Devolution of Health Centers andHospital Autonomy in Thailand : A Rapid Assessment

Hawkins, Loraine ; Srisasalux, Jaruayporn ; Osornprasop, Sutayut

World Bank

关键词: ALLOCATION OF RESOURCES;    BEDS;    BUDGET ALLOCATION;    CAPITAL EXPENDITURE;    CAPITATION;   

RP-ID  :  65019

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This rapid assessment was conducted forthe Thailand Ministry of Public Health with the support ofthe World Bank in partnership with the ThailandInternational Health Policy Program and the Thailand HealthSystems Research Institute. This work was done under theWorld Bank's Country Development Partnership Agreementwith the Government of Thailand. Thailand's healthsystem has some features that lead to complexity and localvariation in the scope of health responsibilities of Healthcare (HCs) and the accountabilities and incentives of HCsbefore and after devolution. HC staff and TambonAdministrative Organization (TAO) leaders in three of thedevolved health centers (Naphu, Salabangpoo, and Pakpoon)have positive perceptions of improvement in managementflexibility, in the sense that future decision making isexpected to be faster and there should be greater scope forinitiative. Three devolved health centers (Naphu,Salabangpoo, and Pakpoon) could point to a number ways inwhich service delivery had already improved and new serviceshad been provided in response to the needs and preferencesof the community. These include a stronger client serviceorientation, increased curative care services, and increasein promotion and prevention (P&P).