ความคิดเห็นของทีมบริการสุขภาพที่ปฏิบัติงานในศูนย์สุขภาพชุมชน ต่อการให้บริการสุขภาพตามโครงการหลักประกันสุขภาพถ้วนหน้า จังหวัดนครราชสีมา ปี 2545 / ณัฐวดี ศรีส่ง = Opinion of health services teams toward health services at primary care unit under the universal coverage, Nakhon Ratchasima province, 2002 / Natawadee Srisong
Background: In the year 2002, national health promotion campaign was a major policy of present government, aimed of developing primary care unit (PCU) from 4,500 subdistrict health centers, to provide primary health service for population under the universal coverage scheme. Objectives: To study opinion of primary care teams toward health services at primary care unit (PCU) under the universal coverage, Nakhon Ratchasima province, during the year 2002.Research Design: Cross sectional descriptive study. Study Population: Primary care teams(PCT) specified as physicians, nurses, and public health technical officers with a total 1,145 personnel who work in 369 primary care units in Nakhon Ratchasima province. Samples: Questionnaires returned 802 out of 1,145 personnel to make a response rate of 70.0%. Research Tool: Pre-tested self administered structured questionnaires were sent to all primary care teams. Statistical tests: Unpaired t-tests, Paired t-tests, Wilcoxon Signed Ranks test, and One-way ANOVA. Results: Majority of the PCT respondents were female (65.4 percent) aged 21-40 years (80.1 percent), married (63.0 percent), with an undergraduate education (57.5%). Most of them worked full time (87.7%), as public health technicians, nurses and health administrative officers (34.4, 23.3, and 21.7%, respectively), in provision of health service (59.2%) and 82.0% had ever been trained regarding PCU. More than a half of the respondents rated as high to very high score (4-5) and resulting with higher mean scores for the importance than the real practice of all 11 steps specified, except the second step: register/screening was rated as high real practice step (51.7%). Further analysis regarding to 45 activities listed in 11 steps revealed the 3 most important activities were 1) security/safety of services 2) core services activities 3) facilitating activities, whereas of the real practice, the 3 least ranks were 1) work evaluation 2) home visit summary report 3) 24-hour counseling by phone. Besides, the study showed statistically significant differences (p<0.05) in the important activity by age groups, marital status, educational level, job position, and duration of work at the PCU. Conclusion: This study revealed a set of highly important activities marked by PCT respondents which should be useful in developing a standard guideline performance indicators for those PCT members in the future and benefit in monitoring and evaluation, or for continuous job training. The low scoring practice activities stated, should be recognized and improved especially the highly important scoring set for building effective PCU teams.
