Development of the Primary Health care System after the Transfer of the Sub-District Health Promoting Hospital to the Amnat Charoen Provincial Administrative Organization.

Abstract

      This action research aims to analyze the current situation, develop a model for primary healthcare services, and evaluate the model for primary healthcare services under the transfer of Subdistrict Health Promoting Hospitals to the Amnat Charoen Provincial Administrative Organization. The sample groups included 24 executives, 42 district-level personnel, 154 subdistrict/community-level personnel, and 296 service recipients. The tools used comprised document analysis, in-depth interviews, focus group discussions, expert feedback forms, satisfaction questionnaires, and quality of life questionnaires. Quantitative data were analyzed using frequency, percentage, mean, and standard deviation. Qualitative data were analyzed by classification, grouping, and content analysis.

      The results indicated that (1) the analysis of the current situation found that the overall context dimension was at a high level (M = 3.78, SD = 0.61); the input factors were at a moderate level overall (M = 3.60, SD = 0.60); the process dimension was also at a moderate level (M = 3.58, SD = 0.57); and the output dimension was at a high level (M = 3.43, SD = 0.46). Regarding challenges, budget and equipment support were not sufficiently flexible, personnel were inadequate and overburdened, data recording was burdensome, and patient care was not continuous, integrated, or holistic. (2) The developed model consisted of one goal, seven major strategies, and 19 sub-strategies, including developing leadership and primary healthcare teams, coordinating network partnerships, developing integrated networks, managing primary healthcare strategic plans, improving quality standards, managing resources and support systems, and developing information technology systems. (3) The evaluation of the model showed that service recipient satisfaction was at a high level overall (M = 3.86, SD = 0.44), while quality of life was at a moderate level (M = 3.00, SD = 0.59). The outcome indicators met both criteria.