Survey of health provision by primary care cluster in Tak Province: Expectation, utilization of health service, and satisfaction of the target patients and caregivers

Abstract

Background The 2017 Constitution of the Kingdom of Thailand requires the state to provide public with effective health services. The quality and standards of care must be continually improved. Thus, the Ministry of Health has reformed every levels of health service system. To strengthen primary health care system, primary care clusters (PCC) have been developed throughout the country, including Tak Province. Therefore, monitoring the performance of primary care clusters by developing a survey tool to understand the operational situation is needed.

Objectives To study the performance outcome of primary care clusters in Tak Province and develop a performance appraisal for empowering to ensure the success of this policy.

Methods Survey study using questionnaire was done among target population who were registered with the two initially established PCC in Tak province. The four primary target populations of the PCC project were 1) the home-bound and/or bed-bound elderly or caregivers, 2) the disabled, 3) the chronically ill patients and 4) palliative group or caregivers. Convenience samples were selected during patient care at PCC between March 1, 2018 to April 30, 2018. For bed-bound elderly, disable and palliative group or caregivers were interviewed at home. Questionnaire consisted of personal characteristics of target groups, their health status during past 3 months, caregivers’ opinion, quality and satisfaction of health service using rating scale from 1 point (less satisfy) to 5 points (the most satisfy). The data was analyzed by using descriptive statistics.

Results Most of the samples were elderly female (65.8 %) with dependent status. During the past three months, health status was stable at 51.6 %. They expected to improve their health status at 67.4 %. Chronically ill patients were improved more than 80 %. They satisfiedwith the health services system provided in PCC, and the integrated community/society services at the average of more than 3.5 points.

Conclusions The research revealed that the current Primary Care Cluster and the integrated community/society services in Tak Province can be judged as positive, where, the target groups are moderately to very satisfy with the service provided. It is recommended that the policy of seamless health services in primary care level should further focus its services on patients with chronic diseases, the elderly, caregivers, and the importance of health promotion and disease prevention.