Implementing the core package of universal coverage health scheme in large-size public hospitals and medical school hospitals
Abstract
The purpose of this study was to investigate the implementation in government hospitals of the core package of the Thai universal health coverage policies, in terms of customer service, as measured by knowledge and understanding of the core package of the Thai universal health coverage plan, and the channels of communications for customer service. The study was undertaken in 5 large government hospitals of at least 500 beds belonging to medical schools or the ministry of public health. The period time for this study was between 15 September and 31 May 2007. The key informants were 8 persons who were responsible for implementing policies set by the director, with direct responsibility for the core package of the Thai universal health coverage scheme. The methodology of the study was qualitative research.
The results of this study revealed that there were 3 main features of implementing the program. The fist was emphasizing team work in routine practice, the second was assigning a doctor who medical treatment consider with director of hospital, and the third was assigning a doctor who medical treatment is having decided person. All 5 hospitals of this study follow a policy of "patient safety". If a case is beyond the hospital's abilities then the patient is referred to a higher level hospital. The medical personnel of all hospitals are competent to deliver the core package of the health scheme, but some smaller hospitals may be unable to deal with complicated diseases or cases needing new medical treatments or techniques. As for the channels of communication, in cases where there were complaints they were usually about timely service or concerns about the most appropriate and beneficial services. The study found that the health care program can be successfully implemented by existing personnel, but the ministry should provide some guidance in ways to reduce the institutional expense of doing so, as this was revealed to be a widespread concern.
The results of this study revealed that there were 3 main features of implementing the program. The fist was emphasizing team work in routine practice, the second was assigning a doctor who medical treatment consider with director of hospital, and the third was assigning a doctor who medical treatment is having decided person. All 5 hospitals of this study follow a policy of "patient safety". If a case is beyond the hospital's abilities then the patient is referred to a higher level hospital. The medical personnel of all hospitals are competent to deliver the core package of the health scheme, but some smaller hospitals may be unable to deal with complicated diseases or cases needing new medical treatments or techniques. As for the channels of communication, in cases where there were complaints they were usually about timely service or concerns about the most appropriate and beneficial services. The study found that the health care program can be successfully implemented by existing personnel, but the ministry should provide some guidance in ways to reduce the institutional expense of doing so, as this was revealed to be a widespread concern.
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