การประเมินตนเองของหน่วยบริการปฐมภูมิในการจัดบริการแบบบูรณาการโดยยึดประชาชนเป็นศูนย์กลางสำหรับผู้ป่วยเบาหวานและความดันโลหิตสูง

Samrit Srithamrongsawat; Paibul Suriyawongpaisal; Vorasith Sornsrivichai; Santi Lapbenjakul; Duangdao Sriyakun

Authors

Samrit Srithamrongsawat Faculty of Medicine Ramathibodi Hospital, Mahidol University
Paibul Suriyawongpaisal Faculty of Medicine Ramathibodi Hospital, Mahidol University
Vorasith Sornsrivichai Faculty of Medicine, Prince of Songkla University
Santi Lapbenjakul Thawung Hospital, Lopburi Province
Duangdao Sriyakun Phetchabun Hospital, Phetchabun Province

Keywords:

primary care, self-assessment, self-management support, patients with diabetes, patients with hypertension

Abstract

Background and Rationale: An implementation research on integrated people-centered primary care has developed protocols and piloted new care processes to patients with diabetes and hypertension in 20 primary care clusters (PCCs) in Thailand. This study was conducted after 4 months of implementation aiming to assess care process provided by the piloted PCCs compared with other types of health facilities within the same district. Methodology: A survey of providers’ opinion on care process provided by themselves was conducted. Samples were all health workers providing care to patients with diabetes and hypertension in 4 types of health facilities in 20 districts, these included 301 piloted PCCs, 240 PCCs outside the project, 172 hospital non-communicable disease clinics, and 351 non-PCC health centers. A self-assessment form developed by the researchers was employed. The form covered 5 care process components: patient-provider relationships, shared care plan, health information system, self-management support, continuity of care and coordination including organizational supports. Data analysis was done using ANOVA test and the least significant difference test. Results: People working in piloted PCCs reported high mean scores on patient-provider relationships, shared care plan, health information system, self-management support, and continuity of care and coordination as 6.3, 6.1, 6.7, 5.9 and 6.3 respectively. Mean scores of all dimensions of the piloted PCCs were significantly higher than those of other types of health facilities (p-value < 0.05). Conclusion and discussion: The piloted PCCs reported highest integrated people-centered care to patients with diabetes and hypertension compared with all other types of health facilities. However, the self-management support got the lowest score that needed further strengthening. Further research on implementation outcomes was proposed including capacity building of staff on essential skills in providing integrated people-centered care.

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