Cost-effectiveness of primary care services provided by nurses' private clinics in Thailand

Abstract

The purpose of this descriptive study was to determine the cost-effectiveness of primary care provided at nurses' private clinics in Thailand. The sample consisted of 63 nurses' private clinics and 3518 clients. These clinics were selected by multi-stage random sampling. An observation sheet and three questionnaires were used to collect the data. The data indicated that Nurses' private clinics can provide services for about 90% of the clients' problem at the primary care level at about a 50% lower cost than physicians' services. Thus, nurses' private clinics' services should be included in the reimbursement criteria of the national health care system. For nurses who run their own clinics, the Thailand Nursing Council should require additional training and certification in primary medical care. Nurses' private clinics should extend to home care service for people in the nearby area.

An investigation of the international literature on nurse practitioner private practice models

“…; Hanucharurnkul et al. ; Presley ). In the USA, NP private practices have been established in retail clinics within shopping centres, rural health clinics and Nurse Managed Health Centres (NMHC; Hansen‐Turton et al.…”

“…In Thailand, the private model is also community based, with nurse‐led private clinics established in remote communities that would otherwise have limited access to health care (Hanucharurnkul et al. ). It is unclear what proportion of these nurse‐led clinics is run by NPs; research showed that 8% were qualified to Masters level and 87% to Baccalaureate level (Hanucharurnkul et al.…”

“…It is unclear what proportion of these nurse‐led clinics is run by NPs; research showed that 8% were qualified to Masters level and 87% to Baccalaureate level (Hanucharurnkul et al. ). One may deduce that those qualified to Masters level are more likely to be NPs since the predominant form of training for community health NPs within Thailand is at Masters level.…”

“…Many of the nurses running these clinics have full‐time, hospital‐based roles and they operate their community‐based, private clinics outside of their normal working day in order to ensure that their community has access to health care (Hanucharurnkul et al. ). For the nurses who are not qualified as NPs, legislation exists which permits them to prescribe medication under the authorization of a physician.…”

“…In Thailand, patients paid directly for the services the NPs provided and, in instances where patients could not afford the costs associated, some clinics allowed payment in vegetables rather than money (Hanucharurnkul et al. ). The remote community clinics are up to 50% lower in cost than the same services provided by physicians and this has allowed the clinics to be more accessible for the communities they served and increased patient satisfaction (Hanucharurnkul et al.…”