Assessment of population health impacts subsequent to the transfer of Sub-district health promoting hospitals to the Provincial administrative organizations in the fiscal year 2023: Phase 2 Evaluation of impacts on health and health services by a retrospe
Keywords:
Health Impact Assessment, Health Status, Transfer of SHPHs to PAOs, Sub-district Health Promoting HospitalAbstract
This mixed-methods research aimed (1) to analyze the predictive capacity of early warning signs related to the transfer of Sub-district Health Promoting Hospitals (SHPHs), and (2) assess the health impacts on the population following the transfer of Sub-district Health Promoting Hospitals (SHPHs) to Provincial Administrative Organizations (PAOs) in fiscal year 2023. The study was conducted in two phases. Phase 1 involved case studies across 12 areas in 10 provinces. Data were collected through group discussions and interviews with PAOs, Provincial Public Health Offices (PPHOs), Contracted Units for Primary Care (CUPs), and Sub-district Health Promotion Hospitals (SHPHs), using semi-structured questionnaires. Instrument was verified by experts. Content analysis was applied to analyze the data. Phase 2 employed a retrospective cohort study using secondary data from fiscal years 2018 – 2023. Key indicators related to: 1) health outcomes in primary care and communicable disease control, 2)healthcare access, and service process effectiveness were analyzed, using descriptive statistics. The research findings were as follows:
1. A framework for primary healthcare services, resource management, and disease prevention and control was developed. The associated indicators could serve as an early warning system for monitoring the impact of SHPH transfers on access to primary healthcare services, public health outcomes, and disease control outcomes.
2. Data completeness in fiscal year 2023 was partial, due to incomplete submissions across all service units with incomplete submissions across all service units equally in both transferred and non-transferred areas. An evaluation of data completeness from fiscal years 2018 – 2023 indicated that populations in areas where SHPHs were transferred to PAOs faced higher health risks compared to those in non-transferred areas. This was particularly evident in key indicators such as child development screening, diabetes and hypertension risk screening, elderly health screenings, and the quality of chronic disease care. Moreover, populations in transferred areas bore a higher burden of chronic diseases compared to non-transferred areas.
In conclusion, all relevant agencies should plan, review, and systematically design effective primary care management strategies, so to mitigate potential public health challenges arising from the transfer of SHPHs to PAOs.
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1. บทความหรือข้อคิดเห็นใด ๆ ที่ปรากฏในวารสารเครือข่าย วิทยาลัยพยาบาลและการสาธารณสุขภาคใต้ ที่เป็นวรรณกรรมของผู้เขียน บรรณาธิการหรือเครือข่ายวิทยาลัยพยาบาลและวิทยาลัยการสาธารณสุขภาคใต้ ไม่จำเป็นต้องเห็นด้วย
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