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Introducing a human dimension in Thai health care: the case for family practice

Thursday, 28 June, 2007 - 18:30
Campus: Brussels Health Campus
Faculty: Medicine and Pharmacy
auditorium P. Brouwer
Yongyuth Pongsupap
phd defence

In Thailand scientific medicine was introduced in
1888. From its inception it was based on a
biomedical model organized through hospital care
provided by specialized physicians. Thai Doctors
were and generally continue to be hospital
doctors. In 1991 family medicine was introduced.
In 2001, Primary Care Units (PCUs) were set up
nationwide, based on the experience of the first
family practices. The thesis presents the rationale
for the introduction of family medicine and
describes the process through which small scale
experimental introduction eventually developed
into a national policy. It focuses on the
performance of doctors in the different
ambulatory settings. Health care provider
behavior is observed through simulated patients
and patient satisfaction assessed through exit
surveys. Several complementary studies with
randomly choosen facilities and doctors in
Bangkok as well as throughout provinces provide
an empirical basis to build health policy upon.
The added value to the Thai health care system
resulting from the introduction of family medicine
can be summarized as follows: (i) family
practices appeared to increase patientcentredness,
with improvement in
responsiveness and control of cost; particularly in
family-practice-health-centres rather than
outpatient-departments of hospitals(ii) family
practices were perceived by patients as better
than non-family practices in the public as well as
in the private sector. To change the paradigm of
health care delivery several constraints a.o. in
medical education, career perspectives offered
and career choice still have to be overcome.