Manuscript

Equity of access to medical care in fooded and non-food area

of Bangkhla district, Chachoengsao province, Thailand 255
Yothin Suwanpredee
1
, Taweewat Kornrit
1
, Sumas Ruenhunsa
1
, Ram
Rangsin
2
, Tanongson Teantavorn
2
, Tassanee Chatmethakul
2

6
th
year Medial Cadet, !hramongkutklao College o" Mediine,
2
Military and
Community Mediine #epartment, !hramongkutklao College o" Mediine,
$angkhla hospital
Background! %n the past deade Thailand had "aed many
natural disaster, whih keep inreasing in &oth "re'ueny and
severity( )lood remains one o" the most "re'uent disaster that
a*et many parts o" Thailand ausing wide arrays o" pro&lems
inluding eonomi, "ood, shelter and espeially medial pro&lem(
Medial pro&lem is the hardest pro&lem to solve due to it+s
assoiation with supply distri&ution, manpower, ommuniation
and servie provider( This leads to poor progression o" hroni
disease and late aess to emergeny are( This study aimed to
analy,e the pro&lems that ause the ommunity to deprived o"
medial servie and to ompare the aessi&ility to medial
servie o" -ooded and non.-ood area to &e use in the "uture(
"#$ectives
1(To speulate e'uity o" aess to medial are in -ooded and
non.-ood area
2(To study eah aspets o" pro&lem that ause medial servie
deprivity
/(To ollet inidents o" eah diseases in -ood event
0()ormulate a strategy to &e use in the "uture event o" -ood(
Study design
Cross.setional #esriptive and 1ualitative study, &y using
1uestionaire and in.depth interview to eveluate eah su&2et(
The olleted data are then used to make ontent analysis(
%aterial and methods3 Cross.setional #esriptive study and
1ualitative study
1(Randomly selete patients who reeive medial servies at
$angkhla hospital 4!# and 5R (#ivide su&2ets into two groups3
patients "rom -ooded area and non.-ood area(
2(%nterview &oth group with prepared 'uestionaire together with
in.depth interview
/(Reording inidents o" eah diseases during the -ood
0(6naly,e and ompare the di*erene o" pro&lems in &oth group
o" su&2ets
7(!resent study result to diretor o" $angkhla hospital to &e use
in "ormulation o" ne8t -ood event preparation strategy
&esults!
1(The pro&lem o" e'uity o" aess to medial are in -ooded
and non.-ood area isn+t "rom laking medial are provider or
servie9supplies distri&ution: , it+s unawareness that one e8ist and
o&stales to reah it(
2()rom the inidene we have "ound that most o" the patients
in -ooded area who seek medial servie, done so to get
mediations "or their underlying disease9hroni disease
eg(dia&etes, hypertension:, "ollowed &y minor trauma;animal &ites(
<owever, "rom the study we have "ound that patients with
hroni disease who have reeived their monthly mediation "rom
$angkhla =eld hospital was presri&ed only 1 month supplies o"
mediation, whih in light o" the situation should have reeived
more(
/(Sample group also revealed that #istrit <ealth !romotion and
!revention Centres in some o" their areas were lose
9inonsistent with healthare poliy:(
Conclusion! 6s the results suggested, improving re"erral
apa&ilities and pu&li relations should &e our priorities
1(Re"erral apalities an &e enhane &y many means suh as
re'uesting aid "rom other department, upgrade urrent e'uipment
to meet re'uirement
2(!u&li relations an &e divide into two parts 3 &e"ore and
during the event
2(1 $e"ore the event,pre.planned medial servie enter
loation should &e delared
2(2 #uring event o" -ood, loation o" medial sevie enter
should &e known throughout the ommunities and apa&ilities o"
that enter should also &e made lear 9wound dressing, surgery
et(: