Abstract
The purpose of this research is to explore the situation of medication management systems and health consumer protection of the health promotion in hospitals under the provincial administrative organization. The readiness, efficiency, medication error prevention, and factors which affect the efficiency were determined to compose policy recommendations. Questionnaires were used as a research tool to collect data. The subjects were stratified random for sampling; this included 300 pharmacists, 808 health team staff and 400 clients. The 170 informants including administrators, pharmacists, clients, and key informants were selected for in-depth interviews. The descriptive statistics, subgroups analysis and binary logistic regression were used to analyze the data. Content analysis was determined some given qualitative data. It was found that most of the respondents were female with a mean age of 38.8 ± 9.53 yrs. The majority graduated with a bachelor’s degree working in the health service area 7, 10 and 1. The rate of antibiotics dispensing among the health promotion hospitals under provincial administrative organization was increased. Most of the Contracting Unit for Primary Care supplied medications, and some of the health promotion hospitals bought all items. The inventory period consisted of 30 days, 7-15 days, and 60 days. Median cost of inventory stock was 13,196.05 baht and maximum were 899,650 baht. The minimum was zero stock. Pharmacists sometimes rotated to service and rarely to enforcement of health consumer protection laws. The support by the provincial administrative organization was low level. Of score 5, mean support in medication management was 2.38 ± 1.12 and health consumer protection was 2.26 ± 1.26. The score by the health team was higher than the scoring of the pharmacists. Half of them were ready in medication management and only 36.7% were ready in purchase planning and 29.3 % could update the inventory and dispensing reports. The majority (54.0%) ready in health consumer protection. One-third ready to follow the guidelines of proactive inspection of the establishment in their service and with 25.0 % of them ready to collect evidence, witnesses and report writing. Of total, 46.7% with high level of efficiency in medication management and 43.1% of the health consumer protection. A statistically significant difference of efficiency was found among groups of provinces. Factors effecting the medication management were attitudes, satisfactions, pharmacists support, readiness, and the practice following the guidelines or recommendations regularly. Factors effecting health consumer protection including health literacy, readiness, satisfaction. The medication error practice was not completed. The triple checking was not incorporating prior to dispensing. It was found there was a low rate in technology application for medication management. In the opinion of the clients, most of those were females aged 20-86 years old. Median of age was 56. The frequency to visit the health promotion hospitals was 5.40 ± 4.26 times in 2022 and was 3.92 ± 3.49 times in 2023. The satisfaction of clients toward drug dispensing in 2023 was in higher level than 2022. Conclusion: The dispensing of antibiotics in the health promotion hospitals under provincial administrative organization was increase in 2022 and 2023. These trends had no effect on the satisfaction of clients and there was no difference among the provinces. The attitudes of the health team towards the medication management and health consumer protection were high level; however, the reports of drug inventory and dispensing had not been updated. They were not ready to make drug purchasing plan and proactive consumer protection, law enforcement and complaints management. Readiness and satisfaction among health team and network were counted to be significant factors for the management and health consumer protection. Attitudes, pharmacists support, and the practice following the guideline regularly effects to the management. Health literacy of health team effects to health consumer protection. Medication error and practice were incomplete, so pharmacists were needed to be their mentors and train them in the knowledge, tactic, and review and improve using technologies seamless connecting to their networks. Relationships need to be built and continue along with the development of the structure to help meet their targets and goals of rational drug uses and health consumer protection of sustainability to the healthy people in the area.
