The National Public Health Reforms and the Challenges of Primary Care Service Systems

Abstract

This study aimed to assess the process of developing primary care service system in Thailand from past to present; and the direction of primary care service system reform that suitable for Thailand in the future; and to provide the policy recommendations for primary care service system reform. The researcher conducted a qualitative study on the reform of the primary care service system in Thailand. The data were collected by document review, in-depth interview and group discussions from April-August 2019. In-depth interview and group discussions emphasized the primary care service system in the future 20 years and the direction of operating the primary care service system that contributes to good health. The results of the study found that a concept of Thailand’s primary care service system reform has been developed continuously until the year 2019, which was an important turning point due to the enforcement of the Primary Health System Act B.E. 2562 and the regulations of the Prime Minister's Office, District Quality of Life Development Board B.E. 2561 (2018). These created mechanisms and collaboration to provide primary health care services at the first stage as well as participation among public sectors, local government organizations, private and civil sectors. The referral system for service recipients and the information linkage through technological platforms between the service units at all levels were initiated as well as the services provided by the family doctor team with multidisciplinary that enhance a holistic, integrated and continuing care. Additionally, people are aware of their own health management. However, accessibility to services in urban areas, factories or large enterprises is suggested to improve. The cooperation and participation between the local government organizations and the private sectors are required to provide primary care services which should reduce the limitations in the administration and government regulations as well as increase the efficiency and accessibility to primary health care services of the people.