Five organisations to introduce standard in patient care as 450,000 Thai people die yearly and half of them pass away at hospitals
Credit photo https://pixabay.com/en/people-adult-indoors-care-diagnose-3167294/
Five governmental and academic organisations signed a memorandum of understanding (MOU) to define palliative care services in Thailand. The movement responds to its ageing society and the increasing number of patients suffering chronic diseases. The organisations are confident that the collaboration will improve the quality of hospice care and they will propose the National Health Commission and the Ministry of Public Health announce the operational definitions of palliative services for implementation at nationwide hospitals and expand three medical treatment funds to cover the services.
The MOU was signed on April 25, 2018, for the five organizations to create the operational definitions of words related to palliative care in Thailand. The five organizations are the National Health Commission Office (NHCO), the Faculty of Medicine at Chiang Mai University, the Department of Medical Services under the Ministry of Public Health, the Health Systems Research Institute (HSRI), and the Thai Palliative Care Society.
Dr Poldej Pinprateep, secretary-general of the National Health Commission, said knowledge on palliative care to let patients pass away with human dignity was important and necessary for the Thai society as the numbers of older people and patients suffering chronic diseases were growing. Organizations in health systems have been implementing policies related to palliative care. For example, the National Health Security Office improved the relevant medical welfare and the budget expenditure that support palliative care in communities and the Ministry of Public Health ordered its hospitals to set up units to provide palliative care. However, there have been problems about the policy implementation because there is not a standard definition of words related to palliative care. This has impacts on, for example, legal action, operational regulations, and budget disbursement and audit.
“The NHCO, as a main organization working for health-related rights and responsibilities in compliance with Section 12 of the National Health Act of 2007, together with the Faculty of Medicine at Chiang Mai University, the Department of Medical Services under the Ministry of Public Health, the Health Systems Research Institute, and the Thai Palliative Care Society are working out the operational definitions of words concerning all palliative services. This is to set a standard for implementation at hospitals and improve palliative care.”
Dr Poldej said that when the definitions are completed, the NHCO will organise an issue-based health assembly to gather opinions from all concerned parties and reach a consensus. Then the definitions will be proposed to the National Health Commission that will in turn issue an announcement and submit it to the Ministry of Public Health that supervises more than 1,000 hospitals. The ministry will issue its announcement to support the palliative care that is sustainable and meets international standard.
The MOU signing event included a discussion on the operational definitions of words concerning palliative care in Thailand. Dr Ukrit Milinthangkool., advisor to the National Health Commission, said 450,000 Thai people died yearly. Half of them died at hospitals and the places where the other half passed away were unknown. The Health Systems Research Institute found from its research that most of patients suffering terminal illness want to die at home but this is not covered with medical treatment welfare from the Social Security Fund and the Comptroller General’s Department which supervises medical welfare for governmental officials.
Dr Ukrit said the standard definitions of words related to palliative care were important to policy implementation, patients’ welfare systems, relevant laws, budgets, human resources development and curricula. They also help reduce the unnecessary exploitation of medical resources and relieve the overall economic burdens of the state.
Dr Suphan Srithamma, head of an academic committee working on the operational definitions, said operational units tasked with palliative care had their own ways of work. The operational definitions will set a standard for their work. They will support policy implementation and maximise patients’ benefits.
“This study should focus on academic principles and participation processes to have the same direction of development. All concerned parties must be heard in all aspects. The government sector and the private sector must share the same stance. When it is completed, it will be discussed in an issue-based health assembly and proposed to the National Health Commission and the Ministry of Public Health for actual implementation in the future.”
Dr Kajeerat Prak-eko, a specialist at the National Health Security Office, said the NHSO provided patients of terminal illness with quality palliative care. It pays lump sums to palliative care units for the treatment of individual patients. It plans to cover 10,000 such patients this year.
“The central committee on benefits is considering relevant matters so that all Thai people will receive the care equally from three sources namely the NHSO, the Comptroller-General’s Department and the Social Security Fund.”
Assist Prof Dr Jaruayporn Srisasalux, the study project manager and representative of the Health Systems Research Institute (HSRI), said HSRI would offer academic support for the definitions of palliative and hospice care, dying, the terminal stage of life and death in medical and legal terms. The definitions will create standard understandings among concerned parties.
“Health personnel will use the definitions for their communications with people, patients, patient carers and staff of the organisations that give financial support for care essential for the quality of life of dying patients.”
Assoc Prof Dr Srivieng Pairojkul, president of the Thai Palliative Care Society, said the MOU would lead to standard understandings on, for example, the definitions of dying patients. Other countries define such patients as the people who are expected to die in 6-12 months. It will also result in the development of medical and social care and welfare benefits for everyone.