Abstract
Overcrowding in hospitals’ out-patient sectors is a chronic problem of public hospitals in Thailand.
Patient visitors have to wait for a long time no matter how serious their illnesses. A reasonable step in
solving this problem is to understand the nature of the attendants, i.e., who they are and why they come.
It is known that over half of the visitors live in the local district; they come with every type of problem;
most of the problems could be taken care of by practical nurses and general practitioners. The reasons for
attending the hospital include ineffective treatment at primary care units, and inconvenience because
there are not enough primary care units to cover the areas, and their quality is not well accepted. Therefore,
an important approach to solving hospital overcrowding is strengthening the function of primary
care units and forming them into a hospital network. Further, management is needed to find out which
outpatient sections are crowded and when, so that supplemental services could be organized accordingly.
Among the top five outpatients are those with diabetes mellitus and hypertension; these are chronic lifetime
patients. Thus, the service system for this group should be organized specifically and efficiently by
linking the provision of care with primary care units and/or private dispensaries to relieve the patient
pressure on big hospitals. Ultimately, owing to the complexity and variability of the problem, ad hoc
teams should be established specifically to be responsible for managing and monitoring the system effectively
