Health Research in Thailand:A Gap Analysis
Krit Pongpirul, MD.International Health Policy Program (IHPP-Thailand)
Outlines for Gap Analysis
Trend (2544 vs 2546) Global Situations National Agencies Observations Proposals
Trend (2544 vs 2546)
2544 vs 2546
24%
53%
18%
5%
Diseases of the Organs Health Problems
Enabling Mechanisms others
12%
53%
27%
8%
Global Situations
Global Situations
Methodology Medline Search using Medical Subject Headings
(MeSH) on July 5th, 2005 Comments from today’s expert panel
Medical Subject Headings (MeSH)
MeSH is the system designed and used by the National Library of Medicine (NLM) for assigning subject headings to books and journals articles in the medical sciences.
MeSH Tree Structure 11. Anatomy [A] 2. Organisms [B] 3. Diseases [C] 4. Chemicals and Drugs [D] 5. Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] 6. Psychiatry and Psychology [F] 7. Biological Sciences [G] 8. Physical Sciences [H] 9. Anthropology, Education, Sociology and Social Phenomena [I] 10. Technology and Food and Beverages [J] 11. Humanities [K] 12. Information Science [L] 13. Persons [M] 14. Health Care [N] 15. Geographic Locations [Z]
MeSH Tree Structure 2 Diseases [C]
Bacterial Infections and Mycoses [C01]+ Virus Diseases [C02]+ Parasitic Diseases [C03]+ Neoplasms [C04]+ Musculoskeletal Diseases [C05]+ Digestive System Diseases [C06]+ Stomatognathic Diseases [C07]+ Respiratory Tract Diseases [C08]+ Otorhinolaryngologic Diseases [C09]+ Nervous System Diseases [C10]+ Eye Diseases [C11]+ Urologic and Male Genital Diseases [C12]+ Female Genital Diseases and Pregnancy Complications [C13]+ …
MeSH Tree Structure 3
Health Care [N] Population Characteristics [N01]+ Health Care Facilities, Manpower, and Services [N02]+ Health Care Economics and Organizations [N03] + Health Services Administration [N04]+ Health Care Quality, Access, and Evaluation [N05]+
Thai vs Global
13%
57%
30%
Diseases of the Organs Health Problems
Enabling Mechanisms
32%
49%
19%
Kendall’s tau-b = -0.19 (p=0.04); Spearman’s rho = -0.31 (p=0.02)
1.Diseases of the OrgansNo MeSH MeSHTotal MeSH% Mrank Total46 Total46% Trank
1 Reference Values / Biomedical Research
126,795 1.61 16 33 8.38 4
2 Cardiovascular Diseases 1,184,425 14.99 2 28 7.11 53 Respiratory Tract Diseases 654,963 8.29 4 17 4.31 104 Liver Diseases 272,577 3.45 13 3 0.76 175 Kidney Diseases / Sudden Death 290,836 3.68 11 15 3.81 116 Gastrointestinal Diseases 470,618 5.96 7 8 2.03 147 Skin Diseases 505,506 6.40 6 7 1.78 168 Nervous System Diseases 1,255,508 15.89 1 24 6.09 79 Endocrine System Diseases 468,234 5.93 8 19 4.82 8
10 Hematologic Diseases 303,332 3.84 10 12 3.05 1311 Musculoskeletal Diseases 521,780 6.61 5 38 9.64 312 Otorhinolaryngologic Diseases 192,223 2.43 14 18 4.57 913 Eye Diseases 283,599 3.59 12 25 6.35 614 Mouth Diseases 158,027 2.00 15 83 21.07 115 Immune System Diseases 798,386 10.11 3 14 3.55 1216 Urinary Tract Diseases 402,453 5.09 9 8 2.03 1517 Anesthesiology 10,495 0.13 17 42 10.66 2
Kendall’s tau-b = -0.039 (p=0.820); Spearman’s rho = -0.036 (p=0.887)
1.Diseases of the Organs
12
3
4
5
6
7
89
10
11
12
13
14
15
16
17
0
2
4
6
8
10
12
14
16
18
0 2 4 6 8 10 12 14 16 18
Global Ranks
Thai
Ran
ks
Kendall’s tau-b = -0.039 (p=0.820); Spearman’s rho = -0.036 (p=0.887)
1.Diseases of the Organs
Thai Mouth Diseases Anesthesiology Musculoskeletal Diseases Reference Values /
Biomedical Research Cardiovascular Diseases Eye Diseases Nervous System Diseases Endocrine System Diseases
Global Nervous System Diseases Cardiovascular Diseases Immune System Diseases Respiratory Tract Diseases Musculoskeletal Diseases Skin Diseases Gastrointestinal Diseases Endocrine System Diseases
2.Health ProblemsNo MeSH MeSHTotal MeSH% Mrank Total46 Total46% Trank
1 Epidemiology 8,731 0.26 21 58 3.26 92 Hereditary Diseases 313,908 9.40 3 6 0.34 243 Communicable Diseases 9,628 0.29 19 114 6.41 54 Chronic Diseases 152,511 4.57 5 11 0.62 235 Accidents 78,914 2.36 9 23 1.29 196 Neoplasms 1,582,694 47.41 1 38 2.14 147 Environmental Health 13,875 0.42 16 53 2.98 118 Nutrition 154,431 4.63 4 84 4.72 79 Reproductive Health 1,582 0.05 25 55 3.09 10
10 Mental Health 8,672 0.26 22 113 6.36 611 Technology Assessment 6,114 0.18 24 24 1.35 18
12 Radiology 391,948 11.74 2 38 2.14 1513 Traditional Medicine 14,177 0.42 15 278 15.64 215 Rehabilitation 149,452 4.48 6 18 1.01 2016 Pharmacology 19,500 0.58 12 180 10.12 317 Diagnostic Reagent Kits 12,072 0.36 18 172 9.67 418 Drug Control 9,108 0.27 20 59 3.32 819 Forensic Medicine 60,574 1.81 10 3 0.17 2520 Molecular Biology 16,121 0.48 14 282 15.86 121 Human Genome 6946 0 23 25 1.4060742 1722 Primary Health Care 40179 1 11 12 0.6749156 2223 HIV 112185 3 8 40 2.2497188 1324 Thalassemia 13044 0 17 14 0.7874016 2125 Substance-Related Disorders 144670 4 7 43 2.4184477 1226 Occupational Medicine 16987 1 13 35 1.9685039 16
Kendall’s tau-b = -0.197 (p=0.168); Spearman’s rho = -0.349 (p=0.087)
2.Health Problems
1
2
3
4
5
6
7
8
9
10
11
12
13
15
16 17
18
19
20
21
22
23
24
25
26
0
2
4
6
8
10
12
14
16
18
20
22
24
26
0 2 4 6 8 10 12 14 16 18 20 22 24 26
Global Ranks
Thai
Ran
ks
Kendall’s tau-b = -0.197 (p=0.168); Spearman’s rho = -0.349 (p=0.087)
2.Health ProblemsThai Molecular Biology Traditional Medicine Pharmacology Diagnostic Reagent Kits Communicable Diseases Mental Health Nutrition Drug Control Epidemiology Reproductive Health Environmental Health Substance-Related Disorders HIV
Global Neoplasms Radiology Hereditary Diseases Nutrition Chronic Diseases Rehabilitation Substance-Related Disorders HIV Accidents Forensic Medicine Primary Health Care Pharmacology Occupational Medicine
3.Enabling Mechanisms
No MeSH MeSHTotal MeSH% Mrank Total46 Total46% Trank1 Health Policy 44,477 0.92 11 10 1.09 92 Health Services 949,351 19.56 2 14 1.53 83 Health Facilities / Health
Manpower / Health Personnel 636,212 13.10 3 166 18.12 3
4 Medical Education 80,125 1.65 9 2 0.22 125 Health Economics 334,147 6.88 4 38 4.15 56 Behavioral Sciences / Health Promotion 158,019 3.25 5 274 29.91 1
7 Medical Informatics 107,577 2.22 7 20 2.18 68 International Health Problems 12,389 0.26 12 1 0.11 139 Ethical Issues 96,121 1.98 8 8 0.87 10
10 Legislation 47,917 0.99 10 5 0.55 1112 Healthcare Quality Assessment 137,306 2.83 6 215 23.47 213 Total Quality Management 7,595 0.16 13 149 16.27 414 Health Care Evaluation
Mechanisms 2,243,501 46.21 1 14 1.53 7
Kendall’s tau-b = 0.297 (p=0.160); Spearman’s rho = 0.432 (p=0.141)
3.Enabling Mechanisms
12
3
4
5
6
7
8
910
12
13
14
0
2
4
6
8
10
12
14
0 2 4 6 8 10 12 14
Global Ranks
Thai
Ran
ks
Kendall’s tau-b = 0.297 (p=0.160); Spearman’s rho = 0.432 (p=0.141)
3.Enabling Mechanisms
Thai Behavioral Sciences / Health
Promotion Healthcare Quality
Assessment Health Facilities / Health
Manpower / Health Personnel Total Quality Management Health Economics Medical Informatics Health Care Evaluation
Mechanisms
Global Health Care Evaluation
Mechanisms Health Services Health Facilities / Health
Manpower / Health Personnel Health Economics Behavioral Sciences / Health
Promotion Healthcare Quality
Assessment Medical Informatics
National Agencies
National Agencies
Sources Priority setting report to NRC & NHF Feedback from expert panel in September 2004 Academic institutions were not included
Agencies National Research Council (NRC) Thailand Research Fund (TRF) Health Systems Research Institute (HSRI) National Center for Genetic Engineering and Biotechnology
(Biotec) Ministry of Public Health (MOPH)
Diseases of the OrgansRank
MeSH NRC TRF HSRI Biotec
MOPH
1 Mouth Diseases
2 Anesthesiology
3 Musculoskeletal Diseases
4 Reference Values / Biomedical Research
5 Cardiovascular Diseases X
6 Eye Diseases
7 Nervous System Diseases X
8 Endocrine System Diseases
9 Otorhinolaryngologic Diseases
10 Respiratory Tract Diseases
11 Kidney Diseases / Sudden Death
12 Immune System Diseases
13 Hematologic Diseases
14 Gastrointestinal Diseases
15 Urinary Tract Diseases
16 Skin Diseases
17 Liver Diseases
Health Problems 1
Rank MeSH NRC TRF HSRI Biotec
MOPH
1 Molecular Biology X
2 Traditional Medicine X X X
3 Pharmacology X
4 Diagnostic Reagent Kits X X
5 Communicable Diseases X X X
6 Mental Health
7 Nutrition
8 Drug Control X X
9 Epidemiology
10 Reproductive Health
11 Environmental Health
12 Substance-Related Disorders
13 HIV X X
Health Problems 2
Rank MeSH NRC TRF HSRI Biotec
MOPH
14 Neoplasms X X
15 Radiology
16 Occupational Medicine X
17 Human Genome
18 Biomedical Technology Assessment X
19 Accidents X X
20 Rehabilitation
21 Thalassemia X X
22 Primary Health Care
23 Chronic Diseases
24 Hereditary Diseases X
25 Forensic Medicine
Enabling Mechanisms
Rank MeSH NRC TRF HSRI Biotec
MOPH
1 Behavioral Sciences / Health Promotion
2 Healthcare Quality Assessment
3 Health Facilities / Health Manpower / Health Personnel
X X
4 Total Quality Management
5 Health Economics
6 Medical Informatics X X
7 Health Care Evaluation Mechanisms
8 Health Services X X X X
9 Health Policy X X X
10 Ethical Issues
11 Legislation
12 Medical Education
13 International Health Problems
Observations
Wide & many gaps still exist Past & Present Global situation Thai situation
Limitations of quantitative approach No systematic research database
Proposals
Further qualitative approach MeSH-based research database Further inter-disciplinary collaboration