Abstract
Background: Health decentralization in Thailand has led to the transfer of sub-district health
promoting hospitals (SHPHs) to provincial administrative organizations (PAOs), representing administrative
structural changes in the primary healthcare system. However, national-level quantitative evidence on
changes in oral health service provision under this policy context remains limited.
Objective: To describe changes in oral health service provision in SHPHs between 2022 and 2025
and to compare differences in service levels and dental health personnel across levels of administrative
transfer provinces.
Methods: A comparative quantitative study was conducted using secondary data from the Health
Data Center, covering 9,538 SHPHs nationwide. The average number of services per facility was analyzed
in three domains: basic dental services, preventive services (excluding oral examination), and total oral
health services. Differences between provincial groups were examined using one-way analysis of variance
(ANOVA).
Results: In 2022, no SHPHs had been transferred to PAOs and 42.9% of SHPHs had dental health
personnel. By 2025, 45.5% of SHPHs had been transferred to PAOs, while 38.9% had dental health
personnel. Starting with a non-significant difference in average basic dental services (F = 1.367, p = 0.251)
but significant difference in average preventive service in 2022, compared with 2025, statistically significant
differences were observed among provincial groups in total services (F = 159.10, p < 0.001), basic dental
services (F = 26.868, p < 0.001), and preventive services (F = 144.769, p < 0.001). SHPHs with dental health
personnel showed higher number of dental services than SHPHs without dental health personnel.
Conclusion: The study demonstrates differences in oral health service provision across provincial
groups during the study period. However, a causal relationship between transfer status and service
levels cannot be concluded.
