Evaluation of the Pharmaceutical Systems, Medical Supplies, and Medical Equipment of the Subdistrict Health Promoting Hospital that Has Been Transferred to the Provincial Administrative Organization, Fiscal year 2023

Abstract

The objectives of this research were to: 1) evaluate the medication, medical supplies, and equipment management systems of Sub-district Health Promoting Hospitals (SHPHs) before and after their transfer to Provincial Administrative Organizations (PAOs); 2) investigate the problems, obstacles, strengths, and weaknesses in medication management post-transfer; and 3) propose guidelines for improving the medication management system of SHPHs after the transfer. The research design was a qualitative evaluation study using an exploratory and descriptive case study approach. The sample consisted of 32 SHPHs in 8 provinces that had undergone the transfer. Research instruments included performance record forms, in-depth interviews, and focus group discussions. Qualitative data were analyzed using Atlas. ti software.

The findings revealed that after the transfer, the medication and medical supplies management systems of SHPHs changed, particularly in terms of reduced dependency on personnel from the parent community hospitals. This resulted in a decline in medication management quality and a lack of continuity in many SHPHs. The main problems identified were pharmaceutical personnel shortages and inadequate medication procurement budgets. However, a notable strength was that SHPHs gained more autonomy in management, allowing them to respond better to community needs. Key recommendations included enhancing staff capacity, developing quality control systems for medications and inventory management, fostering relationships with parent hospitals, and ensuring adequate budget support from PAOs. Additionally, it was suggested that a more transparent and well-defined monitoring and evaluation system for medication and medical supplies management should be developed.