Tagging of healthcare facilities

In Thai OpenStreetMap Facebook Group
https://www.facebook.com/groups/thaiosm/permalink/2666777733371799/

We suggested to use amenity=doctors , maybe with additional tag health_facility:type=health_centre and healthcare = doctor , follow the Peru’s similar guidelines.

Regarding this statement:
“Should we decide to use this tag for the health stations/THPHs (and convert the existing ones to use the tag)?”

I’d say, yes, if we can come to a consensus here, it would be very helpful if someone edited the existing amenity=hospital objects (those that are actually health stations), in Thailand and converted them to the new tagging system. I’ve started to use the newer healthcare tagging but I’m working on Alaska projects right now, mostly geographic and landcover features so am not up to speed on the whole range of possibilities. I haven’t mapped any of these in Thailand in quite a while but when I last did one, I used the simple amenity=hospital tag.

Needless to say, it would also be helpful if the Thailand Wiki were updated to list and explain any specific characteristics relevant to Thailand.

I guess the main consideration would be how we view the semantic meaning of the amenity=doctors/healthcare=doctor tags. Would it still be accurate if the place has doctors available only on certain days, while their main function covers more basic public health activities? (Technically if there are fixed days/hours for doctor visits this could probably be listed with opening_hours:doctor=* or something, but such an approach wouldn’t be practical.)

On the other hand, it’s not just doctors that are available only certain times at the health stations. Dental services, lab testing, counselling, etc. are also similarly scheduled. Looking through this angle, a tag that better reflects the diversity of services offered might be desirable. Tagging as amenity=clinic might be more inclusive in this aspect, but might over-represent their capabilities since the tag is supposed to be used for larger facilities.

In my experience, the requirement that a clinic has a minimum of 10 doctors is overreaching. The discussion page attached to the tag indicates that there was a conversation about that requirement and it is far from obvious that a firm consensus emerged from it.

The small healthcare facilities I see in small towns in Thailand seem to exactly define a clinic in my thinking; “A healthcare office having a doctor or doctors and a nurse or nurses available for less life-threatening health issues. Some offer specialized treatments but many do not and only handle the more general health issues.”

The general comment from the tag’s front page, right panel says “A clinic is a medical centre, with more staff than a doctor’s office, that does not admit inpatients.” This statement fine and I agree with it but then the body of the page goes on to expand the definition extensively.

I am catching up with a larger pile of photos from a mapping trip in Isaan. I saw recently a lot of them tagged as hospital. They even have that in their new name now. Also Google maps to check our competitor has them as hospitals.

Still I feel a bit uncomfortable as with my western background of health care systems I expect from a hospital emergency services. This is why those having a 24/7 emergency department get the additional emergency=yes

I hope that those not local and in need of emergency care do call the ambulance instead of looking up OSM to find some place for treatment. There are also emergencies needing professional care not as time critical as a stroke or heart attack. Like a broken arm or animal bites. I never tried, but according to my wife these Health promoting hospitals should be able to call a doctor from nearby to come there in case of emergencies or they would redirect you to some larger and better equipped facilities. Jo is confident they have paramedic like trained staff there being able to do first aid.

The later would justify the amenity=hospital tagging. Because the amenity=doctors almost always have limited opening hours. I mapped hundreds of them.

In case of emergency the order would be emergency=yes, then hospital, then doctors.

The Subdistrict Health Promoting Hospital is also have limited opening hours.

As I have no first-hand experience with them: How restricted are they? Does it depend on the individual location? Do we have a rule of thumb on what time they are typically available?

I would not expect 24/7 (that would be my requirement to tag emergency=yes), but at least some availability during typical working hours.
Doctors often only three hours in the evening.

This is an example, sorry only on Google as searching my imagery stack takes quite long:
https://www.google.com/maps/@18.7827107,98.9816878,3a,75y,284.08h,87.75t/data=!3m7!1e1!3m5!1s4duu-2jMH4eVZI0EPp2JeA!2e0!5s20110901T000000!7i13312!8i6656

What I am told is that you have doctors at least on stand-by in case something more urgent. Other services will be provided on appointment.

Can you please share what they typically provide in Health Promoting Hospitals from your perspective? What level of doctors are usually available on-site or on-call? what equipment is usually there? to what level can they handle emergencies? out-patients only?

On what criteria should we decide? the tagging? Could it be whether “in-patients” are treated? So beds for multi-day stays are available? And only then call it hospital? That would then bring us to tag these medical centers “amenity=clinic”, even them having the hospital term in their name.

The wiki currently would guide towards this:

Regarding discussing in Facebook link I shared above, the Subdistrict Health Promoting Hospital is not look like “hospital” in their name.
Staff that usually providing service at Subdistrict Health Promoting Hospital everyday is only nurse, not doctor. Operating hours is mostly around 08:00-16:00 daily, can be slightly different for each. It is providing service as first-aid and non-emergency case.
Doctors that look after each Subdistrict Health Promoting Hospital usually stand-by at District-level hospital, and come to provide service at the Subdistrict Health Promoting Hospital for some day in each month, which is scheduled beforehand.

From wiki:

The Subdistrict Health Promoting Hospital does not have patient overnight stay.

I think this is suited this case more than amenity=hospital.

Thanks for the update.

So for these Health Promoting Hospitals/โรงพยาบาลส่งเสริมสุขภาพตำบล how about this tagging:

The distinction from hospital is then based on the inpatient criteria, as also in the wiki: “Admission of inpatients is not provided”
Adding emergency=no to make it clear that this should be not the first point of contact if you have a heart-attack in the middle of the night. Wiki states this this hospital has no “emergency room”. So should not conflict on their ability to provide first aid in less critical cases.

amenity=clinic
healthcare=clinic
emergency=no
name:en=xxx Health Promoting Hospital
name=xxx
name:th=xxx

I hope these Hospitals are not the 776 in Wikipedia mentioned as

but belong to the category of the health centers. I slightly worry about this due to the frequency I observed them during my road trips.

This would allow us to use the amenity=hospital for these officially classified as hospital by the Ministry of Public Health.

No, the community hospitals is district-level. The Sub-district Health Promoting Hospitals is also described in Wikipedia downwards. There are 9826 of them across the country.

I am very surprised that there are so few in OSM mapped. My feeling was that I had mapped dozens of them, I wonder what I tagged them. Searching for “name”~“โรงพยาบาลส่งเสริมสุขภาพ ?ตำบล.+” returns only 111 POI.
And I just fixed one mis-tagged as hospice.

There must be more of them mapped, given that there are nearly 10k of them. And they have quite large signs. At least the ones I mapped. Any idea what the tagging of the missing ones is?

How about the proposed tagging for them?

Previously, the subdistrict health promoting hospital is called “health station” (สถานีอนามัย). In 2009 they all were upgraded to be subdistrict health promoting hospital (โรงพยาบาลส่งเสริมสุขภาพตำบล—รพ.สต.). However the upgrading is mostly focused more on their name than their services, so some people continued to call them health station. Maybe some mappers still tagged it as “สถานีอนามัย” somewhere in osm.

For the tagging scheme, what I’ve been tagging around Ayutthaya are amenity=doctors, following the semi-consensus in Thai OpenStreetMap Facebook Group. However, I’m open to any new tagging scheme we can have a consensus here.

I quickly searched for “name”~“สถานีอนามัย.*” and found another 29 nodes. 30 percent more, but still only a fraction of the total facilities.

We could review them later. I also remember a few years ago about tagging them as government run offices as the hospital category did not fit. Found some of these old nodes tagged like this by long-term mappers.

Waiting for Paul_012 to comment, who initially started this discussion.

I agree with this suggestion. Personally I’m quite not concerned with the mismatched official names, though it might be a source of confusion for casual/irregular contributors, requiring periodical clean-up to fix mistakes.

We might want to keep a tracking tag to help distinguish these facilities from other types of clinics. Maybe designation=รพ.สต. (or designation=THPH)?

There’s a spreadsheet containing coordinates for all government healthcare facilities at data.go.th. Unfortunately the licence is probably not suitable for mechanical import, but perhaps it could be used for cross-checking?

I am just adding “โรงพยาบาลส่งเสริมสุขภาพตำบล บ้านนาไคร้”. Jo suggested to use “Ban Na Khrai Subdistrict Health Promoting Hospital” instead of “Ban Na Khrai Health Promoting Hospital”, which sounds reasonable.

So the boilerplat template to add would be:

amenity=clinic
healthcare=clinic
emergency=no
name:en=xxx Subdistrict Health Promoting Hospital
name=xxx
name:th=xxx

I updated the presets. If you have it in JOSM it will automatically pick it up on the next regular check of the cache.
https://code.osm-tools.org/latest/josm-thai-presets.zip

The name is quite unique. And mis-tagged places do not use this wording. I suspect that most amenity=hospital in Isaan could be these Health Promoting Hospitals. So no designation required.

In case we document it in the Wiki, I can also link to a different page in the presets (maybe a sub-section of the Thailand page?). Currently it points at amenity=clinic.

Overpass query for hospitals:
https://overpass-turbo.eu/s/VAC

A random check directly found Nodes with shortened tagging.
https://www.openstreetmap.org/node/1802406245

For the English name, all varieties of “Subdistrict Health Promoting Hospital”, “Subdistrict Health Promotion Hospital”, “Sub-district Health Promoting Hospital”, “Sub-district Health Promotion Hospital”, “Tambon Health Promoting Hospital” and “Tambon Health Promotion Hospital” appear to be in use on the web. It’s hard to tell if there’s an official preference, since the signs I’ve seen are only in Thai.

Unfortunately there isn’t any official translation for โรงพยาบาลส่งเสริมสุขภาพตำบล.
Since ตำบล have been officially translated to subdistrict, so we should use Subdistrict as the first word. For others, I’m not sure but I think I have seen Promoting more than Promotion.

Based on paul_12’s naming variations I made several Overpass searches to see if I could get a list of all such places in Thailand. My query was to simply retrieve objects having either the tag (amenity=hospital or amenity=clinic) and the word “Subdistrict” **and ** the word “Hospital” in their name:en tag. (A search using the same criteria except to substitute the word “Clinic” for “Hospital” retrieved no results.)

I was surprised to learn that of the 167 found objects none were in the Chiang Mai area. Most are in Issan. Furthermore, only one of those has either the word “Promotion” or “Promoting” in that tag. This was the only one: Ban Khok Klang Subdistrict Health Promoting Hospital. There must be scores of such places that have only a simple amenity tag but no name:en tag. I know I’ve tagged them that way in the past because their Thai names are usually long and tedious for me to translate without a lot of effort.

I think it is going to be very difficult and time-consuming to edit those existing amenities properly without visiting them. The good news (sort of good news, anyway) is that many of the small clinics/hospitals we’re discussing don’t yet have an English name tag and there are only 167 that do.

It’s a good idea to firm up our tagging now before many more of these get added to OSM.

Quite frequently we base on the research the Wikipedia community did before. They call it Health Promoting Hospital
https://en.wikipedia.org/wiki/Hospitals_in_Thailand#Sub-district_Health_Promoting_Hospitals

A cross-check with Google translate also returns Health Promoting Hospital. Removing Tambon then returns Promotion

There seems to be a WHO project with this name:
https://en.wikipedia.org/wiki/Health_promoting_hospitals

and they mention a Bangkok charter: https://www.who.int/healthpromotion/conferences/6gchp/bangkok_charter/en/

On the member states Thailand is not listed. So the status is a bit unclear for me.

This document calls them THPH, Tambon Health Promotion Hospital:
https://www.who.int/alliance-hpsr/projects/alliancehpsr_thailandprimasys.pdf?ua=1

This publication and all references call Health Promoting:
https://www.anamai.moph.go.th/ewtadmin/ewt/advisor/download/Factsheet/Eng/FS_Vol2No8E.pdf

So certainly the translation is not uniform. We could settle on one way. As there are usually no English signs around I think other mappers will follow what is the example on existing places or simply use the preset.