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HealthCare System Development Project. Dr. Pradit Sintavanarong Minister of Ministry of Public Health, Thailand. ยุทธศาสตร์ประเทศ. Growth & Competitiveness Inclusive Growth Green Growth Internal Process Development. วัตถุประสงค์. กลยุทธ์. - PowerPoint PPT Presentation
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HealthCare System Development HealthCare System Development ProjectProject
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ยุ�ทธศาสตร์ปร์ะเทศยุ�ทธศาสตร์ปร์ะเทศ1. Growth & Competitiveness 2. Inclusive Growth3. Green Growth4. Internal Process Development
วั�ตถุ�ปร์ะสงค์วั�ตถุ�ปร์ะสงค์
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1 .สอดคล้�องกับยุ�ทธศาสตร์�ปร์ะเทศ แล้ะป�ญหา / ความต�องกัาร์ของปร์ะเทศ2. เชื่ !อมโยุงหร์ อสนับสนั�นัโคร์งกัาร์อ !นัของร์ฐบาล้3. ม%ธร์ร์มาภิ'บาล้ในักัาร์บร์'หาร์จัดกัาร์โคร์งกัาร์4. กั*าหนัดมาตร์ฐานั5. ปร์ะเม'นัสถานัภิาพ (Gap Analysis)6. กั*าหนัดตวชื่%-วดเพ !อล้ดชื่.องว.าง (Indicators to fill gap)7. กั*าหนัดกัร์อบแล้ะตาร์างเวล้าชื่ดเจันั ฯล้ฯ8. บ0ร์ณากัาร์ร์ะหว.างหนั.วยุงานัในักัร์ะทร์วงสาธาร์ณส�ข แล้ะนัอกัร์ะบบกัร์ะทร์วง
สาธาร์ณส�ขท-งหมดท%!เกั%!ยุวข�อง9. กัาร์ม%ส.วนัร์.วมของภิาคเอกัชื่นั1 0 .พฒนัาคร์บวงจัร์ โร์งพยุาบาล้ บ�คล้ากัร์ ยุา เคร์ !องม อ ร์ายุได� ความ
กั�าวหนั�า1 1 .ม%ความยุ!งยุ นัของร์ะบบ1 2 .ปร์ะโยุชื่นั�ท%!ปร์ะชื่าชื่นัจัะได�ร์บอยุ.างชื่ดเจันัเป4นัร์0ปธร์ร์ม1 3 .เพ'!มค�ณภิาพชื่%ว'ต
กลยุ�ทธกลยุ�ทธ
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Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision
Japan
Korea
China
Thailand
World
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Proportion of elderly (>65 years old)Proportion of elderly (>65 years old)
Disease Year 2011 Year 2012Infectious disease 2007.28 2044.77Non communicable diseases• Circulatory diseases• Accident• Cancer
1881.01712.36700.91467.74
1970.27724.18762.75483.34
Rate per 100,000 populations
MorbidityMorbidity
6Source: Bureau of Policy and Strategy, Ministry of public health
Disease 2007 2008 2009 2010 2011
Infectious disease 60.6 61.2 60.7 64.9 64.6Non communicable diseases• Circulatory diseases• Accident• Cancer
208.2555.268.184.9
209.7356.066.187.6
209.6755.266.188.3
215.7961.962.791.2
227.3268.863.495.2
Rate per 100,000 populations
MortalityMortality
7Source: Bureau of Policy and Strategy, Ministry of public health
Source: Thailand Health Profile 2008 - 2010 8
Major Causes of Death in Thailand, 1967-2009Major Causes of Death in Thailand, 1967-2009
Diphtheria Pertussis
Neonatal Tetanus Measles
Source: Disease Control Department, Ministry of Public Health 9
Mark reduction of vaccine preventable diseases Mark reduction of vaccine preventable diseases Thailand 1977 - 2008Thailand 1977 - 2008
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Health service delivery system in ThailandHealth service delivery system in Thailand
Health centers9,768
Municipality Medical
Centers 365
District hospitals776
Provincial hospitals 68
Pharmacy 11,154
Private clinics 17,671
Other public
hospitals 120
Private hospitals
323
Regional hospitals 28
University hospitals 17
Other MoPH hospitals 55
MOPH facilities
Sub-district
District
Province
Source: 1. Thailand Health Profile 2008-20102. Bureau of Policy and Strategy, MoPH, http://hrm.moph.go.th/res53/res-rep2553.html
Private Hospital Clinics (2013)Private Hospitals• Bangkok 98, Other provinces 224• Total 322
Medical clinics• Bangkok 3,970 , Other provinces 14,533 • Total 18,503
Drugstores• Bangkok 4,912 , Other provinces 11,780 • Total 16,692
Traditional medicine Drugstores• Bangkok 443 , Other provinces 1,615 • Total 2,058
Private Hospital Clinics (2013)Private Hospital Clinics (2013)
11Source: Bureau of Policy and Strategy, Bureau of Sanatorium and Art of Healing, Food And Drug Administration; Ministry of public health
Health Facilities in the Public Sector (2010)
Source : Bureau of Health Administration; Ministry of public health
Administrative Level Health facility
Bangkok • 5 medical school hospitals• 26 general hospitals• 13 specialized hospitals/institutions• 68 community health care centers
Regional level • 6 medical school hospitals• 33 regional hospitals• 48 specialized hospitals
Provincial level • 83 general hospitals
District level • 774 community hospitals• 284 municipal health centers
Sub-district level • 9,768 health promoting hospitals
Village level • 198 community health posts• 48,049 rural community primary health care centers• 3,108 urban community primary health care centers• 1,055,000 Village Health Volunteers
Health Facilities in the Public Sector (2010)Health Facilities in the Public Sector (2010)
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Excellent Center
General,Regional Hos.(96)
Community Hos.(743)
THPH(9,750)
CPHC. Center(9,750)
Family health leader
Province(200,000-2M.)
District(10,000-100,000)
Subdistrict (1- 10,000)
Village
FamilySELF CARE
PHC
1o MC
2o MC
3o MC
Health Service Infra-structureHealth Service Infra-structure
13Source : Bureau of Health Administration; Ministry of public health
Service plan
Regional hospitalHigh level
Advance = 33
Standard = 48
M2 = 91
F1-3 (F1=73,F2=518,F3=92)
P 1-2 (P1=226 ศสม P2=9,750 ร์พ.สต)
Primary health care
Primary care
Secondary care
Large community hospital
Small general hospital
General hospital
Excellent center
M1 = 35Mid level
First level
14Source : Bureau of Health Administration; Ministry of public health
• Health service delivery system in Bangkok is not well organized and fragmented.
• MoPH has limited role in service provision in Bangkok
• Private sector and other ministries play greater role in Bangkok.
15Source: Thailand Health Profile 2008 - 2010
Proportion of hospital beds by region and agency, 2008Proportion of hospital beds by region and agency, 2008
• Declining of the population to bed ratios over time was observed, especially those of the North and Northeast; however, disparities between regions remain.
16Source: Thailand Health Profile 2008 - 2010
Population to bed ratios by region, 1979 - 2008Population to bed ratios by region, 1979 - 2008
17Source: Thailand Health Profile 2008 - 2010
Population to provider ratios, 1979 - 2009Population to provider ratios, 1979 - 2009
• There was mark reduction in the disparities of population to health care provider ratios for Bangkok and the Northeast during 2001-2009
• Population to doctor ratio of the Northeast remained 5 time of Bangkok while the ratios of other professions were 1.5 – 2 times of Bangkok
18Source: Thailand Health Profile 2008 - 2010
Disparities of population/healthcare provider ratios Disparities of population/healthcare provider ratios for Bangkok and the Northeast, 2001 - 2009 for Bangkok and the Northeast, 2001 - 2009
19Source: Kanchanachitr et al (2011)
Thailand has relatively low numbers of doctor and nurse to 1,000 populations compared with countries at the same level of economy
Doctor and nurse to 1,000 populationDoctor and nurse to 1,000 population among ASEAN countries among ASEAN countries
Role of Government Pharmaceutical organization Role of Government Pharmaceutical organization (GPO)(GPO)
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Policies response to increase demand for healthcare of Policies response to increase demand for healthcare of Non-ThaisNon-Thais
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1 .ท*าแผนังานัท%!แบ.งบทบาทหนั�าท%!ของท�กัหนั.วยุงานัหร์ อท�กัภิาคส.วนั
2. ท*าแผนัความต�องกัาร์พร์�อมกัร์อบเวล้า3. ท*าแผนังบปร์ะมาณพร์�อมกัร์อบเวล้า4. กั*าหนัดตวผล้ล้พธ�ท%!ปร์ะชื่าชื่นัจัะได�ร์บ5. กั*าหนัดผ0�ร์ บผ'ดชื่อบในัแต.ล้ะส.วนัของแผนั
วั�ธ�ท�างานวั�ธ�ท�างาน
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