Predictors of Achievement in Primary Care Units, Phatthalung Province - ปัจจัยทำนายผลการดำเนินงานของหน่วยบริการปฐมภูมิในจังหวัดพัทลุง

Abstract

         This explore research was aimed at exploring predictors of achievement, problems and solutions for enhancing achievement of services in Primary Care Units (PCUs), Phatthalung Province. The data were collected from 2 sources: 1)on achievement of PCUs from PCU evaluation reports, and 2) on predictive factors from 130 health providers using a questionnaire. The instrument’s content validity was confirmed by five experts, with a content validity index of 0.87. Data were analyzed using frequency, percentage, and multiple logistic regression. Content analysis was used for the data problems and solutions.

          The results showed that 25.5 percent of PCUs did not meet achievement standards; 1) service standard, regarding the coverage of community folder and family folder utilization 2) the management and administration standard, regarding continuity of staff service and management and 3) the academic standard, regarding local research and development innovation. Significant predictors of achievement in PCUs were the ratio of health personnel to number of the population under their responsibility and the daily number of clients. They collectively predicted 32.5 percent of the variance (adjusted R2 = 0.32, p < 0.05). PCUs in which the ratio of health personnel to number of population was not greater than the standard were more likely to pass the standard for achievement than those units with a higher ratio (OR 10.9, 95% CI 3.4, 35.7). PCUs having a higher daily number of patients were more likely to pass the standard for achievement then those with fewer patients (OR 10.3, 95%, CI 2.7, 39.5).

        Obstacles to achievement were insufficient personnel, limited budget, lacks of consultation, orientation. It is suggested that sufficient manpower, adequate budget allocation, continuing staff development and conducive motivation are required. It is recommended that manpower allocation in service is needed as well as the establishement promote co-ordination with the community.

Key words: achievement, standard of primary care, Primary Care Units