Development of an Empowerment Model to Increase the Potential for Managing the Quality Criteria and Standards of Primary Health Care Services of Directors of Subdistrict Health Promoting Hospitals in Nakhon Pathom Province

Abstract

Objective: The aim was to study the need to increase the potential for managing the quality criteria and standards of primary health care services. Development of an empowerment model and study the effectiveness of the empowerment model to increase the potential for managing the quality criteria and standards of primary health care services of directors of subdistrict health promoting hospitals.

          Methods: A mixed method research was used, both quantitative and qualitative research, divided into 3 phases as follows, Phase 1 was a survey research to explore the need to increase the potential for managing the quality criteria and standards of primary health care services. A questionnaire was used to collect data from 113 directors of subdistrict health promoting hospitals. Phase 2 was a qualitative research to develop an empowerment model to increase the potential for managing the quality criteria and standards of primary health care services by in-depth interviews with 13 experts. And Phase 3 was to study the effectiveness of the empowerment model to increase the potential for managing the quality criteria and standards of primary health care services, consisting of (1) quasi-experimental research with a single group measuring before-after. A questionnaire was used to collect data from 35 directors of subdistrict health promoting hospitals. (2) A summary score assessment according to quality criteria and standards in providing primary health care services, was used to collect data from 35 subdistrict health promoting hospitals. And (3) a questionnaire was used to collect data from 400 people aged 20–80 years. Data were analyzed using percentage, mean, standard deviation, minimum and maximum values. Hypothesis testing was performed using independent sample t test, one-way ANOVA, and paired t test. The statistical significance was set at the .05 level.    

Results: 1) The need to increase the potential for managing the quality criteria and standards of primary health care services of the directors of subdistrict health promoting hospitals were mostly at a high level of 49.6 percent (mean = 179.68, SD = 41.32). 2) The empowerment model to increase the potential to manage the quality criteria and standards of primary health care services was the SER-SIA Model, consisting of “Support” to receive work opportunities; “Encouragement” support; “Resource” support; support for “Self-motivation”; “Information” support; and “Appreciating” the value of work. 3) Effectiveness of the empowerment model to increase the potential for managing the quality criteria and standards of primary health care services, (1) it was found that the potential to manage the quality criteria and standards of primary health care services increased from an average score of 169.20 (SD = 34.79) to 211.91 (SD = 25.81) with statistical significance at the .01 level (p-value < .001). (2) Self-assessment according to quality criteria and standards for primary health care services from an average score of 227.60 (SD = 8.44) increased to 243.57 (SD = 6.73) with statistical significance at the .01 level (p-value < .001). (3) The people were satisfied with the quality and standards of primary health care services at a high level of 90.3 percent (mean = 108.85, SD = 12.36).

Conclusion: The empowerment model discovered by the researcher, namely the     SER-SIA Model, should be used to empower the directors of subdistrict health promoting hospitals in order to increase the potential for managing the quality criteria and standards of primary health care services.