สัดส่วนเวลาการปฏิบัติงานของแพทย์เฉพาะทางโรงพยาบาลภาครัฐ กรณีศึกษา 8 โรงพยาบาล

Passakorn Suanrueang; Utoomporn Wongsin

Authors

Passakorn Suanrueang Health Systems Research Institute
Utoomporn Wongsin Health Insurance System Research Office, Health Systems Research Institute

Keywords:

time-motion study, medical specialist, work distribution, hospital cost allocation

Abstract

There have been little empirical evidences available on a time-motion study of medical specialists, the most vital human resources in Thailand. It is important to study the proportions medical specialist’s workloads working in multiple units in the hospitals for greater visibility of labor distribution and cost consistent with the actual work. The objective of the present study, therefore, was to describe the proportion of work distribution as well as their working patterns in many tasks of specialists in public hospitals. This would be beneficial for hospital cost allocation criteria.

A purposive sampling was employed to select eight public hospitals consisting of 3 regional hospitals, 3 general hospitals of the Office of Permanent Secretary, and 2 hospitals of the Ministry of Public Health (with 600 and 1,000 beds). This study collected data from weekly and monthly work schedules and direct interviews with medical specialists. The data were analyzed by descriptive statistics. Overall, the medical specialists spent 33% to 36% of their time at inpatient department (IPD), followed by 27% to 32% at outpatient department (OPD) and special clinics. In case of medical teachings, the medical specialists spent no more than 4.7% of their total time, except pediatricians spent the highest 7.0% for teaching. The administrative task took the smallest proportion of no more than 4.0%. The proportion of time of each specialty was: otolaryngologists OPD : OR : IPD : teaching : administrative task = 27.6 : 24.8 : 41.7 : 2.6 : 3.3; ophthalmologists OPD : OR : IPD : teaching : administrative task = 30.8 : 19.2 : 42.0 : 4.6 : 3.4; internist OPD : IPD : ICU : teaching : administrative task = 28.3 : 55.8 : 11.0 : 3.2 : 1.7; pediatricians OPD : IPD : ICU : NICU : teaching : administrative task = 32.6 : 33.8 : 10.4 : 14.3 : 7.0 : 1.9, obstetricians and gynecologists OPD : OR : LR : IPD : teaching : administrative task = 30.4 : 15.3 : 17.4 : 33.1 : 2.7 : 1.1; surgeons OPD : OR : IPD : ICU : teaching : administrative task = 29.1 : 16.6 : 42.1 : 7.3 : 3.7 : 1.2; orthopedic surgeons OPD : OR : IPD : ICU : teaching : administrative task = 17.6 : 19.2 : 52.9 : 6.9 : 2.4 : 1.0; anesthesiologist OPD : OR : ICU : anesthesia : teaching : administrative task = 2.2 : 45.2 : 13.5 : 34.7 : 1.5 : 2.9.

Proportions of work distribution in the present study may be used to assist decision makers in hospital cost allocation criteria and human resource management. Additionally, this methodology can be applied to other personnel who multitask and can be used to estimate the health workforce needs.

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