Development of Provision of Services to Foreigners by the Service Units under the Ministry of Public Health, Yasothon Province

Abstract

The purpose of this study is to improve the provision of services to foreigners by service units under the Ministry of Public Health in Yasothon Province by developing activities in 4 areas, namely health insurance, health service system management, medical service compensation system management, and creation of database systems. The implementation was based on the service unit development guideline from February 2018 onwards, and the assessment was conducted during February – April 2020 using purposive sampling from the population under this study: (1) all the foreigners receiving services from the service units, (2) 122 public health officers in hospitals, sub-district health promoting hospitals and Ban Doet Community Health Center, 118 of whom answered questions on Google Form. The instruments employed were a developed service guideline of the service units, a data collection form, and a questionnaire. As for data analysis, qualitative analysis was carried out by the researcher, and quantitative analysis was performed using package software. The statistics used were frequency, percentage, mean, standard deviation, maximum, and minimum. 

          It was found that before the development, in fiscal years 2016-2017, 418 and 83 foreigners of 3 nationalities (Laotian, Burmese, and Cambodian) bought health insurance cards. There were 119 and 102 foreigners receiving services in hospitals, with the total expense of 478,993.00 baht and compensation of 7.59%, and the total expense of 459,258.00 baht and compensation of 10.73%. There were 3,405 times and 2,543 times of service use as outpatients in hospitals, with the total expense of 2,298,196.00 baht and compensation of 63.56%, and the total expense of 940,018.00 baht and compensation of 22.71%. There were1,007 times and 910 times of service use as out patients in sub-district health promoting hospitals, with the total expense of 45,315.00 baht and 40,950.00 baht without compensation. After the development, in fiscal years 2018-2019, 372 and 44 foreigners of 3 nationalities bought health insurance cards. There were 131 and 126 foreigners receiving services in hospitals, with the total expense of 831,734.00 baht and compensation of 17.53%, and the total expense of 758,226.00 baht and compensation of 26.73%. There were 4,463 times and 2,330 times of service use as outpatients in hospitals, with the total expense of 1,587,423.00 baht and compensation of 53.00%, and the total expense of 955,358.00 baht and compensation of 25.78%. There were 851 times and 903 times of service use as outpatients in sub-district health promoting hospitals, with the total expense of 38,295.00 baht and 40,635.00 baht without compensation. The officers had information supporting the operations in 4 areas, which were 1) information on foreigners buying health insurance cards, 2) links to the Foreign Worker Insurance Fund, 3) information on foreigners from the HOSXP database (43 folders) categorized by district, 4) information on foreigners receiving services categorized by service units from the HOSXP database (43 folders). The officers’ opinion on the development was at a moderate level (49.2%), followed by at a low level and a high level (44.1% and 6.8%, respectively). The officers’ satisfaction in the development was at a low level (43.2%), followed by at a moderate level and a high level (33.9% and 22.9%, respectively). The average satisfaction score was 6.42 points (out of 10 points).