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สื่อประกอบการบรรยายระบบบริการปฐมภูมิ PowerPoint PPT Presentation


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สื่อประกอบการบรรยายระบบบริการปฐมภูมิ. พ.ญ.รุจิรา มังคละศิริ สำนักงานสาธารณสุขจังหวัดนครราชสีมา. สิ่งที่ท่านเคยได้ยินเกี่ยวกับการปฏิรูประบบสุขภาพ. ก. สร้างนำซ่อม ข. รุกมากกว่ารับ ค. องค์รวมดีกว่าแยกส่วน ง. สุขภาพเป็นเรื่องของชาวบ้าน. การปฏิรูประบบสุขภาพด้านใดที่ท่านเกี่ยวข้องมากที่สุด.

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สื่อประกอบการบรรยายระบบบริการปฐมภูมิ

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6045623

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6045623

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.

.

.


6045623

.

.

.

.


Family practice fp

(Family Practice-FP) ?

. OPD (GP)

. (Home Health Care)

. .+ .

.

FP = OPD + HHC


6045623

1. (Gate Keeper)

2. (Integrated Care) -

3. (Holistic Care) -

4. (Continuity of Care) - 1-2-3 Care

5. (Self Care)


6045623

/


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Bio-medical Bio-Psycho-Social

Disease

Illness

Suffering


Definitions disease

DEFINITIONS : DISEASE

= Abnormal, medically defined changes in the structure of human body


Definitions illness

DEFINITIONS : ILLNESS

= Personals experience of lack of physical or mental well-being making inability to function normally in social roles


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Health for all

Basic Health Service

Equity

Quality

Efficiency

Social Accountability

Primary Health Care

Community Participation

Appropriate Technology

Intersectoral Collaboration

Reorientation of Health Service

Health For All


6045623

  • Equity ( )

  • Quality () ( )

  • Efficiency ( )

  • Social Accountability


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1).

2). (2.5 10 %)

3).

4).

5). 20

6).

. ...


6045623

  • Capitation () / DRG


6045623


6045623


6045623

()

()

1

STANDARD SETTER

PURCHASER

PROVIDER

USER / CLIENTS

()

()


6045623

Register Registee

2

Register (Provider)

Registee (user,clients)

13

BOND

. ...


6045623

Technical Quality

Specialized Care

Referral Center

Social Quality

Simple treatment

Health Promotion

Hospital

Primary Care

1. 2. 3.


6045623

1 2 3

./

.

./

.

3

.

.

1 2

2

1

1

.

.


6045623

.

.

+


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  • (++ +)

  • Extended OPD


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  • -


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.

  • . . 10,000

  • ( ) 10,000


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  • 1.

  • 2.

  • 3. PCU (Bonding)

  • 4. PCU

  • 5.

  • PCU

  • 6. PCU


  • 6045623

    3.

    7.

    PCU

    8.

    9. PCU

    PCU

    PCU OPD

    . .

    . ...


    6045623

    • Research

    • Re-TrainRe-Think

    • Re-Design Re-Tool

    • Resource management

    • Reassurance


    6045623

    Empathic Relationship / Care Coordinator

    Whole Person Medicine

    . / /


    Basic program

    (Basic Program)

    • PCU in UC

    • Role Model

    Meeting of 2 Experts

    Empathic Relationship

    Sustained partnership


    Advance program

    (Advance Program)

    • (2 )

    • (4)

    • (9 )


    6045623

    PCU 4

    1 PCU 4

    1

    ( = PCU)

    2

    (,

    = . = PCU)

    3

    ( PCU)

    4 = Mobile PCU

    . ...


    6045623

    PCU 4

    2

    Main PCU

    Sub PCUSub PCU

    . ...


    6045623

    PCU 4

    3

    PCU ( 1 )

    PCU

    PCU .


    6045623

    4 1

    • Family Folder 50 %

    • 2 ( Basic Program )


    6045623

    2

    • Family Folder 100 %

    • 2+4

      ( Basic Program + + Counseling )


    6045623

    3

    • Family Folder 100 %

    • 2+4 + 9

    • > 70 %


    6045623

    . 5

    = + . +.

    • . 1

    • .

    • FF +

    • . 2

    • .

    • FF +

    • . 3

    • .

    • FF +


    6045623

    . 5

    = + .+.

    . 1

    . 2

    . 3

    .

    5 . 2 3


    6045623

    .

    • .

    • .

    • .


    6045623

    ( .)

    * . .+ 47 (18%)


    6045623

    ( .)


    Primary care unit

    (Primary Care Unit)


    6045623

    /

    • 1. Acute Care, Emergency Care Chronic Care Whole Person Medicine

    • 2. Self Care


    6045623

    /

    • 3.

    • 4.

    • 5.

    • 6.


    6045623

    /

    • 7. Self Help Group

    • 8. Clinical Practice Guidelines

    • 9.

    • 10.


    6045623

    /

    (Case Approach)

    (Whole Person Approach)

    (Family Oriented)

    (Family as a Unit)

    (Health Care System)

    (Community Oriented Primary Care)


    6045623

    .

    Ward

    .

    OPD . .


    6045623

    1.

    • 1.

    • 2.

    • 3.

    /


    6045623

    Bio-Psycho-Social

    2. /


    6045623

    3. / / / ER /


    6045623

    4.


    5 exit care

    5. (Exit Care)

    • /

    • ( )


    6045623

    Admit .

    Self Care

    6. /


    6045623

    7.

    1.

    2. ( Refer )

    3. /

    4. /

    5. Feed Back

    6.

    7. /

    P

    A D

    C


    6045623

    8.

    • . . . .


    6045623

    9.

    10 .

    Internal / External Surveyor

    PCU 1-8


    Re tool

    1.

    2.

    3.

    1. Family Folder

    7

    2.

    Health Maintenance Card

    3. Acute Card Chronic Chart

    Health Promotion Card

    Re-Tool


    Re tool1

    4.

    5.

    6.

    7.

    8.

    9. ( )

    10.

    4.

    5.

    6.

    7.CQI Form

    8. .1-8

    9.

    10.

    Re-Tool


    6045623

    • CUP

    • ..


    6045623

    (Availability)

    /

    (-)

    (Good Care, Standard)


    6045623

    (Accessibility)

    (Acceptability)


    6045623

    (Efficiency)

    (C P)


    6045623

    (Holistic)

    Empathic Relationship

    >

    (Continuity of Care)

    Episode Care > Visit Care

    Care Coordinator


    6045623

    • 45

    (45 )

    • 1.

    • 1.

    • 95

    • 5. - 5

    • 90

  • 18. 60

  • 20

    • 2.

    • 1.

    • 95

    • 2.

    • 2,500

    • 93


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    • 45

    (45 )

    3.

    • 4. 4

    • 30

    • 5. 5

    • 90

    • 6. - 5

    • 95

    • 7. 5 80

    • 11. 6 - 12

    • 100

    • 12. 6-12

    • 95

  • 13. 6-19

  • 90


  • 6045623

    .45

    4 %

    7%

    .13 % (324,588)

    76%


    2544 2545

    2544-2545

    • 10.84 %

    • 6.82 %


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    (//)

    0.98

    0.22

    0.21

    0.97

    0.67

    0.79

    0.56

    0.93

    0.91

    0.65


    Cup 33 005

    () CUP 33,005


    Cup 127 042 11

    () CUP . 127,042 ( 11 .)

    6

    23

    36

    94

    77

    64


    Dm ht 2544 2545 pcu 3

    . DM HT 2544 -2545 PCU 3

    4%

    14%

    13%

    63%

    83%

    (423 )

    23%

    .315

    .507


    2544 25451

    () 2544-2545


    2544 25452

    () 2544-2545


    6045623

    OPD .

    2694

    2247

    • 15%

    • CUP 10%

    • CUP 75 %

    • 800

    60 %

    40%


    6045623

    85% 5

    • 1. (16%)

    • 2.

    • (13%)

    • 3.

    • (13%)

  • 4. . (11%)

  • 5. .(6%)


  • 6045623

    5

    • 1.

    • (36%)

    • 2. . (33%)

    • 3. (22%)

  • 4.

  • (21%)

  • 5. (17%)


  • 6045623

    ()

    • CUP

    • . .


    6045623

    ()

    • .

    • Super Secondary Care

    • Self Care


    6045623

    • Action Research Evidence Based

    • PL


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