Abstract
The concept of developing a model for primary health care services close to patient
homes aims to reduce overcrowding in public health facilities. This research focuses on allocating
the suitable locations for "Warm Community Clinics," which are primary care units under the
Universal Coverage Scheme: UCS. Currently, the number of participating clinics may be
insufficient compared to the population distribution in Bangkok. An evaluation of the suitability
of primary care units in relation to the population revealed that more than 41 out of 50 districts
have fewer warm community clinics than the ideal number of units required. Therefore, this
study focuses on expanding access to care under the perspective of logistics and health supply
chains by increasing the number of participating clinics. The research includes: (1) allocate the
location of appropriate primary care units based on two criteria: accessibility to primary care
services and adequacy of the number of primary health care units, and (2) developing policy
recommendations for determining the locations of primary health care units in Bangkok. The
study assesses the spatial suitability of primary care units by considering convenience,
accessibility, connectivity with secondary health care units, and visibility. The suitability of
locations is evaluated using the AHP (Analytical Hierarchical Process) technique combined with
Geographic Information System (GIS) data. This involves defining 12 critical factors for indicating
spatial suitability resulting in five levels of spatial suitability.
The analysis of current operation shows that there are 3 7 7 clinics, under the warm
community nursing clinic project, locating in the groups of the most suitable location and very
suitable location only 17%, while the remaining 83% are in moderately suitable, less suitable,
or least suitable areas. When analyzing the coverage by concerned clinics for patients under the
UCS Universal Coverage Scheme, the current coverage stands at 67.73%. Considering uncovered
patients, the additional clinics being candidates for making decision were allocated using GIS
analysis. It can increase the coverage to 90.80% by adding 577 potential clinics. Moreover, this
study also allocates the primary care clinics to 69 public health centers following Bangkok Health
Zone to ensure efficient referrals. In addition, this research proposed the policy
recommendations consisting of five perspectives: 1) factors determining the suitability of primary
care unit locations, 2) enhancing access to primary care services for patients, 3) supervising of
clinics by the 69 public health centers, 4) patient expectations in selecting primary care services,
and 5) other relevant aspects.
