Development of the patient referral coordination system at Khunhan Hospital, Sisaket Province

Abstract

            The referral system is the heart of the health service system management to ensure that people will have access to comprehensive, fair, and continuous standardized services. This research aimed to 1) study the context and situation of patient referrals between Khunhan Hospital and hospitals that treat patients in the referral system, 2) develop a more efficient referral center model in Khunhan Hospital, and 3) evaluate the referral center model in Khunhan Hospital. The action research model based on the concept of Kemmis & McTaggart was used. The research was conducted in 3 phases: Phase 1: context study and problem analysis, Phase 2: referral system development, and 3 cycles of research, each cycle consisting of 4 PAOR steps: 1) Planning, 2) Action, 3) Observation, and 4) Reflection, and Phase 3: Evaluation of the referral system. The research was conducted within the scope of Khunhan Hospital, Sisaket Province, and its network hospitals. The sample group was purposively selected, consisting of 1) executives, A group of personnel providing patient referral services at Khun Han Hospital, and a group of service recipients, totaling 138 people, conducted research between September 2024 and June 2025. The research instruments were 6 sets of questionnaires, including general characteristics and satisfaction assessment. Data were collected using questionnaires, interviews, observations, and group discussions. The statistics used were descriptive statistics, including numbers, percentages, means, and standard deviations, and content analysis.

                The research results found that the sample group of service recipients were mostly female (56.4%), male (43.6%), aged over 70 years old (37.2%), followed by those aged between 50-60 years and 61-70 years old (23.4%), those aged between 30-39 years old (6.4%), those aged between 20-20 years and 40-49 years old (4.3%), and the least aged under 20 years old (1.1%), with an average age of 59 years, and were married (86.2%), followed by those aged widowed/divorced/separated (13.8%), and had a secondary/vocational certificate level of education. 60.6%, followed by an associate degree, 21.3%, higher than a bachelor's degree, 13.8%, a bachelor's degree or equivalent, 4.3%, a merchant, 56.4%, followed by agriculture, 24.5%, civil servants, 12.8%, and the least, employees, 6.4%. The overall satisfaction was at a high level, with an average score of 4.2. The highest level of satisfaction was in the issues of receiving services that completely met the needs, tools, equipment, the system issues that made it convenient for you to receive services, and the issues of having channels to express opinions or make suggestions, with an average score of 4.4. The recipients were least satisfied in the issues of receiving clear and easy-to-understand information, the issues of officers providing services with politeness and friendliness, and the issues of receiving complete services or having information linked, with an average score of 3.9. For the satisfaction of service personnel, it was found that overall, all 28 items were the most satisfied, but some items had different satisfaction. The satisfaction of service personnel who transferred patients with the highest average score was in the appropriateness of the hospital (potential) that the patient was referred for treatment, and item 28. The appropriateness of risk management of patients who were admitted and referred, with an average score of 4.71. The item with the lowest average score was convenience and speed in performing tasks according to the patient admission and referral management system, with an average score of 4.25. The CIPP Model evaluation results found that most personnel were moderately satisfied with almost every item. The item with high satisfaction was there was a plan for implementing the project, with the highest average score of 3.52, followed by there was a systematic and continuous evaluation of project performance, with an average score of 3.42. The item with the lowest average score was the principles and reasons of the work development project are consistent with the current reality, with an average score of 2.45, and the principles and reasons of the project are consistent with the policy of the parent organization, with the lowest average score of 2.23.

In summary, the research found that both service personnel and service recipients at Khun Han Hospital are satisfied with the development of the patient referral system, which focuses on providing efficient and quick care to those receiving services.