Devolution of Health Centers and
            Hospital Autonomy in Thailand : A Rapid Assessment

Hawkins, Loraine; Srisasalux, Jaruayporn; Osornprasop, Sutayut

Devolution of Health Centers and Hospital Autonomy in Thailand : A Rapid Assessment

Autores

Hawkins, Loraine

Srisasalux, Jaruayporn

Osornprasop, Sutayut

Editor

World Bank

Descripción

This rapid assessment was conducted for the Thailand Ministry of Public Health with the support of the World Bank in partnership with the Thailand International Health Policy Program and the Thailand Health Systems Research Institute. This work was done under the World Bank's Country Development Partnership Agreement with the Government of Thailand. Thailand's health system has some features that lead to complexity and local variation in the scope of health responsibilities of Health care (HCs) and the accountabilities and incentives of HCs before and after devolution. HC staff and Tambon Administrative Organization (TAO) leaders in three of the devolved health centers (Naphu, Salabangpoo, and Pakpoon) have positive perceptions of improvement in management flexibility, in the sense that future decision making is expected to be faster and there should be greater scope for initiative. Three devolved health centers (Naphu, Salabangpoo, and Pakpoon) could point to a number ways in which service delivery had already improved and new services had been provided in response to the needs and preferences of the community. These include a stronger client service orientation, increased curative care services, and increase in promotion and prevention (P&P).

Palabras clave

ALLOCATION OF RESOURCES, BEDS, BUDGET ALLOCATION, CAPITAL EXPENDITURE, CAPITATION, CITIZEN, CITIZENS, CLINICS, COMMUNITIES, COMMUNITY HEALTH, COMMUNITY HOSPITALS, COMMUNITY PARTICIPATION, COST SHIFTING, CURATIVE HEALTH CARE, DEBT, DECISION MAKING, DESCRIPTION, DEVELOPING COUNTRIES, DEVELOPMENT PLANS, DISEASE CONTROL, DISTRICTS, DOCTORS, DRUGS, ECONOMIES OF SCALE, EMERGENCIES, EMPLOYMENT, EQUITABLE ACCESS, ESSENTIAL MEDICINES, EVALUATION OF PROCESSES, EXERCISES, EXTERNALITIES, FEE-FOR-SERVICE, FEES FOR SERVICE, FINANCIAL CONTROL, FINANCIAL POLICIES, FINANCIAL RISK, FISCAL POLICY, GOOD GOVERNANCE, HEALTH CARE DELIVERY, HEALTH CARE PROVIDER, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICE DELIVERY, HEALTH CARE WORKERS, HEALTH CENTERS, HEALTH COVERAGE, HEALTH DATA, HEALTH DETERMINANTS, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH FINANCING, HEALTH FINANCING SCHEME, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH NEEDS, HEALTH POLICY, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SECTOR REFORM, HEALTH SERVICE, HEALTH SERVICE DELIVERY, HEALTH SERVICE PROVISION, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH SYSTEMS RESEARCH, HEALTH WORKERS, HEALTH-SECTOR, HOSPITAL, HOSPITAL AUTONOMY, HOSPITAL BOARDS, HOSPITAL MANAGEMENT, HOSPITAL SERVICES, HOSPITALS, HOTEL, HUMAN DEVELOPMENT, HUMAN RESOURCES, ILLEGAL MIGRANTS, IMMIGRATION, INCOME, INCOME COUNTRIES, INFORMATION SYSTEM, INFORMATION SYSTEMS, INTEGRATION, INTERVENTION, LOCAL AUTHORITIES, LOCAL COMMUNITY, LOCAL GOVERNMENTS, LOCAL HEALTH PLANS, MANDATES, MEDICAL ACTIVITY, MEDICAL BENEFITS, MEDICAL CARE, MEDICAL STAFF, MEDICINES, MIGRANTS, MOBILITY, NATIONAL GOVERNMENT, NATIONAL GOVERNMENTS, NATIONAL HEALTH, NATIONAL HEALTH SERVICE, NATIONAL LEVEL, NATIONAL POLICY, NURSE, NURSES, OUTPATIENT CARE, OUTPATIENT SERVICES, PATIENT, PATIENT CHOICE, PATIENT SATISFACTION, PATIENT SATISFACTION SURVEYS, PATIENTS, PERSONAL CHOICE, PHARMACISTS, PHARMACY, PHO, POLICY MAKERS, POLITICAL DECISION, POLITICAL PARTY, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE BEDS, PRIVATE PHARMACIES, PRIVATE SECTOR, PROFESSIONAL ASSOCIATIONS, PROGRESS, PROVIDER PAYMENT, PUBLIC EXPENDITURE, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH EXPENDITURE, PUBLIC HEALTH SERVICES, PUBLIC HEALTH SYSTEM, PUBLIC HOSPITALS, PUBLIC POLICY, PUBLIC PROVIDERS, PUBLIC SECTOR, PUBLIC SERVICE, PUBLIC SERVICES, PURCHASER-PROVIDER SPLIT, QUALITY IMPROVEMENT, REGIONAL NETWORKS, RESOURCE ALLOCATION, RESOURCE MOBILIZATION, RURAL AREAS, SERVICE PROVIDER, SERVICE PROVIDERS, SOCIAL HEALTH INSURANCE, SOCIAL SECURITY, TECHNICAL CAPACITY, TECHNICAL TRAINING, TERTIARY LEVEL, UNIONS, URBAN BIAS, USER FEES, VILLAGE LEVEL, WASTE, WORKERS