Summary Background This study aims to assess the levels of management competencies of primary health care (PHC) managers in Timor‐Leste. Timor‐Leste is a young country. It has made important improvements in reconstructing its health system since its independence in 2002. However, most managers still learn through their failures, and few studies have described the perceptions of managers in Timor‐Leste. Methods This study used quantitative methods, using a cross‐sectional survey involving a structured self‐administered questionnaire. The Cochran formula was used in calculating the sample size. The sample included 183 PHC managers in Timor‐Leste. Stratified random sampling was adopted to conduct the survey. The researcher used confirmatory factor analysis (CFA) to confirm the validity and reliability of the tools and create new dimensions. The data were analyzed using the frequency and percentage. Results This study was initially designed to include seven dimensions, but after confirming it using the CFA, it was reduced to six dimensions. The result of CFA was used. This study found that PHC managers in Timor‐Leste had rated themselves “not competent” in knowing the organization, professionalism in the workplace, problem solving on financial management, and effective leadership and only “competent” in managing human resources and communicating effectively. Conclusion This study determined that policy makers and stakeholders must give more attention to knowing the organization, professionalism in the workplace, problem solving on financial management, and effective leadership. Managers need to be competent and have various skills to perform managerial functions effectively and efficiently.
Purpose The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems. Design/methodology/approach Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel. Findings The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication. Research limitations/implications Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel. Practical implications Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.
This study assesses the association between health insurance and incidence of death in stateless children compared with uninsured children in Tak Province in Thailand. The study used electronic medical records of children aged between 0 and 15 who registered with selected health facilities between 01 January 2013 and 31 December 2017. The required data was obtained from ‘43-files database’ through the Provincial Public Health Office. The death case was used as a binary outcome variable while the exposure was three types of insurance: uninsured, stateless and the Universal Coverage Scheme (UCS). The age, sex and domicile of the children were used as covariates in the multivariate logistic regression. Of 164,435 registered children, 824 death cases were found during the study period. The study results suggest that insurance is associated with the reduced risk of deaths in stateless children. The odds of death is 86 per cent lower in the stateless insurees than in the uninsured children (adjusted odds ratio [AOR] = 0.242, 95% confidence interval [CI] = [0.136,0.403]; p < 0.001). The death is 69 per cent lower in the UCS beneficiaries than in the uninsured children (AOR = 0.385,95 per cent CI = [0.308,0.489]; p < 0.001). Age, sex and domicile of the children were independently associated with a varying risk of death.
Statelessness is the worst possible form of violation of fundamental human rights which can lead to serious adverse health outcome in children. The purpose of this study is to assess the association between insurance affiliations and health status of stateless children in terms of incidence of pneumonia compared to Thai children with the universal coverage scheme (UCS), and the uninsured children.
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