Developing a Financial and Fiscal Management Model for Kham Khuen Kaew Hospital to Enhance Efficiency and Reduce Financial Risks in Healthcare Services Units

Abstract

Kham Khuen Kaew Hospital is facing a level 5 financial crisis with liquidity ratios below standard and accumulated operating losses. This mixed-methods action design research aimed to develop and evaluate a financial and fiscal management model for Kham Khuen Kaew Hospital to enhance efficiency and reduce financial risk. The study was conducted between June and September 2025. The sample consisted of 22 administrators and department heads. Research instruments included the TPS V 3.0 financial performance assessment and qualitative tools based on the Technology of Participation (TOP) Model and AIC process. Data were analyzed using descriptive statistics, paired t-test, and content analysis.

                  The developed model comprised five main plans: proactive revenue enhancement, resource optimization, information system development and monitoring, human resource development and motivation, and systematic process improvement. After implementation, total revenue increased from 124.45 million baht to 160.64 million baht (29.09% growth). Inventory turnover days decreased from 44.21 to 38.35 days. UC receivable collection period decreased from 22.98 to 35.74 days. Inpatient unit cost decreased from a peak of 11,839.10 baht to 11,388.44 baht, and the TPS score improved from grade B to grade A. The application of TQM concepts combined with ADR and participatory processes can systematically improve hospital financial management efficiency.

            However, challenges in profitability remain due to fixed healthcare service costs. Recommendations include expanding the model to similar community hospitals and conducting further research in pharmacoeconomics to develop long-term financial sustainability.