Development of the indicators of administration potentiality for local health security funds in National Health Security Office Region 10, Ubon Ratchathani, Thailand

Abstract

The objectives of this study was to establish and develop indicators and to assess and validate the indicators for measurement the capacity and potential of the local administration controlling the Local Health Security Fund (LHSF). The research took form of mixed methods which  combined  qualitative and quantitative  research  methods.

This study was started by studying related concepts and theories and synthesizing them into components and then into indicators.  Concepts  on  administration  potentiality   were  studied  from  related  textbooks,  academic  documents  and  research reports published domestically and abroad. As a next step the possible components and indicators were explored in focus group discussions,  in  –  depth   interviews  and  finally  in  an  operational  seminar  attended   by   community  health  alliance  members, other stakeholders and experts. A Delphi technique of consensus development was used comprising three rounds. The subjects comprised   1,540  LHSFs  administrative  staff   selected   using  proportional  stratified  random  sampling  of  the  population  of staff in Health Region 10 . The main quantitative data collection tool was a five – level Likert scale questionnaire with a reliability  of .980  and  validity ranging from  0.71  to  1.00.

The  results  of  this  study  given  guidelines  document  and  wide  support  for  developing  an  assessment  instrument  for measuring the capacity of local administration overseeing the LHSFs and the assessment instrument developed comprised 9 components  and  65  indicators;  (1)  Leadership  component  is  composed  of  5  indicators,  (2)  Strategic  Planning  component  is composed  of  6  indicators,  (3)  Process  Management  component  is  composed  of  11  indicators,  (4)  Customer  and  Stakeholder Participation  component  is  composed  of  7  indicators,  (5)  Measuring,  Analysis  and  Knowledge  Management  component  is composed of 10 indicators, (6) Human Resource Development component is composed of 3 indicators, (7) Output component is composed of 11 indicators, (8) Outcome component is composed of 9 indicators and (9) Health Status Impact component is  composed  of  3  indicators.  The  assessment  instrument  developed  was  congruent  with  empirical  data, χ2 =  1.520,  df  =  13, p  - value =  0.101,  GFI =  0.997,  AGFI =  0.990  and  RMSEA =  0.018

   The  suggested  that  it  was  feasible  to  implement  the  assessment  instrument  in  local  government  organizations  and  that comparative  data  on  LHSFs  capacity  and  potential  would  help  policy  makers  identify  where  they  need  to  invest  to  improve administrative capacity.