Health Information Systems of Thailand

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Health Information Systems of Thailand

• Pathom Sawanpanyalert, MD, DrPH
• WHO Country Office for Thailand

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Outline of presentation

• Vital event registration
• Routine health service records
• Disease surveillance
• Periodic surveys
• Publications related to HIS
• Core health indicators

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Vital event registration

• Events birth, death, marriage, divorce, move-in
  and move-out of house
• Mandatory reporting to government officers at
  district levels
• Entered into the computerized civil registration
  database maintained by the Ministry of Interior
  (with computerized access from all districts)
• Constituting population database of Thailand
• Annual report on demographic profiles for general
  dissemination (print and internet-based)
• Ministry of Public Health used to carry out its
  own annual population surveys but no longer does
  so.

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Routine health service records (1)

• Records out-patient and in-patient services at
  public facilities, e.g. hospitals (private
  facilities do not usually report)
• Reporting from the facilities to the Department
  of Medical Services of the Ministry of Public
  Health (in collaboration with Bureau of Policy
  and Strategy of MOPH)
• Only data on in-patient services are routinely
  analyzed and disseminated
• No specific system for records of routine health
  service in private facilities

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Routine health service records (2)

• There are a few disease registries maintained by
  university hospitals (most of them are
  governmental) and some large MOPHs hospitals,
  e.g. tumor (cancer) registry, TB registry
• Efforts are being put into developing registries
  for certain chronic diseases, e.g. diabetes,
  hypertension
• Most of these registries are hospital-based and
  are not linked with each other. They are mainly
  used for patient care in hospitals clinics.

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Disease surveillance (1)

• Routine surveillance system
• Legally-required notifiable diseases/syndromes
  about 80, most of them are communicable
  diseases. However, poisoning and some
  occupational diseases are included.
• It forms part of the countrys outbreak alert and
  response system
• Routine (passive) reporting is mainly from
  governmental facilities, e.g. subdistrict health
  centers, district (community) hospitals,
  provincial hospitals, regional hospitals,
  university hospitals, hospitals under the Bangkok
  Metropolitan Administration (BMA), military
  hospitals, and other governmental hospitals

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Disease surveillance (2)

• Routine surveillance system (Cont.)
• Private facilities do not routinely report the
  diseases/syndromes
• Data are supposed to be used by frontline health
  officers for immediate actions (e.g. responses to
  outbreaks)
• Data are reported (paper reports or mailed-in
  computer files or internet-based) through the
  administrative channel to the Bureau of
  Epidemiology (BoE) of MOPH on a monthly basis.
• There are certain priority syndromes where
  immediate reporting is required, e.g. acute
  hemorrhagic fever, atypical pneumonia, severe
  diarrhea)

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Disease surveillance (3)

• Routine surveillance system (Cont.)
• Certain diseases have their own surveillance
  system, e.g. AFP surveillance as part of the
  global polio eradication, HIV/AIDS and associated
  risk behaviors
• BoE compiles the data on a weekly basis and
  publishes (as well as puts on the web) week
  epidemiological reports and annual
  epidemiological summaries.

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Disease surveillance (4)

• HIV Reporting and Surveillance
• There is a separate system for reporting HIV
  disease and AIDS cases (in adults and children)
  from all hospitals to BoE.
• Data are compiled, analyzed and disseminated on a
  yearly basis.
• BoE used to require reporting of asymptomatic HIV
  infections but no longer does so.

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Disease surveillance (5)

• HIV Reporting and Surveillance (Cont.)
• Sentinel surveillance of HIV serology among
  certain risk groups, e.g. sex workers, drug
  users, pregnant women, STI patients, military
  conscripts, has been implemented for many years.
• In the past, it is on a biannual basis.
  Currently, it is an annual surveillance.
• Governmental health facilities, e.g. provincial
  public health offices, in all provinces collect
  these data for their own use and also report to
  BoE.
• BoE does the national analysis and disseminates
  the data (in print or on the web) on an annual
  basis.

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Disease surveillance (6)

• HIV Reporting and Surveillance (Cont.)
• BoE also initiated behavioral surveillance of
  risk factors related to HIV/AIDS, e.g. visit to
  brothels, casual sex, injecting drug use, among
  certain risk groups, e.g. youths, students.
• The surveillance is carried out at the provincial
  level.
• The data are also compiled and analyzed as
  national aggregates by BoE and made available for
  uses by interested individuals or organizations.

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Periodic surveys (1)

• Population census and survey of demographic
  changes
• National Statistics Office (NSO) carries out the
  census every 10 years and the survey every 5
  years.
• Data are collected by NSO-employed personnel and
  analyzed and made available widely.

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Periodic surveys (2)

• Health and Welfare Surveys
• National Statistics Office (NSO) also carries out
  various other surveys including surveys on health
  conditions, illness episodes, health services
  utilizations, and health care expenditures at the
  household levels.
• The survey is conducted every 5 years.
• Data are collected by NSO-employed personnel and
  analyzed and made available widely.

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Periodic surveys (3)

• Health Interview Survey
• Initiated by the Bureau of Policy and Strategy of
  MOPH several years ago
• Was supposed to carried out at provincial levels
  every 2-3 years
• Mainly for use at provincial levels
• Discontinued shortly after its introduction

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Periodic surveys (4)

• National Health Examination Survey
• The Bureau of Policy and Strategy of MOPH
  initiated this survey about 6 years ago.
• It contracts certain organizations to carry out
  the work, e.g. HSRI (later transferring this work
  to Office of Health Examination Survey).
• The survey is intended to be every 3-5 years but
  is yet to be institutionalized.
• Efforts are being made to improve the
  instruments, e.g. questionnaire, checklist.

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Periodic surveys (5)

• National Health Examination Survey (Cont.)
• Various universities took part in data collection
  and data analysis in the latest survey.
• Laboratory tests were done at provincial
  hospitals.
• Specimens are currently stored at the National
  Institute of Health.
• A committee is set up to govern utilization of
  the store specimens.
• Reports and monograph series of the surveys are
  published.
• Databases of the surveys are made available for
  uses by interested individuals.

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Publications related to HIS

• Mostly available in print and on the web
• Annual reports by the Bureau of Policy and
  Strategy
• Annual report on Thailand Health Profile
  including data on health status, health
  expenditures, and health resources
• Weekly epidemiological reports and annual
  (epidemiological) summary
• Upcoming Health of Thai People (also in
  preparation for the Health Reform Act that
  demands annual reporting of health of the nation
  to National Health Assembly)

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Core Health Indicators

• Is a program coordinated by HSRI (Dr Pinij is the
  coordinator).
• Composed of several components.
• In collaboration with various partners
• Several concepts are being discussed, e.g.
  national vs country-level, indicators vs index
• To be elaborated by Dr Pinij