สื่อประกอบการบรรยายระบบบริการปฐมภูมิ

..

. . . .

. . . .

(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 Care5. (Self Care)

/

Bio-medical Bio-Psycho-Social DiseaseIllnessSuffering

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

Health For AllBasic Health ServiceEquityQualityEfficiencySocial Accountability Primary Health CareCommunity ParticipationAppropriate TechnologyIntersectoral CollaborationReorientation of Health Service

Equity ( )Quality () ( )Efficiency ( )Social Accountability

1). 2). (2.5 10 %)3). 4). 5). 20 6). . ...

Capitation () / DRG

STANDARD SETTERPURCHASERUSER / CLIENTSPROVIDER()()()()1

Register (Provider) Register RegisteeRegistee (user,clients)13 BOND . ...2

Primary CareHospitalTechnical QualitySpecialized CareReferral CenterSocial QualitySimple treatmentHealth Promotion1. 2. 3.

. . +

(++ +) Extended OPD

-

. . . 10,000 ( ) 10,000

1. 2. 3. PCU (Bonding)4. PCU 5. PCU 6. PCU

7. PCU 8. 9. PCU PCU PCU OPD . . 3. . ...

Research Re-TrainRe-Think Re-Design Re-Tool Resource management Reassurance

Empathic Relationship / Care Coordinator . / /

Whole Person Medicine

(Basic Program)PCU in UC Role ModelMeeting of 2 ExpertsEmpathic RelationshipSustained 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 Medicine2. 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)

OPD . ..Ward .

(PCU)

PCU

1.

8.

9.

10. /

2. /

3.

5.

7.

6. /

4. Counseling

1. 1. 2. 3.

/

2. / Bio-Psycho-Social

3. / / / ER /

4.

5. (Exit Care) / ( )

6. / Admit . Self Care

7. 1. 2. ( Refer ) 3. /4. / 5. Feed Back 6. 7. / P A DC

8. . . . .

9. 10 . Internal / External Surveyor PCU 1-8

Re-Tool1.

2.

3.1. Family Folder 7 2. Health Maintenance Card3. Acute Card Chronic Chart Health Promotion Card

Re-Tool4. 5. 6. 7. 8. 9. ( )10.

4. 5. 6. 7. CQI Form 8. .1-8 9. 10.

CUP..

STANDARD SETTER

PURCHASER

USER / CLIENTS

PROVIDER

()

()

()

()

1

(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. 955. - 5 9018. 60 20

2.

1. 95 2. 2,500 93

45 (45 ) 3. 4. 4 305. 5 906. - 5 957. 5 8011. 6 - 12 10012. 6-12 95 13. 6-19 90

.45 76%.13 % (324,588) 7% 4 %

2544-2545 10.84 % 6.82 %

(//)0.560.790.970.670.210.220.650.930.910.98

() CUP 33,005

() CUP . 127,042 ( 11 .)3623 6947764

. DM HT 2544 -2545 PCU 3 .315 .507 23%83%(423 )63%13%14%4%

() 2544-2545

() 2544-2545

OPD .22472694 15% CUP 10% CUP 75 % 800 40% 60 %

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