Journal of Health Policy, Law and Administration

Content

Prof.Dr.Nithat Sirichotiratana — 2026-04-07

Factors Predicting Self-Management Behaviors among Glycemic Uncontrolled Type-2 Diabetes Patients in Tha Mai District, Chanthaburi Province

Natcha Maneechay — 2026-04-07

This cross-sectional descriptive study aimed to examine factors predicting self-management behaviors among patients with type 2 diabetes with poor glycemic control in Tha Mai District, Chanthaburi Province. The sample consisted of 300 patients with type 2 diabetes who had an HbA1c level of ≥7% who were registered and receiving services at three community hospitals. Data were collected using interviews and analyzed using descriptive statistics and multiple linear regression. The results showed that the respondents demonstrated moderate levels of self-management behaviors and knowledge regarding glycemic control, while outcome expectations, conformity to reference groups, self-efficacy, and social support were at high levels. Factors significantly associated with and predictive of self-management behaviors (P < 0.05) included education, occupation, marital status, self-efficacy, social support, outcome expectations, and conformity to reference groups. These factors jointly explained 37.2% of the variance in self-management behaviors. The findings suggest that programs to promote self-management behaviors among patients should be systematically developed, with an emphasis on strengthening self-efficacy, clearly communicating anticipated health outcomes, fostering the involvement of family members or reference groups, and tailoring guidance to patients’ educational levels, occupations, and social contexts, to enhance the effectiveness of self-management.

Development of the Operation Model of the Long-term Care Service Fund for Dependent People of Nong Bon Subdistrict Administrative Organization, Kosum Phisai District, Maha Sarakham Province

Nongluck Phiwphuy — 2026-04-07

This study employed an action research approach with the objective of developing an operational model for the Long-Term Care (LTC) health service system fund for dependent persons under the Nong Bon Subdistrict Administrative Organization, Kosum Phisai District, Maha Sarakham Province. The sample was selected using purposive sampling, with 73 participants: 50 community members, 15 local administrative personnel, and 8 academic representatives. Research instruments included questionnaires, in-depth interviews, and focus group discussions. Quantitative data were analyzed using descriptive statistics and inferential statistics (paired t-test), while qualitative data were analyzed through content analysis.

The results indicated that, prior to the development, the fund’s operational capacity was at a moderate level in terms of knowledge of fund operations and the participation of network partners. The development process comprised four main activities: (1) formulation of an action plan and individual care plans; (2) provision of care for dependent persons according to individual care plans; (3) monitoring and evaluation of operations; and (4) performance evaluation by the Subcommittee for Supporting Health Service Provision for Dependent Persons.

After implementation, participation among network partners increased, and knowledge of fund operations improved significantly. Dependent persons received care aligned with their health needs, supported by family members or caregivers. The success of the study was attributed to clear role understanding and active participation of network partners at all stages, enabling the fund to provide continuous and effective care services.

Factors Associated with the Development of District Health System Networks by the District Quality of Life Development Committee in Ban Muang District Under the Context of Health Promotion Hospitals Transferred to Sakon Nakhon Provincial Administrative Organization

Pantawee Khamsao — 2026-04-07

This cross-sectional survey research aimed to examine the factors and the level of district health system network development, as well as to determine the factors influencing this development under the context of transferring Sub-district Health Promoting Hospitals (SHPHs) to the Provincial Administrative Organization (PAO). The sample consisted of 230 members of the District Quality of Life Development Committee (DQLDC) and health personnel in Ban Muang District. The sample size was determined using a formula for a known population size, followed by stratified random sampling. Data were collected using questionnaires with reliability coefficients ranging from 0.703 to 0.987. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression analysis, incorporating dummy variables for categorical data.

The results revealed that the respondents possessed high levels of knowledge, attitudes, input factors, process factors, and organizational structure factors, alongside a high overall level of network development. Organizational structure, process factors, and knowledge regarding DQLDC roles collectively and significantly influenced the development of the district health system network, accounting for 72.4% of the variance (R² = .724). These findings can be practically applied to establish agreements for cross-organizational resource integration and to develop collective leadership, thereby ensuring seamless and continuous primary health care services.

Factors Associated with Access to Hydrotherapy Clinic Services of Service Recipients at the Hydrotherapy Center, Surat Thani Municipality

Yowwapha Nawalertpanya — 2026-04-07

The Hydrotherapy Center of Surat Thani Municipality is a local government health service unit that charges service fees and currently experiences low levels of service access. This cross-sectional survey research aimed to investigate the relationship between predisposing factors, enabling factors, and health need factors with the level of access to hydrotherapy clinic services among recipients in Surat Thani Province.

Data were collected from a sample of 177 participants using a questionnaire with an Index of Item-Objective Congruence (IOC) ranging from 0.67 to 1.00 and a reliability coefficient of 0.938. Data were analyzed using multiple logistic regression.

The findings revealed that predisposing factors regarding health beliefs and attitudes, enabling factors, and health need factors were overall at high levels. However, the level of service access was predominantly low (≤ 4 times per month), accounting for 58.2%. Factors significantly associated with service access at the 0.05 level were social predisposing factors, specifically marital status and income, and enabling factors related to service costs, particularly reimbursement rights.

Implications: Surat Thani Municipality and relevant agencies should utilize these findings to develop financial support measures or fee-subsidy schemes for low-income groups to mitigate financial barriers. Furthermore, service delivery models should be enhanced to increase flexibility, catering to the needs of individuals with time constraints. These results also serve as essential evidence for advocating the integration of hydrotherapy services into the national health insurance benefits package to ensure equitable and sustainable access to care.

Perception of the Mahidol University Regulations on Graduate Studies B.E. 2567 (2024) Regarding the Appointment of Thesis/Independent Study Committees: A Case Study of Mahidol University

Warunee Asawathanyasakul — 2026-04-07

This study aims to examine the perception and understanding of stakeholders involved in the implementation of the Mahidol University Regulations on Graduate Studies B.E. 2567 (2024) concerning the appointment of thesis and independent study committees. The population and sample consisted of 116 program chairs, curriculum committee members, faculty members, and program administrative staff involved in graduate education at the master’s and doctoral levels.

This study employed a mixed-methods research design, integrating quantitative and qualitative approaches to obtain comprehensive data aligned with the research objectives.

The results indicated varying levels of perception and understanding of the Mahidol University Regulations on Graduate Studies B.E. 2567 (2024). The highest level of correct understanding was the administration and supervision of thesis and independent study proposals and related activities by academic programs 97.41%, whereas the highest level of incorrect understanding was eligibility for appointment as a principal thesis or independent study advisor 43.97%, and the greatest lack of awareness was concerned with the effective date of the regulation 37.07%. No significant differences in overall knowledge and understanding were found among respondents across three disciplinary groups: health science, technology science, and humanities and social science.

The findings reflect the need to enhance communication strategies through continuous training and the development of clear and accessible informational materials to support the accurate and effective implementation of the regulations.

Factors associated with health-promoting behaviors among Buddhist monks in Phichai district, Uttaradit province.

Pratuang Pengkaew — 2026-04-07

This study was an analytic cross-sectional study. The objective was to examine the factors associated with health-promoting behaviors among Buddhist monks in Phichai district, Uttaradit province. This study employed a stratified random sampling technique to recruit 191 monks as participants. Data were collected using a self-administered questionnaire. The reliability coefficients were 0.95 for Part II and 0.87 for Part III. Data were analyzed using descriptive statistics and Pearson’s correlation coefficient, with statistical significance set at p < 0.05.

The results revealed that the overall health-promoting behaviors of the participants were at a good level (x̄ = 3.81, S.D. = 0.55). Perceived susceptibility to disease, perceived severity of disease, perceived benefits of health behavior practices, and perceived barriers to engaging in health-promoting behaviors were also found to be at a good level. (mean=4.1, S.D.=0.54; mean 4.11 S.D.=0.60; mean 4.36 S.D.=0.55; mean=3.72 S.D.=0.70 respectively). The factors associated with The health-promoting behaviors were underlying disease, age, years in monkhood, perceived susceptibility to disease, perceived severity of disease, perceived benefits, and perceived barriers to practicing health-promoting behaviors were examined in relation to health-promoting behaviors.

Based on the findings, administrators can utilize this information as a foundation for formulating health promotion policies for monks. At the community level, environmental strategies should include campaigns promoting the offering of healthy food to monks and the organization of appropriate physical activity programs within temples that are suitable for monastic life.

Factors Affecting Participation in the Management of the Local Health Security Funds by the Local Health Security Fund Committees in Pathum Thani Province

Preeyanoot Pannil — 2026-04-07

This cross-sectional analytical study examined factors influencing the level of participation in the management of Local Health Security Funds (LHSFs) among committee members in Pathum Thani Province. The sample comprised 335 LHSF committee members selected through multistage sampling. Data were collected using a structured questionnaire. Descriptive statistics were used to summarize participants' characteristics, while inferential statistics—namely, chi-square tests and multivariable logistic regression—were employed to identify predictors of participation, with a significance level of 0.05. The findings indicated that three factors significantly predicted committee members’ participation in the management of Local Health Security Funds (LHSFs) in Pathum Thani Province. First, members with a high perception of the fund’s benefits were 2.87 times more likely to engage in fund management than those with low perceived benefits (95% CI: 1.247–6.592, p = 0.013). Second, members who highly perceived their committee roles were 2.22 times more likely to participate compared with those with low role perception (95% CI: 1.083–4.546, p = 0.029). Finally, members with a high perception of leadership were 4.43 times more likely to engage in fund management than their counterparts with a low perception of leadership (95% CI: 1.876–10.474, p = 0.001).

Policymakers should enhance committee members’ understanding of the benefits and roles associated with fund management and support the development of leadership capacities among fund chairpersons and committee members to effectively stimulate participation in fund governance.

The Development Of Road Accident Prevention By Community Network Participation Of Thung Si Mueang Subdistrict, Suwannaphum District, Roi Et Province.

Nonglak Prawat — 2026-04-07

This research aimed to study the development of road traffic accident prevention operations in Thung Si Mueang Subdistrict, Suwannaphum District, Roi Et Province, using Participatory Action Research (PAR). The objective was to enhance safety and reduce losses from road traffic accidents in the area.

The PAR was conducted in four stages (Plan, Act, Observe, and Reflect) over a six-month period. The sample consisted of 66 network partners and 335 road users. Data were collected through focus group discussions, workshops, observations, and questionnaires. Data analysis was performed using descriptive statistics, inferential statistics (Wilcoxon Signed Rank Test), and content analysis.

The implementation of five activities (festival safety campaigns, knowledge training, a safety helmet fund, risk point correction via a LINE group, and mobile compulsory motor insurance services) resulted in a 53% decrease in festival-related injuries, with zero fatalities. Risk behaviors, such as riding without a safety helmet and drunk driving, also decreased. Furthermore, the participation level of the network partners increased from 3.79 to 4.30, and satisfaction with the operations increased from 3.62 to 4.53, showing statistical significance (p < 0.001).

The success of this model resulted from the integration of all sectors, strong local leadership, and the use of an evidence-based data system. Policy implications suggest that subdistrict-level collaborative mechanisms and a sense of community co-ownership should be supported to ensure sustainable road safety management.

Problems in the Enforcement of Laws for Reducing Disparities in Access to Medical Technology

Budsaya Chantarawisut — 2026-04-07

This study examines the background, concepts and theories related to reducing health disparities, alongside the National Health Act B.E. 2550 (2007), the National Health Security Act B.E. 2545 (2002) and other relevant legislation. Currently, access to healthcare services for Thai citizens, particularly vulnerable groups, remains restricted regarding timely diagnosis, treatment and access to essential medical technologies. Consequently, it is imperative to establish guidelines for legal amendments to mitigate inequalities in medical technology access appropriate for Thailand's context.

The researcher proposes amending the National Health Security Act B.E. 2545 (2002), expanding the scope of public health services to encompass modern and essential medical technologies, digital health innovations and health applications. The amendment should encourage private sector participation in developing innovations while guaranteeing the public's right to standardized public health services. Furthermore, a specific chapter on health applications should be introduced, including the establishment of a Health Application Committee. The National Health Security Board should be empowered to support and regulate private sector involvement in public healthcare services. Finally, the amendment should limit the liability of medical practitioners who perform their duties in good faith, in accordance with professional standards, or with patient consent, except in cases of willful misconduct or gross negligence.

Development Chronic Disease Clinic Service at Nongkham Health Promoting Hospital, Nongkham Subdistrict At Samat District, Roi Et Province

Aem-orn Singpong — 2026-04-07

Non-communicable diseases (NCDs) are a major challenge for the primary care system. Although the chronic disease clinic at Ban Nongkham Health Promoting Hospital met the "Quality NCD" criteria, patient health outcomes failed to achieve the "NCD Clinic Plus" standards. This research, therefore, aimed to develop health services by adopting the Chronic Care Model (CCM) as its core conceptual framework.

This six-month action research project involved 211 participants, including patients with diabetes and hypertension (86), caregivers (86), and a development team (39). The study followed the four-stage PAOR cycle (Plan, Act, Observe, Reflect). Data were collected through questionnaires, observations, and reflections, then analyzed using descriptive statistics, paired t-tests, and content analysis.

The results of the NONGKHAM Model implementation showed significant positive developments in health knowledge, self-care behaviors, and service satisfaction (p < 0.001). These improvements directly contributed to enhanced clinical outcomes, specifically in blood glucose and blood pressure levels. This confirms the success of a service system that is integrated with the actual context and lifestyles of the patients.

The integration of CCM with action research can effectively elevate the quality of chronic care in primary services. This model serves as a prototype for other service units with similar policies and operational contexts.

Effectiveness of Self-Directed Video-Based Learning on Elderly Caregiver Knowledge: A Pre–Post Study in Phoknoi Sub-District Health Promoting Hospital, Sakon Nakhon Province

Passakorn Ongarj — 2026-04-07

Thailand enters an aging society, resulting in an increasing number of dependent older adults who require long-term care. Community-based elderly caregivers therefore need adequate knowledge and skills to provide appropriate care. This study aimed to compare the knowledge levels of elderly caregivers, before and after receiving a self-directed video-based learning program. A quasi-experimental study using a one-group pretest–posttest design was conducted. The participants were 50 elderly caregivers who had completed the caregiver training program, provided by the Department of Health, and were working in the service area of Phoknoi Sub-district Health Promoting Hospital, Phannanikhom District, Sakon Nakhon Province, Thailand. Research instruments included a demographic questionnaire, and a 10-item knowledge test related to elderly care. The intervention consisted of three video-based learning modules covering nasogastric tube feeding, oxygen therapy care, and urinary catheter care. Data were analyzed using descriptive statistics and paired t-test.

The results showed that the mean knowledge score of caregivers after the intervention was significantly higher than before the intervention (p < .001). The mean score increased from 3.52 to 7.66 points. These findings indicate that the self-directed video-based learning program was effective in improving caregivers’ knowledge regarding the care of dependent older adults. This approach may serve as an appropriate educational tool for enhancing caregiver competencies in community settings and may be applied to improve elderly care practices in other areas.

Health Behavior Modification among Risk Group of Hypertension in Khongchaipattana Subdistrict, Khongchai District, Kalasin Province

Woramalee Ngoendee — 2026-04-07

This action research aimed to modify health behaviors among individuals at risk of hypertension in Khongchaipattana Subdistrict, Khongchai District, Kalasin Province, through a health literacy-based participatory approach. The participants included 50 individuals at risk of hypertension, as well as local stakeholders and academic experts. Research instruments consisted of interviews, focus group discussions and questionnaires. Quantitative data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (paired t-test), while qualitative data were examined using content analysis.

The results indicated that, after the intervention, the mean overall health literacy score increased from 92.36 to 113.06, and the mean health behavior score increased from 34.94 to 41.36. Participants demonstrated improved health behaviors based on the 3E 2S principles, including healthy eating, regular physical activity, emotional management, smoking reduction/cessation, and decreased alcohol consumption. These changes enabled participants to better manage their own health.

The key success factors included: (1) active participation of network partners, (2) appropriate learning processes and context-based communication, (3) continuous creative activities, (4) follow-up through home visits, and (5) social support. These factors can serve as guidelines for organizing sustainable health behavior modification programs.

Factors influencing parental oral health care behaviors for preschool children in Mueang Phichit District, Phichit Province

Namthip Sriraungphan — 2026-04-07

This study utilized a cross-sectional analytical survey design to investigate the behaviors and factors influencing oral health care for preschool children among parents in Mueang Phichit District, Phichit Province. The sample consisted of 385 preschool children, selected through stratified random sampling. Data were analyzed using descriptive statistics and multiple regression analysis.

The results revealed that the majority of participants were female (66.8%), aged 25–34, with an education level below a bachelor's degree and an average monthly income of less than 10,000 THB. While most parents exhibited high levels of knowledge, attitudes, enabling factors, and reinforcing factors regarding preschool oral health care (53.5% – 80.8%), their actual oral health care behaviors were at a moderate level (76.1%). Six factors significantly predicted these behaviors, explaining 21.5% of the variance at a statistical significance level of 0.05. The most influential predictor was the purchase of oral health care products, followed by average monthly income, attitudes toward preschool oral health care, guidance and support from close associates, knowledge of oral health care, and exposure to public relations information from various media outlets (Beta = 0.686, 0.571, 0.508, 0.244, 0.225, and 0.165) respectively.

Factors Associated with Organizational Commitment of Registered Nurses in Community Hospitals, Pathum Thani Province

Petch Buaban — 2026-04-07

This cross-sectional analytical study aimed to examine factors associated with organizational commitment of registered nurses in community hospitals, Pathum Thani Province. Independent variables included personal characteristics, organizational support factors, and happiness at work, while the dependent variable was organizational commitment. The study population comprised 269 professional nurses working in all seven community hospitals in Pathum Thani Province. Data were analyzed using descriptive statistics (frequency, mean, and standard deviation) and inferential statistics, including Chi-square tests and binary logistic regression.

The results revealed that factors significantly associated with organizational commitment included gender, age, employment status, number of shifts meeting standard criteria (24 shifts per month), and work experience. In addition, organizational support, incentive factors, and happiness were significantly related to organizational commitment at the 0.05 level. Factors influencing organizational commitment included: (1) organizational support (AOR = 5.097, p = 0.001, 95% CI: 1.892–13.730), (2) incentives (AOR = 5.769, p = 0.039, 95% CI: 1.097–30.345), and (3) happiness (AOR = 3.632, p = 0.002, 95% CI: 1.602–8.232).

These findings suggest that hospital administrators should prioritize policies that enhance incentives, including compensation, welfare, and career advancement opportunities, to strengthen nurses’ long-term commitment to the organization. Additionally, promoting work–life balance and well-being is essential to improve nurses’ overall happiness, both at work and in personal life, which in turn supports their retention in the organization.

Work life quality of caregivers for elderly or dependents in care-giving services establishments, Health Region 4

Wanwipha Chueyrash — 2026-04-12

This is a cross-sectional survey study, designed to examine the relationships among individual factors, job characteristics, work stress, and organizational atmosphere, affecting the quality of work life of caregivers for elderly or dependents in Care-giving Services Establishments, Health Region 4. The sample consisted of 259 caregivers. The research instrument was a questionnaire. Data were analyzed by using frequency, percentage, mean, standard deviation and Chi-square.

The findings revealed that the overall caregivers’ work life in these establishments was high. Correlation analysis showed significant associations with the quality of work life at the 0.05 level for several factors, including gender, age, highest level of education, location of the establishment, average daily work hours, and the number of elderly or dependent individuals under care, as well as job characteristics, work stress, and organizational atmosphere. Based on the results, administrators of elderly or dependent care facilities should develop policies and guidelines aiming at improving the quality of life for service providers in the workplace in the future.

Organizational Commitment of The Nurses in Public Health Centers, Health Department, Bangkok Metropolitan Administration

Chaloemkeit Tansa — 2026-04-12

This analytical cross-sectional study aimed to examine organizational commitment, and investigating factors associated with organizational commitment among nurses working in public health centers under the Health Department, Bangkok Metropolitan Administration. A total of 272 nurses who had worked at the centers for at least one year were selected using multistage sampling. Data were collected using an online self-administered questionnaire between August 15^th and 30^th, 2025, with a response rate of 81.44%. Descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple linear regression were used for data analysis at a significance level of 0.05.

The findings showed that organizational commitment was at a high level (mean = 3.81, S.D. = 0.39). It was significantly correlated with both overall work motivation (r = 0.70) and organizational climate (r = 0.63). Multiple linear regression analysis revealed that the motivation factor (B = 0.33, p < 0.001) and the hygiene factor (B = 0.26, p < 0.001) were significant predictors of organizational commitment, jointly explaining 49.5% of the variance (adjusted R² = 0.495). Executives of the Health Department can use these findings to formulate policies and strategies to enhance the nurses’ organizational commitment by enhancing work motivation and promoting work–life balance among the professional nurses.

Regulatory Measures for Digital Platform Operators Affecting Consumer Rights: A Case Study of Facebook

Krisda Saengcharoensap — 2026-04-16

This study aimed to examine the situation of victimization arising from digital platform scams in Thailand, and to propose appropriate regulatory approaches for digital platform operators impacting consumer rights. The researchers employed a mixed-methods research design for data collection. Quantitative data were collected through an online questionnaire. A total of 288 respondents participated in the study, while qualitative data were obtained through in-depth interviews with 16 key informants.

The findings indicated that digital platform scams in Thailand remained a serious issue, particularly on Facebook, with a large user base. The results revealed that elderly individuals and users accessing Facebook approximately four to six times per week constituted a high-risk group for being victimized by such scams. Furthermore, the study identified significant challenges in the effective enforcement of self-regulatory measures by digital platforms. Legal and enforcement difficulties were also evident, particularly in pursuing litigation and enforcing judgments against digital platform operators not registered under Thai law. These issues represented major obstacles to effective platform governance.

The researchers recommend that digital platforms adopt interim measures to temporarily suspend access to reported fraudulent content, or user accounts, while complaints are under review. Additionally, policy measures should be developed to incentivize foreign digital platforms to formally register their business operations in Thailand. Finally, enhanced regional cooperation among ASEAN member states is suggested as a venue to strengthen bargaining power in regulating large digital platforms such as Facebook.

Factors Affecting Solid Waste Management Behavior of People in the Area of Ban San Sa Lee, San Sa Lee Sub-District, Wiang Pa Pao District, Chiang Rai Province

Supawadee Sujantha — 2026-04-21

This cross-sectional descriptive study aimed to examine the levels of knowledge, attitudes, and behaviors regarding solid waste management among residents of Ban San Sa Lee, San Sa Lee Subdistrict, Wiang Pa Pao District, Chiang Rai Province, Thailand, and to identify factors affecting solid waste management. The study population consisted of 545 household heads, or household representatives. Data were collected using questionnaire and analyzed using descriptive statistics, independent t-test, one-way analysis of variance (ANOVA), and stepwise multiple regression analysis.

The results revealed that 57.25% of participants had a moderate level of knowledge, while 40.55% had a high level. A high level of attitudes toward solid waste management was observed in 70.25% of participants, whereas 60.10% demonstrated a moderate level of waste management behavior. Comparisons of behavior across personal factors showed that behavior scores differed significantly by educational level (p < 0.001). Factors significantly affecting solid waste management behavior included attitudes, knowledge, and educational level, which together explained 40.0% of the variance in behavior (R² = 0.40, p < 0.001).

These findings suggest that continuous efforts to enhance knowledge and promote appropriate attitudes are essential for improving solid waste management behaviors among community residents.

Factors Associated with Continuous Telemedicine Utilization among Service Users at the Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Thailand

Natthita Limpaiboon — 2026-04-22

Objective: Continuous telemedicine utilization is important for sustaining digital health services. This study examined factors associated with continuous telemedicine usage among service users at the Institute of Dermatology, Department of Medical Services, Ministry of Public Health, Thailand.

Methods: A cross-sectional descriptive study was conducted among 285 adults selected by simple random sampling from 1,077 telemedicine users in fiscal years 2024–2025. Data were collected using a researcher-developed questionnaire based on Extended TAM, UTAUT, and HBM. Questionnaires were administered in paper form at the clinic and online via Google Form through SMS and LINE OA. Descriptive statistics and chi-square tests were used.

Results: Continuous telemedicine usage was reported by 83.2% of participants. Significant factors included marital status (p = 0.007), cumulative telemedicine visits (p < 0.001), duration of dermatologic illness (p < 0.001), self- or family-initiated scheduling (p = 0.014), future intention to use telemedicine (p < 0.001), travel convenience (p = 0.003), private vehicle ownership (p = 0.009), and low travel expenditure (p = 0.042). Overall technology acceptance and all eight dimensions were not significantly associated (p > 0.05).

Conclusion: Continuous telemedicine usage was associated with actual service experience, follow-up needs, and family support. Patients with convenient travel still chose telemedicine, suggesting it has become a preferred mode of care. Teledermatology services should improve appointment systems, caregiver support, and service design.

Factors Related to Digital Leadership among Staff in the Department of Health Service Support, Ministry of Public Health, Thailand

Phinimmit Dangpairoj — 2026-04-23

This analytic cross-sectional study aimed to examine factors related to digital leadership among staff in the Department of Health Service Support, Ministry of Public Health, Thailand. The sample consisted of 461 personnel from the Department of Health Service Support. Data were collected using a questionnaire, and analyzed using descriptive statistics, including mean, standard deviation, and percentage. Inferential statistics, including point-biserial correlation and eta coefficient, with Tukey’s post hoc test, were analyzed. The level of statistical significance was set at 0.05.

The results indicated that overall digital leadership was at a high level. The highest mean score was found in digital technology learning, while the lowest was in networking and partnership. Personal factors, including educational level and job position, were significantly related to digital leadership (p < 0.001), whereas gender, age, years of service, and job category were not significantly related (p > 0.05). Pairwise comparisons based on educational level revealed that personnel with a master’s degree or higher significantly differed from other groups (p < 0.05). In contrast, no significant differences in mean digital leadership were found across job positions (p > 0.05).

The findings can be used to inform policy development aimed at enhancing digital leadership among personnel in the Department of Health Service Support. Points to consider are differences in educational level and job position, and by systematically promoting digital skill development to strengthen organizational capacity for sustainable digital transformation.

Thailand's Social Security System development guidelines for insurer’s contribution for pension in place of healthcare

Vasin Pipatanachat — 2026-04-23

The concept of developing Thailand's social security system, where insured persons are exempt from healthcare costs and their contributions are added to their old-age pension, arose to address the potential challenges of an aging society in Thailand. The objective is to amend Thailand's social security law so that insured persons do not have to pay for healthcare services, but contributed for their pension instead. This is achieved by analyzing the system of insured persons under Articles 33, 39, and 40 of the Social Security Act. The study used a comparative approach with case studies from abroad.

The study found that a practical approach to develop Thailand's social security system, by exempting from healthcare costs but contributed for their old-age pension, is feasible. This requires amendments to the social security law to accommodate this approach, as well as improvements to the National Health Security System to support insured persons who voluntarily choose this option.

Conclusion:

Section 40/1 should be added under Chapter 1, "Insured Persons under the Social Security Act," because the existing health benefits of insured persons under Section 40 already utilize the National Health Security Office (NHSO) system. Therefore, amending just this single section could resolve the issue of insured persons not having to pay for health services, but contributed to their old-age pension. Initially, it should be voluntary to avoid negatively impacting the overall social security system.

Support Staff Participation in Hospital Quality Improvement at a General Hospitals in Samut Songkhram province

Wantana Chomphet — 2026-04-24

This cross-sectional descriptive study aimed to examine the factors influencing participation in hospital quality improvement among support staff in a general hospital in Samut Songkhram Province. The sample consisted of 303 support staff working in the hospital. Data were collected using an online questionnaire, with 260 completed responses returned. The research instrument was a questionnaire developed by the researcher and tested for validity and reliability. Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, and inferential statistics using the chi-square test.

The results indicated that overall participation in hospital quality improvement among support staff was at a moderate level (48.5%). Personal factors—monthly income, length of service, membership in quality improvement committees, and participation in quality improvement training—were significantly associated with participation (p < .05). In addition, organizational support, attitudes, and job burnout were significantly related to participation (p < .05).

The findings can be utilized as policy guidelines for hospital administrators to formulate plans and strategies to strengthen quality management systems and enhance sustainable participation among support staff.

Cost Analysis of Cold Plasma for Wound Care Among Patients with Type 2 Diabetes Mellitus in Thai Community Hospitals

Utoomporn Wongsin — 2026-04-24

This study estimated unit cost of cold plasma wound care for Type 2 Diabetes Mellitus (T2DM) patients in Thai community hospitals. Utilizing a retrospective cross-sectional design, we analyzed 2025 cost data from four representative facilities from the provider’s perspective. The hospital cost information consisted of wound care service data, hospital statistics, and cost information. We used the codes from the 10th revision of the International Classification of Diseases (ICD-10) to identify diagnosis code of T2DM. Applied Activity-Based Costing: ABC were used to estimate average cost per visit and cost per person.

The results indicated that labor cost was the majority of total cost, while material and capital costs varied between hospitals. The unit cost of wound care using cold plasma per visit for patients with T2DM in 2025 was between THB 519 and THB 939. The unit cost of wound care using plasma per person for patients with T2DM was between THB 4,436 and THB 9,176. Considering in each hospital, Hospital C reported the highest total cost (THB939), followed by Hospital A (THB 794), Hospital B (THB 676), and Hospital D (THB 519). Our cost analysis was based on real-world cost data, offering valuable insights to support budgeting and resource management for cold plasma wound care among patients with T2DM at community hospitals.

Factors Influencing Personal Sanitation and Hygiene Practices of Food handlers in Takhli Town Municipality, Nakhon Sawan Province

Jitanong Phongkaew — 2026-04-26

This study aimed to examine personal factors, predisposing, enabling, and reinforcing factors, and Personal Sanitation and Hygiene practices among food handlers, as well as to identify factors influencing such practices in Takhli Town Municipality, Nakhon Sawan Province. A total of 120 food handlers were selected as the sample. Data were collected using a structured questionnaire with reliability coefficients of 0.76 (KR-20) and 0.71 (Cronbach’s alpha). Data were analyzed using descriptive statistics and stepwise multiple linear regression. The results showed that the majority of the sample were female (70%), with ages ranging between 40 and 60 years (51.56%). Most participants were married (49.2%), had primary school education (32.5%), earned 10,000–20,000 baht per month (64%), and had an average work experience of 11.30 years. Regarding key variables, 39.2% had a high level of knowledge, 65.8% had positive attitudes, and 73.3% reported good environmental conditions of food establishments. However, 68.3% had never received sanitation training, and 85% had never received sanitation-related awards. Overall, 42.5% demonstrated good Personal Sanitation and Hygiene practices. The factors significantly influencing Personal Sanitation and Hygiene practices were enabling factors, specifically environmental conditions of food establishments (B = 2.13, p<0.001), and reinforcing factors, particularly sanitation training (B = 5.20, p< 0.001). These variables jointly explained 86.2% of the variance in practices.