Abstract
The purpose of this research is to “Assess the overall primary health management system of Subdistrict Health Promotion Hospitals that have been transferred to Provincial Administrative Organizations in the fiscal year 2023” that “after transferring to the new jurisdiction What changes have occurred? Particularly in terms of the characteristics of the model's key components (building blocks), how are they, or not, in comparison to the state they were in before the transfer?” in terms of research methodology. The research team has chosen a mixed methods evaluation research method. Start with the qualitative research process. Data were collected by means of proactive surveys along with interviews with people with direct experience in producing that data from 32 Subdistrict Health Promotion Hospitals in 8 provinces and 4 regions. The second step was quantitative research. This is to remove the important points from the first step to check for generality. This step involved sending questionnaires to 3,263 Subdistrict Health Promotion Hospitals, which received 450 responses from Provincial Administrative Organizations and Provincial Public Health Offices in 49 provinces, which was sufficient to serve as a sample at a low level of confidence. More than 95 percent. The results of the evaluation found that: Component 1: Basic characteristics or beliefs of the system, found both before and after the transfer. Basic features of this element Still adhering to the principle of being able to reach the target group thoroughly. It is a holistic system. It is an integrated service system. and is a system that connects primary, secondary, and tertiary levels. Component 2, the structure of the primary health system, was found to have a strong political governance structure. Ready to deal with the high threat of disease But the financial structure is not yet strong and stable enough. and there is still no stable personnel structure. Component 3: Sufficient stability in imported resources. It was found that the size and location of the Subdistrict Health Promotion Hospital were appropriate. But there are other systems that are not suitable, such as a manpower system that is not sufficient to meet the needs of the mission, a system of drugs, medical supplies, and medical equipment that is not stable. The information system is not yet suitable. And there is still no appropriate technology system. Component 4: Service Process: It was found that there was an appropriate primary care service model. But compliance with the model is still far below the standard. There is no appropriate process for continually evaluating and improving services. And there is a medical referral and return system, but in practice most of the time there are still problems with vehicles. and the emergency medical system is still not comprehensive. Component 5, service output, was found to have high physical ability to access services. There is high readiness to provide services both during and outside of business hours. The quality of service is still much lower than the standard. Because there is still a lack of medical personnel. In terms of service efficiency and effectiveness, there is not enough information to make a diagnosis. And regarding safety in providing services, it was found that there have been no complaints regarding insecurity due to the services of the Subdistrict Health Promoting Hospital. Component 6: The results of the management system were found to have a high ability to reach the target group. The satisfaction of service recipients is at a high level. Equality provides high service. But there are still services that cannot be responded to by the Subdistrict Health Promotion Hospitals themselves at a high level. In terms of comparing the services between before the transfer and after the transfer, it was found that most of them remained the same. There were only a few who answered that it was better than before. Because there was an increase in budget and personnel from before. But there were very few who answered that it was worse than before. This is because there are personnel who do not voluntarily transfer and the Provincial Administrative Organization is still unable to find replacement personnel.
