Desired Health Outcomes Under Regional Health Area Reform Project (Health Areas 1, 4, 9 and 12)

Abstract

This research objects were to study the desired health outcomes under the Regional Health Area
Reform Project, and compare the outcomes before and after the reform, as well as to study the factors
affecting the desirable health outcomes. The study used a mixed method. It began with a quantitative
method. The samples were administrators of service units in the 4 Regional Health Areas (regions 1, 4,
9, and 12) totaling 299 people. Data were collected from September to October 2023 (210 responses)
using a newly developed questionnaire with a reliability value of alpha 0.97. Statistics for data analysis
were percentage, mean, standard deviation, paired sample T-test, Chi-square, and multiple regression
analysis. It was followed by a qualitative research method. The samples were 40 people receiving the
services. Data were collected from November to December 2023. The research instrument was a newly
developed in-depth interview, and the data were analyzed by using content analysis. It was found that the
level of opinions of the service unit executives of the pilot health district regarding management affects the
desired health outcomes in providing quality services. Overall, the majority, 61.9%, was at a high level
(126 - 170 points out of a full score of 170 points). When considering each aspect, it was found that the
governance, system and leadership aspect had the highest score, accounting for 79.5 percent, followed by
health manpower, financial aspect, health information, and health technology (78.8%, 76.3%, 75.1%,
and 73.5%, respectively}. When comparing the desired health outcomes before and after the Under
Regional Health Area Reform, there was a statistical significant difference at the 0.01 level, with the
overall average score after the Under Regional Health Area Reform increased from 26.2 to 40.0 of the
full score of 48 points. This was consistent with the results of qualitative research which revealed that
most service recipients were satisfied with services after the Regional Health Area Reform. When considering
each aspect, it was found that the satisfaction was associated with management of the administrative
system and leadership in the area of health manpower, financial aspect, information, and health technology,
which was significantly related to the desired results of Desired Health Outcomes Under Regional Health
Area Reform at 0.01 level in all 5 parts. When analyzing the factors affecting the desired results of the
health district reform pilot health district, it was found that information factors had a positive influence
on the desired health outcomes Under Regional Health Area Reform, p<0.01. It could explain up to
51.3 percent of the variation (R2 = 0.513). It is recommended that the approach should be expanded
according to the reform guidelines. All 12 regional health areas should develop and strengthen operations
regarding management in all 5 parts, consisting of system governance and leadership, health manpower, finance,
information and health technology. Priority should be given to the development of information as a first priority.
Proposals for future research should focus on tracking the outcome operations in all regional health areas.