Thailand Country Report on

Quality of Dental services

Sutha Jienmaneechotchai DDS. MPH.

Director, Bureau of Dental Health, Dept. of Health

ASEAN Chief Dental Officers Meetings 27-28 August 2013

About Thailand

Quality of Dental Services

Patient safety, Effectiveness

Patient centeredness

Timeliness

Efficiency

Equity

About Thailand

Ethnic Groups

People and Society

Population67,448,120 (July 2013) Urbanization

urban population: 34.1% of total population (2011)

rate of urbanization: 1.6%

Life expectancy at birth:(2013)• total population: 74.05 years• male: 71.66 years• female: 76.58 years

Health expenditure3.9% of GDP(2010)

Physicians density:0.3 physicians/1,000 population (2004)Hospital bed density:2.1 beds/1,000 population (2010)

Source: https://www.cia.gov/library/publications/the-world-factbook/geos/th.html#People

Quality of Dental Services

Patient safety, Effectiveness

School of Dentistry

• Curriculum meets requirements

Dental Students

• Meet school Standards

Thai License Exam

part 1 Written Examination of Basic Biomedical Science

part 2 Written Examination of Clinical Science

part 3 Clinical examination

Input: Dental personnel

Dental Council School Dentistry

CDA-TDC

Dental Safety Goals and Guidelines 2010: Safety Communication, Treatment, Infectious control and Record

Process

Clinical practice Guidelines

Any kinds of Accreditation (HA, ISO, PSO)

Educate consumer

Output, outcome

Objective/KPI

Re accredit

Consumer protection

Record,report and survey

Quality of Dental Services

Patient centeredness

Patient centeredness

• Primary care unit in every sub-district

• Care provide by doctors from local

communities

• Dental Etiquettes

Quality of Dental Services

Timeliness

Not much has been done

Long waiting list

Long waiting time

No time point standard

Within the care units under universal coverage

Quality of Dental Services

Efficiency

Promote health

rather

than cure

• National level oral health promotion program

• Area based oral health promotion

Fully utilized of equipmen

t

Balance of cost

• Toothbrush’s Labeling (MR 2012)• DOH Tooth brush standard • TSI Committee for oral care product

• No sugar added in follow on formula milk (MR#26)• Ban carbonated drink sale in school Policy

• F in Drinking water (<0. 7mg/L)• F in Bottled Water (MR# 6)• F in Toothpaste ( < 1000 ppm )

• Dental Networks Against Tobacco • Smoking cessation in Dental Clinic

Oral Health Promotion: National Level :

NATIONAL

LEVEL

SUGAR CONTR

OL

TOBACCO

CONTROL

Law enforcement / Regulation / Policy / Standard set up

Fstandard

Oral Care Products

STRENGTHEN NETWORKWHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012

AREA BASE

A

D

B

C

E

Oral Health Promotion : Area base

Elderly

Mothers &Child• Dental Exam in ANC 77 %• Dental Exam in WCC 77 %• F varnish application 42%

Preschool/ Daycare

School Children

• Toothbrush after lunch 96%• Fissure sealant in 1st grade 22.5% • Comprehensive care• Schools Ban on sale of Carbonated drink 77 %

• Elderly Club 365 clubs/year• Dental Prostheses 30,000 /year• Preventive Clinic for the Elderly

Environment/ Community

• Surveillance for F in water in risk area cover 20 province • Dental Fluorosis mitigation project in 10 province

CAPACI TY BUI L DIN

G

STRENGTHEN

NETWORK

Tooth brushing after lunch No sweetened milk Safe sancks • Implement 96.5 %• Oral exam & treatment

WHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012

Source: Bureau of Dental Health, 1994-2012

Result of Oral Health Promotion Program

1994 2001 2007 20120

10

20

30

40

50

60

70 66.5 66.161.4

51.753.9

57.3

56.9

52.3

3 year old12 year old

Year

Dental Caries Prevalence in Thai children (1994-2007)

Quality of Dental Services

Equity

Equity

20

Percentage of the Thai with health insurance, 2003 and 2011

2003 2011

Social security schemeCivil service welfareUniversal coverage Other schemesNo insurance

Service Utilization of Thai People in 2011

Dental service utilization rate in Thai people increased (7.4 % in 2006 to 9.3 % in 2011)

7.48.4

9.1 9.3

0

2

4

6

8

10

2.3

11 11.19.5

7.6

02468

1012 •The highest utilization rate

were 5-14 and 15-24 yrs each group at 11 %

•The lowest utilization rate was 0-4 years at 2.3 %

Dental service utilization rate (2006-2011)

2011 Service utilization in 12 m, distributed by age

2006 2007 2008 2009

0-4 5-14 15-24 25-59 60+ Source: National Statistic Office, 2011

In 2011

WHO Regional Consultation on Oral health strategy, Kathmandu, Nepal 28-29 November 2012

Promote health rather than cure Nation

al Health

Act

National Health Act 2007

• Efficient use of resources by good administrative and management practices.

People should be the part of the ownership

• People have the right to choose their health services

expenditure and equity of access to the same quality of health

• An equal sharing of  health care services

Health

Health Act, 2007Healthy Public Policy, people

participation

Health Promotion Foundation Act, 2001

Support health promotion action

Health Security Act 2002Health care reform

• Equity• Efficiency• Quality

• Health behavior• Health belief

• Socio-economic• Culture• Community / family

pattern• Politics• Infra structure• Technology

Thank you for your attention