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Published Researches in the Year 2010 1 PUBLISHED RESEARCHES IN THE YEAR 2010 VOLUME 4 No.1 Title: An application of Decision Tree Algorithms with Diagnosis of the Diseases of the Respiratory System ∗ Researchers: Ditapol , † Mantuam Lily Ingsrisawang† ∗ Corresponding author, e-mail: [email protected] † Department of Statistics, Faculty of Science, Kasetsart University Abstract: The Knowledge Discovery in Database (KDD) has been extensively used through “data mining”, a statistics and computer sciences, to organize the crucial useful data into knowledge base form for further research purpose. The data classification is a techniques applied by the KDD to various fields and medical research. The primary purpose of this study was aimed to applications and compare the performance of the 3 decision-tree algorithms, including ID3, C4.5, and CART, which have currently become famous in sorting data. The results would be expected to support the screening process and to be used as guidelines for primary diagnosis. The medical record of 7,327 out-patients at the Pranakorn Sri Ayutthaya Hospital during 2004-2006 was examined. The results have demonstrated that algorithm C4.5 which percentage split method was used to divide the data into 70:30 was 99.41% accurate in respect of no selection of variables. The Kappa was 0.9881. Sensitivity was 99.31% while specificity 99.50%. Positive predictive value (PPV) was 99.40% while negative predictive value (NPV) was 99.41, ROC area was 99.70%, regarded as the most effective classifier. On the other hand, it found that algorithm ID3 which percentage split method was used to divide the data into 70:30 was 95.85% accurate in case of selection for variables. The Kappa was 0.8821. Sensitivity was 91.55% while specificity was 97.22%. Positive predictive value (PPV) was 90.25% while negative predictive value (NPV) was 97.52%, ROC area was 97.60%. The results indicated that there was no significant difference in classifying patients’ data in both cases (Selection of variables, no selection of variables). However, in case of the selection of variables, lesser variables were used, resulting in time and cost saving. The algorithm ID3 produced higher performance in classifying patients’ data in respect of the selection of variables. Keywords: Data Classification, Decision Tree, Diseases of the Respiratory System, Diagnosis (Published in Journal of Health Systems Research Vol.4 No.1 Jan.-Mar.2010) Title: Decision making on patient compensation related to adverse events Researchers: Pattapong Kessomboon*, Nusaraporn Kessomboon**, Supasit Pannarunothai***, Amorn Premgamone* *Faculty of Medicine, Khon Kaen University, **Faculty of Pharmaceutical Sciences, Khon Kaen University, ***Faculty of Medicine, Naresuan University Abstract Adverse events occurred in health service settings lead to more lawsuits than ever before. The new patient compensation Bill is expected to resolve patient-provider conflicts. It will be designed to cover all groups of Thai people with acceptable claim process and amount of compensations. 1 Objective: To study decision making processes on compensation for injured patients under the Article 41 of the National Health Security Act 2002. Method: This was a descriptive study. The reasons used by committees in making decisions on whether to “pay” or “not pay” the victims conducted under the article 41 were analyzed and compared with the compensation criteria set out by the National Health Security Office. Altogether, 1,276 claims during 2003 - 2008 were recruited for the study. Results: Among 1,276 claims, compensations were “paid out” for 1,049 cases (82.2%) and 227 cases (17.8%) were “not paid”. The main reason for paying compensation was that “it was an unavoidable situation” (76.5%). However, the reason above was not in accordance with the criteria for compensation. There were only 27.1 % of claims that were in accordance with the criteria saying that the injuries were related to medical errors or mistakes or substandard care. The main reason for not paying compensation was that “the adverse events were the results of disease processes” (61.6%). This was in accordance with the criteria. Conclusion: Inconsistency and unclear decision making on patient compensations were found. Two cases with the same kind of injury might be paid or not paid. This might motivate patients to bring the case to court. Key words: criteria for decision making, adverse event, medical service, patient compensation (Published in Journal of Health Systems Research Vol.4 No.1 Jan.-Mar.2010) Title: Good Governance Index for Health Systems Research Management Unit:Case of Health System Research Institute Researchers: Decharut Sukkumnoed1, Rungthip Sukkumnoed2 1 Lecturer, Faculty of Economics, Kasetsart University 2 Researcher, Healthy Public Policy Foundation Abstract The project of developing good governance index is a part of developing the research management system in Health Systems Research Institute (HSRI) and its research alliances. Objectives of this project are 1) to define the framework of monitoring and evaluating the project administration in accordance with good governance practices 2) to develop good governance index 3) to study the appropriateness of the developed index and barriers for index perceived 4) to set a guideline to gather essential data for project performance evaluation which is based on good governance principle of research management team in health system. The process of this project begins with 1) reviewing theories, concepts, and research reports related to good governance practices and its index both domestically and internationally 2) interviewing experts from related disciplines, and research managements 3) developing and testing questionnaire and then analyzing data 4) using the drafted good governance index to conduct internal pilot test with HSRI 5) reviewing index and modifying it to be more suitably. The result of this study has indicated that two crucial conceptual frameworks of index development has emerged and they are comprised of 1) conforming to six good governance practices including Rule of Law, Transparency, Worthiness, Participation, Quality, Accountability and 2) applying six good governance practices to five steps of the research management process. The outcome of evaluating Health Systems Research Institute (HSRI)’s good governance practices has been depicted that overall in the organizational level HSRI has high good governance practices. When considered in the perspective of five research management process, the process of gathering and allocating resources gains the highest level of engaging good governance practices and is followed by the process of planning the research management as a second. Other research 2 management processes are evaluated that their involvement in good governance practices are in the middle level. Keywords : Good Governance, Health Systems Research Unit. (Published in Journal of Health Systems Research Vol.4 No.1 Jan.-Mar.2010) Title: Health Decentralization in 5 countries Researchers: Jiraboon Tosanguan*, Siriwan Pitayarangsarit*, Hathaichanok Sumalee* *International Health Policy Program (IHPP) Abstract Decentralisation is one of the tools for the development of health system which can have many benefits such as the improvement in technical and allocative efficiency, the improvement of the responsiveness of the health system in meeting the needs of the people. According to Rondinelli , decentralization has been categorized into deconcentration, devolution, delegation and privatization. In Thailand, there has been an increasing emphasis on community participation and decentralization following the Constitution of B.E. 2540 and the Decentralisation Act of B.E. 2542 which has led to the development of the Decentralization Plan of B.E. 2544 and the Devolution Plan to LAO in B.E. 2545. These plans dictated that the provisions of public services were to be devolved to Local Administrative Organisation which include the transfer of infrastructure and the authority to provide health and health promotion services. This study will examine these issues by reviewing international experience of Mexico, Sweden and New Zealand in the decentralization of health promotion services will also be discussed. From the review, after the reform, decentralization has led to many benefits to the provision of health services and to the health system as a whole. In Portugal (deconcentration), it was found that the health status of the population improved significantly after the improvement in access to care. Furthermore, the local authority has become more autonomous and more flexible in order to be more responsive and efficient. Also, in Italy and the UK, the internal market and the purchaser-provider split have been introduced in order to improve efficiency, quality and service satisfaction. However, problems related to decentralization were also found. For example, the occurrence of political conflicts from the reform, inequity which emerged in many forms, the problems relating to responsiveness in the deconcentration system, and the problems with unfavorable condition and contract in the internal market system. The Ottawa Charter has been adopted in many countries as a model for their policies on health promotion which it has emphasized on community participation. In Mexico, they have developed a method of evaluating their progress of the implementation of health promotion policy, and then they have developed a national policy on health promotion, called Health Promotion Operation Model (MOPS)
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