In Search of Best Practices for Improving the Operational Efficiency of the Primary Healthcare Hospitals in Thailand through Benchmarking

Abstract

Background: Thailand's public health policy emphasizes equitable access to healthcare services, leading to a rapid increase in primary healthcare demands. Enhancing efficiency has become a crucial solution to address this challenge, especially amidst the constraints of limited resources. Aims: To measure the operational efficiency of sub-district or tambon health-promoting hospitals (THPHs) in the Eastern Economic Corridor (EEC) by applying the mathematical technique of Data Envelopment Analysis (DEA) and to identify best practices from efficient THPHs that can be applied to improve the operational efficiency of other THPHs. Methods: First, the operational efficiency of 104 THPHs in Chachoengsao, a province in EEC, was measured using the DEA method. Second, 13 efficient THPHs were selected as benchmarks for operational best practices. In-depth interviews were conducted with five individuals from each selected THPH, including the director and four key stakeholders. The interview data were analyzed and synthesized using directed content analysis to formulate a list of best practices. Finally, the identified best practices were evaluated using the Delphi technique to produce a final list of best practices to improve the operational efficiency of THPHs. Results: 76 best practices were initially generated from the content analysis of the benchmark interviews. However, after the Delphi experts' evaluation, 66 best practices met the required criteria (Mdn > 3.50 and IQR < 1.50) and were ultimately accepted as potential general strategies for improving the efficiency of THPHs. Of these, 35 best practices were related to input management, and 31 were related to output management.