Abstract
The objectives of this research are to analyze the health situation, problem, people’s needs and opinions on health care services, to study the administrative systems and mechanisms, roles, and responsibilities of the Provincial Administrative Organization (PAO), as a health care provider, for readiness support. The study was carried out with Mixed-method research. Data were collected and analyzed quantitatively and qualitatively in seven provinces in the north of Thailand, consisting of Lamphun Province, Phayao Province, Uttaradit Province, Phichit Province, Sukhothai Province, Phetchabun Province, and Uthai Thani Province. The results showed that 1) The health situations and disease groups at the highest rankings are high blood pressure (BP), diabetes, cancer, general diseases, raised blood lipids, and heart disease, respectively. The main types of health services provided to people are regular health check-ups, vaccinations, disease screening services, health counseling for the elderly, and other health care services. When comparing both situations, before and after the transfer, some problems found in providing health services by the Sub-district Health Promoting Hospitals (SHPH) that were consistent with each other areas that reflect the level of people's satisfaction in quality, efficiency, and effectiveness of health care services, as well as the administrative systems and mechanisms. 2) The local team leaders have a direct role and responsibility to restructure, define the strategies management and implement to achieve the goals. The key success factors in preparing and supporting primary care services systems based on the "people-centered care concept" consisted of the following systems; health care service, budget, building and environment, human resource development, quality standard, medical equipment & supplies, technology and communication, monitoring and evaluation. 3) The proposed policy and regulations improvement to support Local healthcare services are followings; 3.1) The Systematic development of internal strategies management for Healthcare Services. 3.2) Establishing effective mechanisms for driving the health care system towards a "Wellness city" for taking preventive care of people of all ages, increasing green areas for food sources and healthy production, and creating learning space that created by everyone. The finding also indicated that the Social Determinants of Health are main conditions in the environments where people are born, live, learn, work, and play that affect a wide range of health, happiness, and quality-of-life outcomes and risks. 3.3) Improving laws and regulations to support, encourage, and facilitate the performance of service duties, according to the Provincial Administration Act, are the Budget Allocation Act, the Employee Compensation Act, the Local Personnel Administration Act, the Ministry of Finance Regulations, and the Medical Profession Act.
