Self-Assessment of Primary Healthcare Service Delivery System at Family Medicine Clinics for Managing Non-Communicable Chronic Diseases in Municipal Districts

Abstract

This cross-sectional study was conducted with a group of 54 healthcare personnel working in family physician clinics of Chaiyagun network of Sunpasitthiprasong Hospital, Ubon Ratchathani province, who voluntarily participated in the study. Instruments used in this study were based on the Primary Care and Chronic Care Model (CCM) frameworks, which were content-validated by experts (IOC=0.8). Data were collected through self-assessment and analyzed using frequencies, percentages, means and standard deviations.

The study found that the majority of the Primary Care Unit (PCU) workforce samples were female (83.3%) with an average age of 44.4 years (SD=9.85) and had more than 3 years of experience working in primary care (=7.69, SD=5.72). They served as service providers/care team members. The samples self-evaluated their performance in 5 domains of the CCM framework. Overall, the quality of the main care process was at level B (79.6%) with =6.40 (SD=1.44), while the quality of the supporting care process was at level B (51.9%) with =7.18 (SD=1.39). The obstacles to providing primary health care services were: high workload of health professionals compared to the available workforce, lack of fit between the Ministry of Public Health's indicators and the community's contexts, budget management system linked to the district hospital, unfavorable working environments, and limited medical tools. However, the work atmosphere was characterized by autonomy and good collaboration among health professionals. The development of the support system from the network organization involved reviewing the learning management process, continuous and clear communication, as well as designing a clear health care management system.

Therefore, the principle of designing family physician clinics to provide primary healthcare services should be based on the contexts of the target population and the potential of the interprofessional team. Regular communications among healthcare professionals should be maintained to promote collaborative learning and ensure autonomy in the management of family physician clinics.