การเปลี่ยนแปลงของการจัดบริการสุขภาพช่องปากระดับปฐมภูมิภายใต้บริบทการถ่ายโอนโรงพยาบาลส่งเสริมสุขภาพตำบล: การวิเคราะห์เปรียบเทียบปี พ.ศ. 2565 และ 2568

Sunee Wongkongkathep; Nitichote Ninkumhaeng

Authors

Sunee Wongkongkathep National Health Commission Office
Nitichote Ninkumhaeng Chaiyaphum Provincial Public Health Office

Keywords:

primary oral health service provision, transfer of sub-district health promoting hospitals, provincial administrative organizations, health decentralization, comparative analysis

Abstract

Background: Health decentralization in Thailand has led to the transfer of sub-district health promoting hospitals (SHPHs) to provincial administrative organizations (PAOs), representing administrative structural changes in the primary healthcare system. However, national-level quantitative evidence on changes in oral health service provision under this policy context remains limited.

Objective: To describe changes in oral health service provision in SHPHs between 2022 and 2025 and to compare differences in service levels and dental health personnel across levels of administrative transfer provinces.

Methods: A comparative quantitative study was conducted using secondary data from the Health Data Center, covering 9,538 SHPHs nationwide. The average number of services per facility was analyzed in three domains: basic dental services, preventive services (excluding oral examination), and total oral health services. Differences between provincial groups were examined using one-way analysis of variance (ANOVA).

Results: In 2022, no SHPHs had been transferred to PAOs and 42.9% of SHPHs had dental health personnel. By 2025, 45.5% of SHPHs had been transferred to PAOs, while 38.9% had dental health personnel. Starting with a non-significant difference in average basic dental services (F = 1.367, p = 0.251) but significant difference in average preventive service in 2022, compared with 2025, statistically significant differences were observed among provincial groups in total services (F = 159.10, p < 0.001), basic dental services (F = 26.868, p < 0.001), and preventive services (F = 144.769, p < 0.001). SHPHs with dental health personnel showed higher number of dental services than SHPHs without dental health personnel.

Conclusion: The study demonstrates differences in oral health service provision across provincial groups during the study period. However, a causal relationship between transfer status and service levels cannot be concluded.

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