The development of efficiency indicators for primary care units under the Office of the Permanent Secretary for the Ministry of Public Health, Thailand

Abstract

        Efficiency is a vital part of health care system evaluation. It is necessary to develop health care efficiency indicators which are systematic and easy to implement. The purpose of this study was to establish a set of elements, indicators and criteria for evaluating the efficiency of primary care unit services. The study was divided into 3 phases. The first phases involved establishing elements, indicators and criteria drawn from a literature review and the opinions of experts. Secondly, indicators and criteria were selected by using the Delphi technique. Finally, the indicators and criterias were confirmed by utilizing confirmatory factor analysis. Tools for the study included: I) a structured questionnaire for interviewing the experts, 2) a questionnaire for Delphi technique among the experts for collecting an opinion about the selection of the indicators, and 3) a questionnaire assess the possibility of data collection concerning the indicators from heads of primary care units or their representatives. Data analysis was conducted by using descriptive statistics and confirmatory factor analysis.

        Two hundred and eighteen efficiency evaluation indicators were drawn from literature reviews. Based on the opinions of experts and a study of 260 research reports, 63 efficiency indicators remained after screening. After 3 rounds following the Delphi technique, the efficiency indicators were reduced to 58, and finally reduced to 56 by confirmatory factor analysis. All of these indicators are appropriate for primary care unit efficiency evaluation.

        This study suggests that the National Health Security Office and Bureau of Health Service System Development should announce a policy concerning utilizing this set of efficiency indicators to evaluate the services of primary care units. In addition, a comparative study applying this set of efficiency indicators to different primary care units under different institutions should be conducted.