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Health Services Provided at the Primary Care Network of the Faculty of Medicine, Thammasat University.

Background
Health care network of Faculty of Medicine, Thammasat University is one of Contracting Unit for Primary
Care (CUP) under Thai Universal Coverage (UC) scheme. It comprises four primary care units (PCUs): Khukhot Subdistrict Health Promoting Hospital (KSHPH), Lamsamkaeo Municipality Health Center (LMHC), Khukhot Municipality Health Center (KMHC), and Thammasat Health Center (THC, also acted as CUP).A primary objective of this research was to study health service indicators of these four health centers.


Material and Method
A retrospective study was performed. Data between January 1, 2014 and December 31, 2014 were collected. Following indicators for health service quality were collected and analyzed: 1) numbers of patients visiting PCU/number of patients visiting CUP (OP visit), 2) charge on drugs and medical supplies for outpatient services, 3) newborn and children under five mortality, 4) maternal mortality, 5) low birth weight 6) nutrition status of children under five, 7) diabetes mellitus (DM) patients with Hemoglobin A1C, low density lipoprotein, urine microalbumin tests, diabetic retinopathy screening,
and feet examination, 8) hypertension (HT) patients with lipid profile, urine protein and fasting blood sugar tests, 9) controlled DM patients, and 10) controlled HT patients.


Results
OP visit of KSHPH, LMHC, and KMHC were 0.22, 0.19, and 0.05, respectively. Charge on drugs and medical
supplies for services of KSHPH, LMHC, KMHC, and THC were 102.39, 91.47, 162.04, and 463.85 baht/visit, respectively. There was no newborn, children-under-five and maternal deaths. Percentages of low birth weight of KSHPH, LMHC, KMHC, and THC were 14.3, 14.3, 0, and 9.1%, respectively. Percentage of children under aged five with underweight of KSHPH, LMHC, KMHC, and THC were 12.6, 12.0, 5.6, and 9.1%, respectively. Percentages of children under aged five with overweight of KSHPH, LMHC, KMHC, and THC were 3.7, 22.2, 1.9, and 12.8%, respectively. Percentages of DM patients with HbA1c test of KSHPH, LMHC, KMHC, and THC were 95.4, 87.6, 74.3, and 90.8%, respectively. Percentages of DM patients with LDL tests of KSHPH, LMHC, KMHC, and THC were 98.5, 90.0, 75.7, and 81.5%, respectively. Percentages of DM patients with urine micro albumin tests of KSHPH, LMHC, KMHC, and THC were 6.9, 3.3, 10.0, and 10.2%, respectively. Percentages of DM patients with DR screening of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.6%, respectively. Percentages of DM patients with feet examination of KSHPH, LMHC, KMHC, and THC were 0, 18.7, 0, and 22.7%, respectively. Percentages of HT patients with lipid profile tests of KSHPH, LMHC, KMHC, and THC were
90.8, 73.2, 60.2, and 92.2%, respectively. Percentages of HT patients with urine protein tests of KSHPH, LMHC, KMHC, and THC were 7.3, 17.3, 0.4, and 7.8%, respectively. Percentages of HT patients with FBS screening of KSHPH, LMHC, KMHC, and THC were 92.2, 84.3, 61.0, and 78.1%, respectively. Percentages of controlled DM patients of KSHPH, LMHC, KMHC, and THC were 54.8, 57.9, 54.8, and 61.4%, respectively. Percentages of controlled HT patients of KSHPH, LMHC, KMHC, and THC were 75.7, 19.3, 35.7, and 66.3%, respectively.


Conclusion
Several health service indicators need to be improved including: low OP visit, low birth weight, high underweight and overweight among children under aged five, low coverage of urine micro albumin, DR screening, and feet examination among DM patients, low coverage of urine protein among HT patients, and high percentage of uncontrolled DM and HT patients.