The Effectiveness of Primary Health Care Service Systems Management in Subdistrict Health Promotion Hospitals after Task Transfer to Provincial Administrative Organization, Pattani Province
Keywords:
Effectiveness, Primary Healthcare Services, Subdistrict Health Promoting Hospitals, Provincial Administrative Organization, Budget AllocationAbstract
This research and development project aimed to study the current situation of the primary healthcare service system, budget allocation, the development of healthcare service models, and the evaluation of budget allocation and service systems in Subdistrict Health Promoting Hospitals (SHPHs) after the transfer of responsibilities to the Pattani Provincial Administrative Organization (PAO). The study was conducted in three phases. Phase 1 examined the situation of the primary healthcare service system and budget allocation. A purposive sampling method was used to select 130 SHPHs that transferred their responsibilities to the PAO during fiscal years 2023 and 2024. Data were collected from 16 key informants, including representatives from the Provincial Public Health Office (PPHO) and the PAO, and were analyzed using content analysis. Phase 2 involved developing a healthcare service system and budget allocation model through the Area Health Board (AHB). Phase 3 assessed the effectiveness of the developed healthcare service system and budget allocation model, based on service provision and expenditure data from fiscal years 2023 and 2024. Descriptive statistics, including frequency and percentage, were used for data analysis. Research findings were as follows:
1. In fiscal years 2023 and 2024, Health services in SHPHs were arranged based on the standard healthcare facility data under the National Health Security System which managed by the Ministry of Public Health (MoPH)and the PAO. Moreover, budget allocation was conducted through the Subcommittee on Budget Allocation. Direct payment from National health security office and Support medical and non-medical supplies from Contracting Unit for Primary Care (CUP) were presented for budget allocation.
2. Primary Healthcare Service and Budget Allocation Model: The model was designed to support both OP and P&P services. In 2023, capitation-based budget allocation for OP services accounted for 7%, while 90% was allocated to P&P. In 2024, the capitation budget for OP services was adjusted to 8%, while P&P was reduced to 85%. The remaining 15% was pooled into a central fund to support joint P&P activities between the PPHO and the PAO.
3. Performance-Based Budget Allocation for P&P Services: The implementation of performance-based budgeting resulted in increased healthcare service delivery. In 2024, an additional budget of 5,621,459.88 THB was allocated for P&P services, and 265,558.56 THB was designated for medical and non-medical supplies.
Therefore, it is recommended that the PPHO and PAO collaborate in monitoring and supervising healthcare service performance and budget allocation to prevent adverse effects on the public and ensure appropriate financial distribution for public healthcare services.
References
Cashin, C., Ankhbayar, B., Phuong, H. T., Jamsran, G., Nazad, O., Phuong, N. K., et al. (2015). Assessing Health Provider Payment Systems: A Practical Guide for Countries Moving toward UHC. Joint Learning Network for Universal Health Coverage.: Washington DC.
Fuengkhajorn, A., Singweratham, N., Siewchaisakul, P., & Wungrath J., (2024). Comparison of access to dental services and oral health status among children aged 0-12 years between Tumbon health promoting hospital with and without transferred to the local administrative organization in the northern region of Thailand. The Southern College Network Journal of Nursing and Public Health, 11(2), e268398. (in Thai)
Health Systems Research Institute. (2009). Subdistrict Health Promoting Hospital Service Manual. Nonthaburi. Health Systems Research Institute. (in Thai)
National Health Security Office. (2022). Manual of National Health Security Fund Management Fiscal Year 2022. National health security office: Bangkok. National health security office. (in Thai)
Office of the Decentralization Commission for Local Administrative Organizations Office of the Permanent Secretary, Office of the Prime Minister. (2021). Guidelines for Transferring Missions of the Chaloem Phrakiat 60th Anniversary Nawaminthrachini Health Station and Subdistrict Health Promoting Hospital to the Provincial Administrative Organization. Bangkok: Office of the Permanent Secretary. (in Thai)
Quality and Standard Service Unit Support Office. (2016). Service Unit Registration Audit Guideline for Main Contractor Service Unit, Primary Care Service Unit, Coordinate Service Unit. Bangkok: National Health Security Office. (in Thai)
Rutjamathamrong, P., Singweratham, N., Techakehakij, W., Boontiam, N., Kaewsing, P., Bunpean, A., et al. (2022). Development of Management Guideline for the Health Security Funds to Allocate Budget for the District Health Promoting Hospitals Transferred to The Local Administrative Organizations. Nonthaburi: Health Systems Research Institute. (in Thai)
Singweratham, N., Phodha, T., Techakehakij, W., Siewchaisakul, P., Bunpean, A., & Chautrakarn, S., (2024). Unit Cost Study for Health Care Service in Chaloem Phra Kiat 60 Years Nawamin Maharachini Health Center and Tambon Health Promoting Hospital with Transferred to the Provincial Administrative Organizations. Nonthaburi: Health Systems Research Institute. (in Thai)
Singweratham, N., Phodha, T., Techakehakij, W., Wongyai, D., Bunpean, A., & Siewchaisakul, P., (2024). A comparison on budget allocation of the national health security fund between contracting unit for primary care and the Tambon health promoting hospitals with and without transferred to the local administrative organizations. The Southern College Network Journal of Nursing and Public Health, 11(1), e266462. (in Thai)
Sriratanaban, J., Singweratham, N., Komwong, D., & Maneechay, M. (2023). Assessment of population health impacts from the transfer of Subdistrict health promoting hospitals to the Provincial administrative organization in 2023: Phase 1 Potential warning signs. Journal of Health System Research, 18(2), 152-72. (in Thai)
Sudhipongpracha, T., Choksettakij, W., Phuripongthanawat, P., Kittayasophon, U., Satthatham, N., & Onphothong, Y. (2021). Policy Analysis and Policy Design for the Transfer of Subdistrict Health Promotion Hospitals to Provincial Administrative Organizations (PAOs). Health Systems Research Institute. (in Thai)
Techakehakij, W., Singweratham, N., & Wongphan, T. (2018). Unit Cost and Budget Impact of Compulsory Programs for Health Promotion and Disease Prevention in Thailand. Bangkok: Aksorn graphic and design. (in Thai)
Uansri, S., Markchang, K., Chotchoungchatcha, S., Onthong, S., Panapong, N., & Pattanasiri T., (2024). The transfer of health facilities to the local government administration: progress and challenges. Journal of Health System Research, 18(3), 314-330. (in Thai)
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Journal of Nursing and Education
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
