The Implementation of Primary Care Cluster According to the Integrated Service Model Based on People-Centered: Saraphi District, Changmai Province

Abstract

This mixed-method study aimed to examine the development of primary care services in a network or cluster configuration; based on an integrated service model with a people-centered approach. Participants were 61 primary care service personnel from Saraphi hospital and Tambon health promoting hospitals in Saraphi district selected by purposive sampling, along with 212 chronic patients with diabetes and hypertension. Data were collected between October and December 2019 via questionnaires and focus groups. Descriptive statistics in terms of percentage, average and standard deviation, and Pearson Chi–square were used to analyze quantitative data, while the analysis of common research topics was used to analyze qualitative data.   

The results revealed that: 1) the overall quality of the service provision process was rated as at an A level, which accounted for 34.43% and 27.05% of organizing of health care data system and interacting between clients and family doctors respectively. The organizational support system received a high rating of 6.71 (S.D.= 1.97). The received service satisfaction had significant relationship with controlling of hypertension and receiving the services with the same family doctors of the clients had significant relationship with types of health care units (p<0.05); and 2) regarding providing chronic care service, the patients had a high level of satisfaction. ( =4.56, S.D. = 0.78)

The implementation for development consisted of: 1) straightforward and uncomplicated strategic planning; 2) allocating proper workloads between personnel and tasks; 3) improving work patterns including rethinking, working processes, tools and evaluations; 4) promoting personnel to be concentrated and determined in their efforts; 5) providing patient-centered services; 6) building strong relationship and promoting engagement among all personnel; and 7) continuously enhancing competency of personnel.