The Participation Development Referrals System in Banlaem District, Phetchaburi Province

Abstract

The opportunity to refer patients from a lower to a higher level of the health delivery system should be
an integral part of a quality health service. This especially is important for patients suffering from chronic
diseases. Due to limited resources at the primary health delivery system to establish a referral system is a
necessity, but it should be done in observing well recognized standards. This one group pretest-posttest
design aimed to develop a chronic patient referral system at the Banlaem District, Phetchaburi Province. The
study was conducted by applying the AIC process and Demming’s quality cycle. The study participants
consisted of 33 purposively selected subjects. The study was conducted for 12 weeks. Actual participation,
learning and sharing experiences with one another was a major aspect of the undertaking. Information was
obtained using a questionnaire asking about performance outcomes and personnel’s satisfaction with the
chronic patient’s referral system. Conventional statistics were used for analyzing the data such as calculating
frequency distribution, percentage, mean, standard deviation, and paired-sample t-test.
The findings revealed that after the participatory development of the chronic patient referral systems
most of the personnel involved performed very well. Operational structures, resource support, coordination
among the different levels of the health delivery system improved considerably and were much better after
then before the project started. Also the personal of the health delivery system involved were finally satisfied
with the outcome of the efforts.
In conclusion, the applications of the AIC process and the Demming’s quality cycle (PDCA) were
valuable tools to improve the patient’s referral system. It proofed to be of importance that the health personnel
shared their experiences, understand the problems involved and participate in improving the referral system.