Development of a Support Model for Primary Healthcare Services for Subdistrict Health Promoting Hospitals Transferred to the Trang Provincial Administrative Organization

Abstract

     This study was a research and development (R&D) project aimed at examining the situation, developing a support model, and evaluating the model for a support model for primary healthcare services for Subdistrict Health Promoting Hospitals (SHPHs) transferred to the Trang Provincial Administrative Organization. The research and development process was divided into three phases: (1) analyzing the situation, identifying needs, and fostering collaboration; (2) developing and piloting the model; and (3) refining the model and evaluating its effectiveness. The sample group consisted of personnel from the Trang Provincial Public Health Office, the Trang Provincial Administrative Organization, and members of the public who had received services from the transferred Subdistrict Health Promoting Hospitals. Data were collected through interviews, focus group discussions, and questionnaires. Data were analyzed using descriptive statistics, content analysis, and comparative analysis with the Paired t-test.

     The study found that: 1) In Trang Province, there were 30 Subdistrict Health Promoting Hospitals transferred to the Trang Provincial Administrative Organization (24%). A total of 290 public health personnel (10.86%) were involved. Problems identified included inadequate preparation, uneven distribution of personnel, unclear resource management, and a need for a joint task force. 2) The TRANG-ME Model comprised 7 components: Team Management, Resource Development, Access to Health Services, Network Integration, Good Governance, Monitoring, and Evaluation. 3) The results before and after the model implementation showed significant statistical differences in the average scores according to primary healthcare service quality standards (p < 0.05). The areas that changed the most were management, personnel management, and information systems, respectively. The satisfaction level of service users was the highest ( ± SD = 4.37 ± 0.192), and the satisfaction level of personnel was high (  ± SD = 4.04 ± 0.104). The research results suggest that implementing the TRANG-ME Model would improve the support system's effectiveness, covering all dimensions. It would help promote the development of effective management mechanisms, quality standard improvements, expanded access to services, and systematic budget management in the Subdistrict Health Promoting Hospitals transferred to the Trang Provincial Administrative Organization. It would also ensure continuous monitoring and evaluation to provide primary healthcare services in line with the goals of the Primary Health Care System Act B.E. 2562.