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Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand

Nithra Kitreerawutiwong, Sue Jordan Orcid Logo, David Hughes

PLOS ONE, Volume: 12, Issue: 3, Start page: e0174055

Swansea University Authors: Sue Jordan Orcid Logo, David Hughes

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Abstract

This paper examines primary care performance in three types of community health facilities in five provinces in northern Thailand. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were hampered by sho...

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Published in: PLOS ONE
ISSN: 1932-6203
Published: PLOS 2017
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spelling 2020-10-15T14:22:28.4299492 v2 32382 2017-03-14 Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false f1fbd458e3c75d8b597c0ac8036f2b88 David Hughes David Hughes true false 2017-03-14 HNU This paper examines primary care performance in three types of community health facilities in five provinces in northern Thailand. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were hampered by shortages of trained doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. While the plan is to move over time to doctor-staffed THPHs, many rural areas rely on facilities staffed by public health officers or nurses. The study used structured interviews to measure patient views on performance, defined in terms of accessibility, continuity, comprehensiveness, co-ordination and community orientation, in 23 THPHs divided across the three types. Counter-intuitively it was the THPHs staffed by public health officers which achieved the highest scores, followed by nurse-staffed facilities and then doctor-staffed facilities. The sharpest differences found were in the scores for accessibility, continuity, and comprehensiveness of care. The authors argue that these are associated with local services, which rural patients in particular value more than services offered by doctors on rotation in larger outpatient department-like centres. Patients value these aspects of care more than professional skill-mix per se. This is not an argument for delaying an increase in use of qualified staff, but an indication of the need to do this in a way that preserves the features of local services that patients value. Journal Article PLOS ONE 12 3 e0174055 PLOS 1932-6203 primary care, primary care assessment, primary care performance, health workforce 24 3 2017 2017-03-24 10.1371/journal.pone.0174055 The initial analysis was undertaken while Nithra Kitreerawutiwong was a visiting researcher at Swansea University.Open access at:http://dx.doi.org/10.1371/journal.pone.0174055 COLLEGE NANME Nursing COLLEGE CODE HNU Swansea University Naresuan University 2020-10-15T14:22:28.4299492 2017-03-14T06:32:19.5683485 College of Human and Health Sciences Public Health and Policy Studies Nithra Kitreerawutiwong 1 Sue Jordan 0000-0002-5691-2987 2 David Hughes 3 0032382-27032017075119.pdf FacilitytypeandPCperformace.pdf 2017-03-27T07:51:19.5600000 Output 760066 application/pdf Version of Record true 2017-03-24T00:00:00.0000000 This is an open access article distributed under the terms of the Creative Commons Attribution License. true eng
title Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
spellingShingle Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
Sue Jordan
David Hughes
title_short Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
title_full Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
title_fullStr Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
title_full_unstemmed Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
title_sort Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
f1fbd458e3c75d8b597c0ac8036f2b88
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
f1fbd458e3c75d8b597c0ac8036f2b88_***_David Hughes
author Sue Jordan
David Hughes
author2 Nithra Kitreerawutiwong
Sue Jordan
David Hughes
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description This paper examines primary care performance in three types of community health facilities in five provinces in northern Thailand. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were hampered by shortages of trained doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. While the plan is to move over time to doctor-staffed THPHs, many rural areas rely on facilities staffed by public health officers or nurses. The study used structured interviews to measure patient views on performance, defined in terms of accessibility, continuity, comprehensiveness, co-ordination and community orientation, in 23 THPHs divided across the three types. Counter-intuitively it was the THPHs staffed by public health officers which achieved the highest scores, followed by nurse-staffed facilities and then doctor-staffed facilities. The sharpest differences found were in the scores for accessibility, continuity, and comprehensiveness of care. The authors argue that these are associated with local services, which rural patients in particular value more than services offered by doctors on rotation in larger outpatient department-like centres. Patients value these aspects of care more than professional skill-mix per se. This is not an argument for delaying an increase in use of qualified staff, but an indication of the need to do this in a way that preserves the features of local services that patients value.
published_date 2017-03-24T03:44:24Z
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