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Health systemmn tdevelopment

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  • 1. CURRENT TREND HEALTH SYSTEM DEVELOPMENT AND MANAGEMENT chuchai.s@nhso.go.th Facebook , twitter : Morchuchai Line : chuchai55
  • 2. = Relationships between the functions and objectives of health systems Performance framework (WHO, 2000)
  • 3. Evidence already exists tiering practice changes within primary care. tier 1 : "full-service brokers" and will be delivered by a wide variety of clinicians. tier 2 : grapple with tensions created by patient demand and bureaucratic systems tier 3 : concerned with community health and social justice.
  • 4. Strengthening health systems Building Blocks of the health system and link to health outcomes Source: World Health Organization. Everybody’s Business: Strengthening health systems to improve health outcomes— WHO’s Framework for Action. Geneva: WHO, 2007, page 3.
  • 5. Building blocks – Health systems are highly context specific – No single model for improved performance – Key challenge: cost-effective and high-impact interventions available – But…they require a functioning health system to have an effect at the population scale – Question: how to get drugs, vaccines, and other forms of prevention, care and treatment – on time, reliably, in sufficient quantity and at reasonable cost – to those in need? – Need for learning from country’s experience on integration of building blocks
  • 6. Building blocks – Integration of building blocks Leadership/ stewardship Human Resources Pharmaceuticals Planning and M&E Health Care Financing Health Services
  • 7. The World Health Report 2008 The social values that drive PHC and the corresponding sets of reforms
  • 8. Three ways of moving towards universal coverage (WHR: 2008 & 2010)
  • 9. Chronic Care Model Epping-Jordan, J E et al. Qual Saf Health Care 2004;13:299-305
  • 10. (Home services) (Home care) (Home modification) (Home nursing services) (Home-based & Community Health services) (Day care) (Respite care) (Hospital day care) (Intermediate care) : : 19
  • 11. Community Based Rehabilitation
  • 12. Percent DALY 1999, 2004 and 2009 Male 24 Burden of Disease Thailand, 2009
  • 13. Percent DALY 1999, 2004 and 2009 Female 25 Burden of Disease Thailand, 2009
  • 14. Percent DALY 1999, 2004, and 2009 Both 26 Burden of Disease Thailand, 2009
  • 15. Integration of building blocks CEO District Health System Leadership/ stewardship Human Resources Pharmaceuticals Planning and M&E Health Care Financing Health Services
  • 16. 2557- 2557 [ ] 1,056.96 1,056.96 1,018.35 1,027.94 3 281.02 271.33 4 383.61 383.61 5 14.95 14.95 6 8.19 8.19 7 128.69 128.69 8 3.32 3.32 9 - 0.10 2,895.09 2,895.09
  • 17. 29 Quality and Outcome Framework 2557 Quality and Outcome Framework :QOF) 25571: 1.1 Low Birth Weight ( CUP) 1.2 2: 2.1 OP PCU) 2.2 PCU) 2.3 PCU) 2.4 HT ( PCU) 3: 3.1 PCU) 3.2 CUP) 4: QOF
  • 18. •Concept & Policy •Structure & Organization •Resources Allocation & Sharing •Manpower Development •Information System •Supportive mechanism •New Management (Partnership & Networking) 1. P &P 2. MCH 3. EMS 4. Acute Minor Diseases 5. Dental Health 6. Chronic Diseases 7. Psychiatric Diseases & Mental Health 8. Disabilities 9. End of life care 10.High risk groups (Pre- school, Adole scent, Elderly)
  • 19. 2542 - 2555 80 68 Trainees: Resident Training program. Trainees: In-service training Prctical FM
  • 20. 314 : 2550-2552 , 2553-2555 . 130 157 96.34 PT 27
  • 21. 0 2000 4000 6000 8000 10000 12000 14000 2549 2550 2551 2552 2553 2554 2555 : 2549 – 2553 2554 2555 on top 2555 - 11,531 (NP) 9,392 81.45% 2549 – 2555
  • 22. 213
  • 23. 38
  • 24. chuchai.sn@gmail.com

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