%, 47%, and 26%, respectively. A combined modality treatment (surgery and radiation or chemotherapy) was used to treat the advanced stage (III and IV) patients. The rate of incomplete therapy was high (47.78%). In the group that completed the protocol (i.e., neoadjuvant, surgery, and post ...

PubMed, Oct 1, 2014

Background: The study ofcost management with regard to cleft lip patients under the Universal Hea... more Background: The study ofcost management with regard to cleft lip patients under the Universal Health Coverage Program at Tawanchai Cleft Center Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, was conducted in order to provide fundamental information for the administrative team on how best to administrate and manage the organization. Objective: To study the cost management of cleft lip patients under the Universal Health Coverage Program. To compare individual patient management costs and costs from the National Health Security Office (NHSO), and to offer proper guidelines for cost management to the organization. Material and method: The study was performed retrospectively. The data were collected by reviewing secondary sources of information from patients with cleft lips who consistently underwent treatment at Tawanchai Cleft Center. As for the provider prospects, the cost management did not address the other expenses. The study analyzed the comparison between cost management and income from the Universal Health Coverage Program, which it receivedfrom the National Health Security Office (NHSO). The study was conducted over 2 years (October 1, 2010 to 30 September, 2013). There were 21patients in this study. Microsoft excel was the instrument used to calculate the cost ofmanagement. Results: (1) Total costs were lower than real payments because this cost did not take into account the total cost of the operation room, patient room, common bed, and costs of the medical equipment. Moreover the information regarding the building's price and the facility were not clear enough. The database of materials and equipment was also not yet complete. (2) The average cost ofpatient management was 12,025.14 Bahtperperson, but the compensation receivedfrom the National Health Security Office (NHSO) averaged 10,527.63 Bahtperperson, which was 87.55% ofthe total cost management. The department with the largest expenses was Anesthesia (36.42%). Conclusion: This study indicated that the cost of patient management is lower than usual due to the lack of clear cost information. The cost of medical care, which was received from the National Health Security Office (NHSO), was only 87.55%; the department with the highest costs was Anesthesia (36.42%).

Journal of the Medical Association of Thailand, Jun 1, 2019

Journal of the Medical Association of Thailand, May 1, 2018

Journal of the Medical Association of Thailand, May 1, 2018