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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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..


.

.

.

.


.

.

.

.


(Family Practice-FP) ?

. OPD (GP)

. (Home Health Care)

. .+ .

.

FP = OPD + HHC


1. (Gate Keeper)

2. (Integrated Care) -

3. (Holistic Care) -

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

5. (Self Care)


/


Bio-medical Bio-Psycho-Social

Disease

Illness

Suffering


DEFINITIONS : DISEASE

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


DEFINITIONS : ILLNESS

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



Basic Health Service

Equity

Quality

Efficiency

Social Accountability

Primary Health Care

Community Participation

Appropriate Technology

Intersectoral Collaboration

Reorientation of Health Service

Health For All


  • Equity ( )

  • Quality () ( )

  • Efficiency ( )

  • Social Accountability


1).

2). (2.5 10 %)

3).

4).

5). 20

6).

. ...


  • Capitation () / DRG




()

()

1

STANDARD SETTER

PURCHASER

PROVIDER

USER / CLIENTS

()

()


Register Registee

2

Register (Provider)

Registee (user,clients)

13

BOND

. ...


Technical Quality

Specialized Care

Referral Center

Social Quality

Simple treatment

Health Promotion

Hospital

Primary Care

1. 2. 3.


1 2 3

./

.

./

.

3

.

.

1 2

2

1

1

.

.


.

.

+


  • (++ +)

  • Extended OPD


  • -


.

  • . . 10,000

  • ( ) 10,000


  • 1.

  • 2.

  • 3. PCU (Bonding)

  • 4. PCU

  • 5.

  • PCU

  • 6. PCU


  • 3.

    7.

    PCU

    8.

    9. PCU

    PCU

    PCU OPD

    . .

    . ...


    • Research

    • Re-TrainRe-Think

    • Re-Design Re-Tool

    • Resource management

    • Reassurance


    Empathic Relationship / Care Coordinator

    Whole Person Medicine

    . / /


    (Basic Program)

    • PCU in UC

    • Role Model

    Meeting of 2 Experts

    Empathic Relationship

    Sustained partnership


    (Advance Program)

    • (2 )

    • (4)

    • (9 )


    PCU 4

    1 PCU 4

    1

    ( = PCU)

    2

    (,

    = . = PCU)

    3

    ( PCU)

    4 = Mobile PCU

    . ...


    PCU 4

    2

    Main PCU

    Sub PCUSub PCU

    . ...


    PCU 4

    3

    PCU ( 1 )

    PCU

    PCU .


    4 1

    • Family Folder 50 %

    • 2 ( Basic Program )


    2

    • Family Folder 100 %

    • 2+4

      ( Basic Program + + Counseling )


    3

    • Family Folder 100 %

    • 2+4 + 9

    • > 70 %


    . 5

    = + . +.

    • . 1

    • .

    • FF +

    • . 2

    • .

    • FF +

    • . 3

    • .

    • FF +


    . 5

    = + .+.

    . 1

    . 2

    . 3

    .

    5 . 2 3


    .

    • .

    • .

    • .


    ( .)

    * . .+ 47 (18%)


    ( .)


    (Primary Care Unit)


    /

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

    • 2. Self Care


    /

    • 3.

    • 4.

    • 5.

    • 6.


    /

    • 7. Self Help Group

    • 8. Clinical Practice Guidelines

    • 9.

    • 10.


    /

    (Case Approach)

    (Whole Person Approach)

    (Family Oriented)

    (Family as a Unit)

    (Health Care System)

    (Community Oriented Primary Care)


    .

    Ward

    .

    OPD . .


    1.

    • 1.

    • 2.

    • 3.

    /


    Bio-Psycho-Social

    2. /


    3. / / / ER /


    4.


    5. (Exit Care)

    • /

    • ( )


    Admit .

    Self Care

    6. /


    7.

    1.

    2. ( Refer )

    3. /

    4. /

    5. Feed Back

    6.

    7. /

    P

    A D

    C


    8.

    • . . . .


    9.

    10 .

    Internal / External Surveyor

    PCU 1-8


    1.

    2.

    3.

    1. Family Folder

    7

    2.

    Health Maintenance Card

    3. Acute Card Chronic Chart

    Health Promotion Card

    Re-Tool


    4.

    5.

    6.

    7.

    8.

    9. ( )

    10.

    4.

    5.

    6.

    7.CQI Form

    8. .1-8

    9.

    10.

    Re-Tool


    • CUP

    • ..


    (Availability)

    /

    (-)

    (Good Care, Standard)


    (Accessibility)

    (Acceptability)


    (Efficiency)

    (C P)


    (Holistic)

    Empathic Relationship

    >

    (Continuity of Care)

    Episode Care > Visit Care

    Care Coordinator


    • 45

    (45 )

    • 1.

    • 1.

    • 95

    • 5. - 5

    • 90

  • 18. 60

  • 20

    • 2.

    • 1.

    • 95

    • 2.

    • 2,500

    • 93


    • 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


  • .45

    4 %

    7%

    .13 % (324,588)

    76%


    2544-2545

    • 10.84 %

    • 6.82 %


    (//)

    0.98

    0.22

    0.21

    0.97

    0.67

    0.79

    0.56

    0.93

    0.91

    0.65


    () CUP 33,005


    () CUP . 127,042 ( 11 .)

    6

    23

    36

    94

    77

    64


    . DM HT 2544 -2545 PCU 3

    4%

    14%

    13%

    63%

    83%

    (423 )

    23%

    .315

    .507


    () 2544-2545


    () 2544-2545


    OPD .

    2694

    2247

    • 15%

    • CUP 10%

    • CUP 75 %

    • 800

    60 %

    40%


    85% 5

    • 1. (16%)

    • 2.

    • (13%)

    • 3.

    • (13%)

  • 4. . (11%)

  • 5. .(6%)


  • 5

    • 1.

    • (36%)

    • 2. . (33%)

    • 3. (22%)

  • 4.

  • (21%)

  • 5. (17%)


  • ()

    • CUP

    • . .


    ()

    • .

    • Super Secondary Care

    • Self Care


    • Action Research Evidence Based

    • PL


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