Abstract
This study assesses some of the lessons learned in primary care management under
the universal health-care coverage scheme in the contracting unit for primary care at PhuKradueng Hospital, which received the Golden Universal Coverage Innovation Award
(UCIA) from the National Health Security Office in 2004. The study was conducted by
analyzing the hospital’s management in terms of structure, process and output, comparing the outcome before and after starting the universal coverage programme and comparing the outcome with that of other contracting units for primary care in the same
province. This study showed that the contracting unit for primary care could meet service standards in manpower by motivating nurses from Phu Kradueng Hospital to work
in subdistrict health centers. Every subdistrict health center could meet the manpower
standard in terms of quantity (health officer per population 1:1,250) and quality (every
subdistrict health center operated with more than one nurse). Although the manpower
levels were lower than the mean for the whole country, Phu Kradueng Hospital could
still provide health services with a customer-focus policy, extending service times in both
the hospital and subdistric health centers. Among its innovations were those related to
the distribution of resources, recruiting manpower as in the private sector, paying staff
according to a performance-based budgeting system, and dividing family health status
into four levels, which enabled health officers to plan in a systematic maneuver to provide efficient health care. This study concluded that a small rural health service unit
could provide standard services while reducing indirect and direct household costs, if
the health organization had a common goal, modified private management and managed human resources efficiently
