Abstract
The aim of this development research study was to develop the patterns of the primary
care service in Sritia and Laoyaw tambons of Baan Hong District in Lamphun Province,
where they conjoin with Chiang Mai Province. The study was undertaken in the
period 2003 - 2006. The study was conducted in a number of phases: first, correcting the data, then planning, followed by processing, and finally evaluating the outcome. In the
first period of this study, the population of the Sunpulauy Primary Care Unit (PCU) required
extraordinary health-care service out that posed a budgetary problem under the
Universal Coverage system in the Banhong PCU. Subsequently a meeting was held to
study and correct the statistical data, the health-care services received, the number of
patients with chronic illness, the ways to establish health-care services, the ability to recruit
new patients, evaluate the competency of the health-care team, and prepare to develop
the pattern of health-care services. In second phase, arrangements were made for
family nurses to work in the PCU full time and be associated with the community based
health-care services. In the third phase the Laoyaw PCU was developed to become the
center for community medical-care services with the provision of a doctor for providing
medical care and evaluating the outcome of processing.
In the fourth phase, the people in Sritia and Laoyaw tambons enjoyed a greater
range of health-care services. Patients in the Laoyaw PCU increased from 11.94 percent
of the population in 2004 to 24.60 percent in 2006, because family nurses were working in
this PCU and developed it into a community medical-care center. The Laoyaw PCU decreased
the UC budget following the DRGs of the Sunpulauy PCU. The population receiving
health-care services increased from 20.69 percent in 2004 to 36.13 percent in 2006.
The screening of patients with hypertension increased 3.32 more than three fold, and that
of patients with diabetes mellitus increased more than 5.6 times from 2003. The number
of patients with respiratory diseases decreased; increased screening was carried out for
diseases associated with community problems, that is, myalgia of the muscle and skeleton
systems. The community medical hub was connected to the primary health-care
service system in this area. The study found that it is possible to develop persons in the
community and public health volunteers following the system policy that stresses improving
health using the Banhong UC budget.
