Development of the Primary Health care System after the Transferring of the Sub-District Health Promoting Hospital to the Provincial Administrative Organization: A case study of the Sub-District Health Promoting Hospital in Nakhon Ratchasima Province

Abstract

This is action research. The objective is to analyze the current situation in the development and evaluation of the primary health care system after the transferring of the sub-district health promoting hospital to the provincial administrative organization. The sample group included administrators of primary health care units. At the provincial and district levels, there are 34 people, 102 people working in district primary health teams, 17 people working in sub-district primary health teams, and 17 people working in community primary health teams. people, and groups of service recipients from 5 groups of primary health care teams, totaling 85 people. Research instruments used in this research include document analysis, in-depth interviews, group discussions, expert opinions and suggestions, area follow-up visits, service recipient satisfaction questionnaires, and service recipient quality of life questionnaires. As for the quantitative data analysis using descriptive statistics such as frequency, percentage, mean, and standard deviation, the qualitative data section analyzed the data by classifying and grouping the data.

This research found that (1) the results of the evaluation and analysis of the current situation in terms of context showed that the overall average was at a high level (M = 3.94, SD = 0.61), in terms of input factors. Overall was at a moderate level (M = 3.60, S.D. = 0.60), process aspect The overall level is at a moderate level (M = 3.64, S.D. = 0.58), and the overall level of productivity is at a high level (M = 0.62, S.D. = 0.47). In terms of obstacles, including personnel, work processes in the area are increasing. Inadequate personnel to carry out the work (2) Development of the primary health care system. Found factors for success include: having true leadership; creating characteristics that are ready for development; and having management and team management. Primary health is systematic and integrated, requiring the participation of network partners who must work according to the process by adhering to the plans and goals that have been set, and there must be a model and guidelines for managing the primary health system. The model for developing the primary health care system consists of 1 goal, 4 issues, and 16 measures. (3) Evaluation of service recipient satisfaction The overall average satisfaction was still at a high level (M = 4.07, S.D. = 0.49), and the results of the assessment of the quality of life of service recipients The overall average quality of life of service recipients was at a moderate level (M = 3.29, S.D. = 0.61). Recommendations should encourage the participation of health network partners. Provincial level and area level, and should add a variety of communication channels.