A Study of Healthcare Facility Advertising Law Violations on Facebook by Aesthetic Clinics in Nakhon Si Thammarat Province

Abstract

This cross-sectional descriptive study examined the prevalence, types, severity, and co-occurrence patterns of healthcare facility advertising law violations on Facebook by aesthetic clinics in Nakhon Si Thammarat Province. The sample comprised the 10 most recent posts from 62 aesthetic clinics in the province, totaling 620 posts. Violations were assessed using a 19-item framework synthesized from 6 relevant laws and professional regulations, together with operational guidelines issued by the Department of Health Service Support. Severity was evaluated using the Weighted Severity Score (WSS). The researcher, an authorized official under the Healthcare Facility Act B.E. 2541 (1998), served as the sole adjudicator, with an independent rater re-evaluating 10% of posts, yielding a Cohen's Kappa of 0.9742 (Almost Perfect). Results showed that 98.4% of clinics had at least one violating post, and 86.3% of all posts contained at least one violation. The most common violations were failure to display the advertising approval number (82.7%), false or exaggerated claims (65.8%), and failure to display legally required warnings (46.3%), which frequently co-occurred as a cluster (Phi Coefficient 0.415–0.517). Severity assessment revealed that 55.0% of posts were rated as high or very high risk. Multi-branch clinics had significantly higher violation rates and severity scores than independent clinics (p = 0.002 and p = 0.025, respectively). The study recommends developing proactive AI-integrated monitoring systems and prioritizing law enforcement according to violation severity.