Management Effectiveness of Primary Care Units or Primary Care Networks in Sisaket Province

Abstract

          This research aims to 1) study the management effectiveness of primary care units or primary care unit networks in Sisaket Province, 2) analyze factors affecting management effectiveness, and 3) synthesize policy recommendations for improving the management of primary care units. The study employs a mixed-method approach combining quantitative and qualitative research. The sample consists of 104 primary care units in Sisaket Province, with 312 informants, including 104 primary care unit heads and 208 staff members. Research instruments include a questionnaire assessing management effectiveness in four areas: adaptability, integration, culture maintenance, and goal achievement, and in-depth interviews with 20 executives and staff members. Data analysis involves descriptive statistics, multiple regression analysis, and content analysis.
          The findings reveal that 1) the management effectiveness of primary care units is at a good level, with integration scoring the highest (x̄=4.21, S.D.=0.68), followed by adaptability (x̄=4.15, S.D.=0.72), culture maintenance (x̄=4.08, S.D.=0.75), and goal achievement (x̄=4.03, S.D.=0.79), respectively. Unit heads consistently rated effectiveness higher than staff in all areas. 2) Factors significantly affecting management effectiveness (p<0.05) include support from higher-level agencies (β=0.42), staff capacity development (β=0.38), community participation (β=0.35), leadership of unit heads (β=0.31), and resource and budget availability (β=0.29). These variables collectively explain 68.5% of the variance in management effectiveness (R² =0.685). 3) Key policy recommendations include (1) developing clear and continuous policies to support primary care systems, especially during the transition period after transferring responsibilities to local administrative organizations; (2) creating mechanisms for integrating work between relevant agencies such as provincial health offices, hospitals, and local administrative organizations; (3) allocating sufficient and timely resources and budget for primary care unit development; (4) developing continuous training and capacity-building systems for personnel; and (5) promoting community participation in planning and delivering primary health services.
The research results can be used as guidelines for improving the management effectiveness of primary care units in Sisaket Province and other areas with similar contexts, particularly in planning personnel development, resource allocation, and building cooperation with communities and relevant agencies to enhance the quality of primary health services for the public.