การพัฒนาคุณภาพการจัดบริการสุขภาพของโรงพยาบาลส่งเสริมสุขภาพตำบลภายหลังการถ่ายโอนภารกิจให้องค์การบริหารส่วนจังหวัดปราจีนบุรี

Patinya Issarangkur Na Ayutdhaya; Kiraphol Kaladee; Sompoch Ratioran

Authors

Patinya Issarangkur Na Ayutdhaya Student in Master of Public Health Program in Public Health Administration, School of Health Sciences Sukhothai Thammathirat Open University
Kiraphol Kaladee School of Health Sciences, Sukhothai Thammathirat Open University
Sompoch Ratioran Independent academia

Keywords:

health service quality development, success factors, problems and obstacles, sub-district health promoting hospital

Abstract

Background and Rationale: Prachinburi Province has successfully transferred sub-district health promoting hospitals (SHPHs) to the provincial administrative organization (PAO), concurrent with the adoption of new primary care standards. Maintaining and developing health services quality to ensure continuing access to standardized healthcare is crucial. This study aimed to: (1) examine the outcomes of health service quality development in SHPHs, (2) compare outcomes of the quality of health service delivery in fiscal years 2023 and 2024, and (3) examine success factors and obstacles in developing the quality of health services of SHPHs after devolution to the Prachinburi PAO.

Methodology: This was a mixed methods research study. The quantitative component involved comparing secondary data of primary health care service quality assessment scores in 8 parts of 94 SHPHs using descriptive statistics and Wilcoxon signed-rank test statistics. The qualitative component consisted of in-depth interviews with a purposive sample of 31 SHPH directors registered as primary care units and primary care networks. The qualitative data were analyzed using content analysis. This study was conducted from February 2024 to July 2025.

Results: (1) The development of health service quality of the SHPHs after the devolution led to overall sustained or improved standards across nearly all aspects, with enhanced management agility. The provided services were consistent with the local context, and received support from network partners, resulting in service units being able to better respond to the needs of the people. (2) Comparing between fiscal years 2023 and 2024, the quality of health services of the SHPHs increased significantly (p < 0.05), especially in terms of management, personnel management, information systems, and pharmaceutical services. Clear PAO policies and objectives have created concrete direction and efficient operation of the SHPHs. And, (3) key success factors included policy support and resources from the PAO, effective management, and cooperation of personnel and communities. Obstacles included increased paperwork, insufficient personnel, incomplete information systems, and some complex evaluation criteria.

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