Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 1;13(15):1884.
doi: 10.3390/healthcare13151884.

The Lack of Impact of Primary Care Units on Screening Services in Thailand and the Transition to Local Administrative Organization Policy

Noppcha Singweratham  1 , Jiruth Sriratanaban  2 , Daoroong Komwong  3 , Mano Maneechay  4 , Pallop Siewchaisakul  1
Affiliations

The Lack of Impact of Primary Care Units on Screening Services in Thailand and the Transition to Local Administrative Organization Policy

Noppcha Singweratham et al. Healthcare (Basel). .

Abstract

Background/Objectives: In Thailand, the transition of primary care units (PCUs) to Local Administrative Organizations (LAOs) has raised concerns regarding the potential impact on healthcare service delivery. This study aimed to compare health services between PCUs that have been transferred to LAOs and those that have not. Methods: A total of 15 transferred PCUs (T-PCUs) and 45 non-transferred PCUs (NT-PCUs), matched by population within the same provinces, were purposively sampled. The study population consisted of the cumulative number of diabetes (DM) and hypertension (HTN) screenings retrieved from the National Health Security Office (NHSO) database from 2017 to 2023. The impact of the LAO transfer policy on health service delivery was assessed using generalized estimating equation (GEE) models. All analyses were performed using Stata version 15. Results: The result showed no significant difference in the population and size of PCUs. DM screening was non-significantly lower by 18.9% (AdjRR: 0.811), and HTN screening was lower by 18.6% (AdjRR: 0.814), when comparing T-PCU with NT-PCU. Similarly, the DM and HTN screening in T-PCU was non-significantly lower than NT-PCU when interacting with time. Both T-PCU and NT-PCU show decreases over time; however, the decrease was not statistically significant. Conclusions: Our results show a non-significant difference in DM and HTN screening between T-PCU and NT-PCU. Therefore, decentralization did not clearly demonstrate a negative impact on the delivery of these health services. Further research is needed to consider other confounding and covariate factors for DM and HTN screening.

Keywords: Thailand health system; diabetes screening; generalized estimating equations (GEE); health policy evaluation; health service delivery; hypertension screening; local administrative organization (LAO); primary care unit (PCU).

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Trends in the mean number of individuals screened for diabetes and hypertension, 2017–2023.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Panda B., Thakur H.P. Decentralization and health system performance—A focused review of dimensions, difficulties, and derivatives in India. BMC Health Serv. Res. 2016;16:561. doi: 10.1186/s12913-016-1784-9. - DOI - PMC - PubMed
    1. World Health Organization . Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies. World Health Organization; Geneva, Switzerland: 2010. [(accessed on 16 July 2025)]. Available online: https://iris.who.int/handle/10665/258734.
    1. World Health Organization Primary Health Care. [(accessed on 17 June 2024)]. Available online: https://www.who.int/news-room/questions-and-answers/item/primary-health-....
    1. Sumriddetchkajorn K., Shimazaki K., Ono T., Kusaba T., Sato K., Kobayashi N. Universal health coverage and primary care, Thailand. Bull. World Health Organ. 2019;97:415–422. doi: 10.2471/BLT.18.223693. - DOI - PMC - PubMed
    1. World Health Organization Primary Health Care Systems (Primasys): Case Study from Thailand: Abridged Version. 2017. [(accessed on 17 July 2005)]. Available online: https://iris.who.int/handle/10665/341041.

LinkOut - more resources