U.S. technology in Thai hospitals will have a positive, negative or neutral effect on the mortality rate of patients in Thailand. U.S. hospitals currently offer patients some of the most modern and complex technology available. Patients whether at private or public facilities are very often afforded modern urgent care that reduces the likelihood of mortality from common and less common illness. The mortality ratio, or comparison of patients admitted vs. discharged in most U.S. hospitals is close to or less than 1.00 (Comaro, 2003).
In Thailand hospitals, modern technology used in community hospitals is somewhat limited and typically consists of the use of X-Ray technology and ultrasound for imaging and diagnosis (Dionson, 2003). Many community hospitals currently lack the advanced technology available in U.S. hospitals that has been proven to save lives. There are several private institutions within Thailand however, that do offer more advanced technology.
However, Thai hospitals historically have focused on health improvement measures unrelated to technological advances, including alternative health care and prevention mechanisms. These aspects of health care will be excluded for purposes of conducting this study; however their relation to mortality rates and significance for future study use will be examined in some detail.
A contributing factor to mortality rates within Thailand may be the lack of appropriate technological resources, an important asset when managing health care and illness. In order to justify this rationality, the type of illnesses and mortality rates of specific populations within Thailand must first be identified before any deduction can be made regarding the use of modern technology, such as that used in the U.S. Similarly, a survey must be conducted of the technologies widely used in like hospitals with similar doctor to patient ratios in each hospital to be examined.
This study will potentially show that the mortality rate in Thai hospitals will be affected should U.S. technologies be used more profusely within community based and private hospitals in Thailand. With recent scares such as the SARS epidemic, one must question the importance of the use of technology in reducing mortality rates. The SARS epidemic greatly ravaged much of Asia. There is some question as to whether modern technology may have prevented the devastating impact of the disease. Could more modern technology have resulted in less mortality?
Mortality rates within the U.S. when examined in relation to diseases such as cancer, heart disease and digestive disorders seem to indicate that use of advanced technology does reduce the impact of mortality on patients (Comaro, 2003).
The U.S. health care system has been touted as being one of the most successful and advanced systems in the world today. It is feasible therefore, to postulate that the use of U.S. technologies might improve mortality ratios and statistics in Thai hospitals as well.
Statement of Problem
Increased mortality rates are unavoidable in situations where adequate technology and healthcare resources are not available to the general public. In Thai Hospitals access to the most modern technology is limited to patients who can afford to attend private hospital institutions. The general public is often uninsured, and must rely on the technology currently available in community hospitals. Community hospitals have access to imaging technology but not necessarily more advanced technologies such as those used within the U.S.
Technologies currently used within the U.S. include advanced glucose monitoring equipment, hematology devices, immunoassay technology such as the ADx and TDx, molecular diagnostics equipment such as the ABI Prism and m1000 and Transfusion systems such as the Quantum II (Abbot, 2003). The gap between technologies between U.S. hospitals and Thai hospitals must be identified and examined more closely to assess whether Thai hospitals would benefit from introduction or more advanced technologies.
The purpose of this study is to examine the following: will use of U.S. technology in Thai Hospitals have statistically significant impact mortality rates of patients, whether positively, negatively or neutrally?
Secondarily, the importance of advanced technology will be revealed as a result of the data collected in this study. Currently the U.S. attributes its reduction in mortality rates in part to the advent of more advanced technologies. Other countries however, such as Thailand, have also realized improved healthcare statistics in recent years, despite the lack of access to high tech technologies.
Statement of Hypothesis:
Null Hypothesis: There is no statistically significant difference between mortality rates with in U.S. hospitals vs. Thai Hospitals of like function. The use of U.S. technology in Thai hospitals will not affect mortality rates.
Alternative Hypothesis: There is a statistically significant difference in mortality rates within Thai vs. U.S. hospitals as a result of the use of U.S. technology.
Definition of Terms
Antigen - A naturally occurring substance in the body that stimulates production of antibodies, which include toxins and bacteria (Abbot, 2003).
Antibody - Protein secreted in the blood that binds to antigens and neutralizes it, a lymphatic or protective response of the body to fight disease (Abbot, 2003).
Glucose Monitoring - Technology used to monitor blood glucose/sugar levels, typically in patients that are diabetic (Abbot, 2003).
Hematology - Measure of the components of whole blood which includes measurement of red and white blood cells, platelets (Abbot, 2003).
Reputational Score - Percentage of a specialty's responding to board-certified physicians who named the hospital in U.S. News Survey's (Comaro, 2003)
Mortality Ratio - Number of Medicare patients from admission to discharge in 1999, 2000, and 2001, compared with deaths expected after adjusting for severity. Above 1.00 is worse than expected; below 1.00 is better (Comaro, 2003)
Discharges - Number of Patients Discharged in 1999, 2000 and 2001 after receiving specified care (Comaro, 2003)
Immunoassay Systems - Tests that analyze diseases and patient conditions by measuring the body's "antigen/antibody reaction" (Abbot, 2003).
Molecular Diagnostics - Testing that incorporates the study and examination of DNA, RNA and proteins "that are possibly infected with disease" (Abbot, 2003).
Technology Services - Number of key specialty -specific technologies offered (Comaro, 2003).
Transfusion Technology - Products designed to ensure the safety of blood supply that typically detect hepatitis, retrovirus and similar blood diseases (Abbot, 2003).
Questionnaire - A tool or instrument used to collect responses and gather data regarding specific facts or objectives (Alreck & Settle, 1995).
Importance of Study
The purpose and significance of this study is to reveal the relationship between use of modern technology and mortality rates in hospitals. This study will assist hospital administrators and government healthcare officials in deciding which technologies are most essential to use when establishing standards of excellence for care. Currently adequate studies have not been conducted that assess whether Thai hospitals would benefit from use of U.S. technologies.
The government of Thailand recently enacted legislation that reduces the cost of accessing community healthcare to just 30 baht (Agence, 2003). This study will enable patients and community leaders to assess whether the mortality rates within Thai hospitals might actually be reduced with the advent of more technologically advanced diagnostic and treatment technologies. The results gained from this study will enable officials to assess what technologies are critical and which may be overlooked in the face of future budget cuts.
Scope and Delimitations of the Study
Patients to be studied will include patients with the following general conditions:
Heart and Heart Disorders
Patient mortality ratios will be examined in each of these categories in X number of select U.S. hospitals and X number of select Thai hospitals of similar size and scope. The hospitals studies will have similar physician to patient ratios and R.N. To patient ratios. The study will be limited to hospitals with a capacity of 300 -2000 beds only. Patients in the specified categories will have access to or may benefit from technologies associated with their disease.
Research indicates that mortality rates are affected by a variety of factors increased technology being one of them. There is some evidence that points to increased advanced technology within the U.S. As a factor in mortality reduction over the last century. The U.S. has been credited with having one of the best emergent health care systems in the world. This does not however, assume increased satisfaction with health care among U.S. citizens.
Mortality rates have in fact steadily declined and are almost non-existent in some states, due in part to advances in medical technology that allow for better diagnosis and treatment of disease. Poverty also however, has statistically been proven to affect mortality ratios in many countries. Thailand in the past has attempted to provide access to healthcare to all of its citizens, which may compensate for a lack of equitable "high tech technologies" such as those offered within the U.S. Thailand has to deal with issues of poverty more often when assessing mortality rates.
Recently in Thailand, hospitals and medical facilities have faced drastic price cuts initiated by the government which has resulted in a shortage of medicine and supplies (Agence, 2003). According to the Rural Doctors Society in Thailand, of 700 community hospitals, currently "one in three was facing…