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The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos.

A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes.

In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB.

To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.

This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.

Twenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.

TB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.

Thailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.

The purpose of this paper is to determine the factors associated with patient delay among tuberculosis patients in border hospitals, Chiang Rai province, Thailand.

A cross-sectional study was conducted in the four biggest border hospitals in Chiang Rai province, Thailand during May to July 2018 among 103 identified TB cases. Data were collected by a face-to-face interview with structured questionnaire on patients’ general characteristics, HIV status and patient delay status. Descriptive statistics were used to analyze the patients’ general characteristics, HIV and patient delay status. The association among variables and patient delay was analyzed by χ²-test. The variables with p-value<0.20 obtained in bivariate analysis were further analyzed by binary logistic regression and considered significant with p-value<0.05.

All patients enrolled, most were reported with patient delay (65.0 percent). Bivariate analysis demonstrated that level of education, nationality and HIV status were associated factors for patient delay. Among these factors, binary logistic regression revealed that HIV negative TB patients were increased 6.806-fold odds of being patient delay (OR = 6.806; 95% CI: 1.174–39.462), while non-Thai TB patients were also increased 2.824-fold odds of being patient delay (OR = 2.824; 95% CI: 1.041–7.660).

Patient delay among TB patients in Chiang Rai province was high. This study further supports the requirement on promoting of TB knowledge and awareness emphasized on non-Thai population and general public along the border areas of Chiang Rai province.

Women of Haitian nationality comprise a sizeable proportion of all women seeking labor and delivery services in a public hospital in Dominican Republic (DR), along the central border of Haiti. The purpose of this paper is to better understand and address the needs of Haitian women receiving labor and delivery services in this border region.

The authors conducted a mixed-methods study to identify personal motivations, demographic characteristics, and migration history of women seeking labor and delivery services at a public hospital.

The majority of women (83 percent) were born in Haiti but spoke Spanish (74 percent) and were long-term residents of the DR (mean 7.8 years). While many women reported they felt they had a positive experience delivering at the public hospital, some described feeling unwelcome or resented.

The study sample was small and from one hospital. Future studies could explore the differences in experiences among Haitian women who are long-term residents of the DR and those whose presence is more transient.

Women residing on both sides of the border would likely benefit from coordinated efforts by the Haitian and DR Ministries of Health to strengthen referral services to and from either country.

Hospital staff and services in the DR should consider the unique needs of this population, which makes critical contributions to workforce and culture in the DR.

This study is the first to assess labor and delivery service seeking practices and experiences within this population.

The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.

The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.

Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.

The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.

Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.

This study aims to examine the systems and mechanisms at provincial level to develop health volunteers to improve health of the immigrant workforce in Ubon Ratchathani, Thailand.

This qualitative study collected data from document research and in-depth interviews with 22 concerned people who worked at policy and provincial levels to develop health volunteers to improve the health of immigrant workforce. Data were collected from May to July 2017. Then, content of the conceptual framework was analysed. The research objectives were examined and summary and induction analysis interpreted data from documents, observations and interviews.

Ubon Ratchathani has developed a Thai village health volunteer network to provide health care to immigrant workforce. This consisted of four systems and one supporting mechanism, namely, selection of health volunteer, knowledge management on primary health care, welfare management and moral enhancement and resource and budget support. Development is driven through the committee under the mechanisms of government agencies, i.e. the provincial public health office together with non-government organizations and network partners.

The findings from this study could help develop health volunteers to significantly improve the health of the immigrant workforce in the Thai health service system.

The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.

A total of 33 experts participated in a three-round Argument Delphi process. Opposing views of management and leadership in 2030 were analyzed using inductive content analysis.

The experts’ perceptions were divided into two main categories: management and leadership orientation and future organization. Perceptions relating to management and leadership orientation were classified as relating to patient-centred, clinical dominance, professionally divided and management career options. Perceptions relating to future management and leadership organization were classified as representing shared, pair, team and the individual-centered leadership. The results highlighted the most distinctive issues raised by the participants.

This qualitative study was conducted in the context of Finnish healthcare according to the principles of the Argument Delphi Method. The panel consisted of high-level experts representing a diverse set of roles. However, as suggested in previous literature, these experts may not be the most astute in predicting the future development of hospital organizations.

The findings can be used to develop and renew management and leadership training and management practices in hospitals.

The findings can be exploited in discussions, planning and decision making regarding future management and leadership in hospitals.

Only a few studies have investigated perceptions of future management in hospitals. This study adopted the Argument Delphi Method to identify distinct perceptions on the future orientation and organization of management and leadership in hospitals.

Purpose – Hospitals need to determine if an international patient department is a necessity to communicate with and manage international patients.

Design/Methodology/Approach – A benchmarking instrument was created to assess the level of professionalism in managing international patients, including reviewing and validating processes by two university hospitals, professionals, and an expert panel.

Findings – First, the differences between the hospitals depended on the will of the hospital to engage in such activities. Second, the differences depended on the embedding national context in which the hospital was situated. Further validation revealed the importance of other supportive services, such as cultural sensitivity and language. Finally, the microlevel phenomenon of international patient departments is placed within a macrolevel transnational health region development scheme.

Originality/Value – This study focused on the supply of services with respect to international patient departments, which could be related to efficiency and sustainability on a public health and health systems level.

Hospitals worldwide command the majority of any countries’ health care budget. Reasons for these higher costs include the aging of the population requiring more intensive health care treatments provided in hospitals, the relatively high costs of labor in this labor intensive industry and payment systems that may encourage inefficient behavior on the part of hospital managers and physicians, that have not been fully mitigated via reforms and regulations.

This research examines how social media helps increase the dynamic capabilities of health organizations. Using the concepts of “technical fitness” and “evolutionary fitness,” the research focuses on changes in: (1) the number of “likes”; (2) the amount of discussions in these pages; and (3) enabling factors for (1) and (2) over time.

Missouri Hospital Association (MHA) provides a sample of 164 hospitals. The Facebook pages of these hospitals are analyzed. Specifically, the number of “likes” and the amount of discussions are readily available for analysis. Data collection was conducted at two time points.

At time 1, 39% of the hospitals had an official Facebook page, increased to 47% at time 2. On average, there was a 22.2% increase in likes and a 4.0% increase in pages of discussions. Whether measured by staffs or patients’ capacity, size is a significant factor that contributes to the increase in likes and discussions. Yet, the location of a hospital — measured by urbanity — is statistically insignificant. Qualitative analyses suggest that certain patient groups particularly welcomed social media. Beside, pictures, videos, and “happy news” tended to increase usage of social media for hospital stakeholders.

Social media can help health organizations fulfill the social needs of their patients. This research applies several useful concepts. In further study, researchers may examine how hospitals optimize staffs’ and patients’ inputs. Besides, comparing how hospitals’ social media platforms operate differently in other states or countries may yield findings with practical implications.