Author Information
Phatlapha Kaewnu, Ban Khao-Kwan Sub-district Health Promotion Hospital, ThailandVallop Ditsuwan, Thaksin University, Thailand
Phatthira Thongphlat, Centers of Vector Borne Disease Control 11.3 Surat Thani Province, Thailand
Supawadee Suwanno, Songkhla Hospital, Thailand
Thanittha Ditsuwan, Office of Disease Prevention and Control Region 12 Songkhla, Thailand
Dusanee Suwankhong, Thaksin University, Thailand
Abstract
Background: Thailand's public health decentralisation aimed to improve healthcare management and community participation at the local level. This study investigated the management of non-communicable diseases (NCDs), specifically diabetes and hypertension, in Tham Phannara District from 2021 to 2024. Methods: This descriptive cross-sectional study collected data from a community hospital, encompassing three provider types: the main hospital (PCU), Ministry of Public Health Primary Care Units, and Local Administrative Organisation Primary Care Units (LAO PHC). Data analysis focused on NCD types, medical check-ups, and key laboratory tests including Fasting Blood Sugar (FBS), Glycated Haemoglobin (HbA1c), LDL cholesterol, total cholesterol, and estimated Glomerular Filtration Rate (eGFR). Results: Medical check-ups significantly increased from 254 in 2021 to 1,795 in 2024. LAO PHCs emerged as pivotal providers, handling 1,273 check-ups in 2024. Most patients were female (67.60%), with an average age of 64.43 years. Hypertension was considerably more prevalent (69.70%) than diabetes (30.30%). While NCD management showed improvements in diabetes and lipid control, kidney function (eGFR < 90 mL/min/1.73m²) concerns rose significantly to 696 cases in 2024. Subdistrict Health Promoting Hospitals (SHPHs) generally demonstrated better HbA1c and LDL control compared to LAO PHCs, which exhibited more outliers and variability, indicating some inconsistent management in decentralised units. Conclusion: The findings confirm that decentralisation has substantially improved healthcare access and NCD management. The success of LAO PHCs highlights the potential of local-level care. Future efforts must focus on strengthening local health systems, standardising care protocols, and fostering collaboration to ensure equitable and high-quality services.
Paper Information
Conference: ACSS2025Stream: Environmental and Health Sciences
This paper is part of the ACSS2025 Conference Proceedings (View)
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To cite this article:
Kaewnu P., Ditsuwan V., Thongphlat P., Suwanno S., Ditsuwan T., & Suwankhong D. (2025) Healthcare Decentralization Impact on NCD Management: Four-Year Analysis of Thai Primary Care Centers (2021-2024) ISSN: 2186-2303 – The Asian Conference on the Social Sciences 2025: Official Conference Proceedings (pp. 539-552) https://doi.org/10.22492/issn.2186-2303.2025.45
To link to this article: https://doi.org/10.22492/issn.2186-2303.2025.45
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