title: From health situation to health education and health service reforms for Thai society.
abstract: BACKGROUND
  Health problems and service utilization patterns among Thai populations have changed significantly over the past three decades. It is imperative to scrutinize the changes so that the health service and human resource development systems can appropriately respond to the changing health needs.
  
  
  OBJECTIVE
  To synthesize critical issues for future planning of health service reforms, medical education reforms and health research for Thai society.
  
  
  METHODS
  The authors analyzed data on health service utilization, types of illnesses and hospital deaths among Thais in the fiscal year 2010. Information on the illnesses of in-/out-patients and hospital deaths was extracted from the three main health insurance schemes providing coverage to 96% of the population. The authors then synthesized the key issues for reforming medical education and health services.
  
  
  RESULTS
  In summary, Thai patients have better access to health services. The total number of out-patient visits was 326,230,155 times or 5.23 visits per population. The total number of in-patient admissions was 6,880,815 times or 0.11 admissions per population. The most frequent users were between 40-59 years of age. The most common conditions seen at OPD and IPD and the causes of in-hospital mortality varied between age-groups. The key health issues identified were: psychosocial conditions, health behaviour problems, perinatal complications, congenital malformations, teenage pregnancy, injury, infectious diseases, cardiovascular diseases and neoplasms. Medical education reforms need to be designed in terms of both undergraduate and post-graduate education and/or specialty clinical needs. Health service reforms should be designed in terms of patient care systems, roles of multidisciplinary teams and community involvement.
  
  
  CONCLUSIONS
  The government and other responsible organizations need to actively respond by designing the health service systems and human resource development systems that are relevant, appropriate and integrated. Different levels of care need to work collaboratively in order to achieve the greatest quality and efficiency.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. chapan@kku.ac.th
authors.forename: Charnchai
authors.initials: C
authors.lastname: Panthongviriyakul
authors.forename: Pattapong
authors.initials: P
authors.lastname: Kessomboon
authors.forename: Sumitr
authors.initials: S
authors.lastname: Sutra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004501:Education, Medical / Q000639:trends; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006304:Health Status; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D012106:Research / Q000639:trends; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology