Development of Management Mechanisms for the Health Service System in Bangkok Metropolitan Area
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Abstract
This research article aimed to: 1) analyze the overall situation of the management mechanisms of the health service system in the Bangkok Metropolitan Area; 2) identify the problems within these management mechanisms; and 3) explore strategies for developing the management mechanisms of the health service system in Bangkok. This qualitative research involved purposive sampling of 20 key informants, including nine public health administrators from Bangkok Metropolitan Administration, nine medical personnel and health volunteers, and two academics/experts with specialized knowledge and experience. Data were collected through interviews and analyzed using descriptive summarization.
The findings revealed that 1) Although the health service system in Bangkok has implemented zonal health divisions and established new hospitals, secondary-level service units remain insufficient, and primary care services are still difficult for the public to access. Workforce shortages persist, especially among physicians, nurses, and pharmacists. While information systems have improved, issues with data integration and reliability remain. Innovative medicines and technologies exist but lack systematic management. Budget constraints are evident. Governance focuses on decentralizing services to communities and promoting public participation but lacks unified coordination; 2) The primary problems include inequitable access to services, incomplete service networks impacting referral systems, workforce attrition, disconnected health information systems, lack of systematic tools and plans for medication use, budget allocations misaligned with needs, and insufficient inter-agency cooperation; and 3) Recommended development strategies include upgrading health services to comprehensive coverage, establishing district-level hospitals, increasing healthcare personnel and adjusting their compensation, employing technology to reduce workload, creating centralized and integrated health databases, automating medication management systems, allocating budgets based on regional needs, and promoting collaboration under good governance mechanisms.
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