THE STUDY OF CONFLICT MANAGEMENT IN MEDICAL AND PUBLIC HEALTH SERVICE SYSTEM OF SERVICE DELIVERY UNITS IN PHRA NAKHON SI AYUTTHAYA PROVINCE

Abstract

This research aimed to (1) investigate the problems and complaints related to medical and public health services, (2) compare the results before and after the training of the conflict management by peaceful means, (3) develop the service conflict management system of service delivery units, and (4) analyze cases of medical and public health conflicts settled by peaceful means of negotiation. This research had a mixed-methods research design. The research instruments included the documents from the initial subsidy consideration meeting, pre- and post-training knowledge assessments, and complaint handling standard evaluation forms. An analysis of medical and public health service conflicts was conducted using descriptive statistics, including frequency, percentile, means, and paired t-test. For the qualitative part, there was an analysis of the negotiation process.

            The results showed that:

            (1) Conflict problems occurred among clients under the age of 5 years old and between 6-20 years old respectively. The persons who filed complaints were fathers and mothers. These incidents occurred at tertiary hospitals. The areas with the highest rates of complaints were obstetrics, gastrointestinal, and brain surgery. The reasons for complaints ranged from the delay in diagnosis to the treatment itself. 73.3% were eligible for receiving initial subsidy.

            (2) According to the comparison of conflict management training results, it was found that the mean scores after the training were higher than before the training, with statistical significance of 0.001.

            (3) For the development of service conflict management system, a complaint center was established and according to the evaluation, the complaint center was found to pass the five criteria.

            (4) From the case analysis, it was revealed that the conflicts ended with the establishment of trust, and the search for standpoints and interests in order to build good relationship, allowing the service providers and the clients to see the problems and work toward a solution collaboratively, without the need for a lawsuit. The suggestions were that every complaint should be settled with negotiations along with risk management of the service delivery unit and proactive work development together with the community to build relationship.