งานและอัตรากำลังเภสัชกรงานปฐมภูมิในจังหวัดเชียงใหม่

Abstract

This study was a cross-sectional analytical study. The objectives were to find job characteristics for pharmacist’s responsibilities in primary care service, and pharmacist workload for each job and to study the workload for pharmacist workforce according to the context of contracting unit for primary care (CUP). The study was conducted in all 24 primary care unit of the CUPs all around Chiang Mai. The data were collected primarily by a data collection form. Additional data was gathered partially form a secondary data at Chiang Mai Provincial Health Office. Data were collected during April-June 2021 and were analyzed by descriptive and analytical statistics. The study results revealed that in Chiang Mai, the service areas of the CUPs were in both plain and remote areas. 79.17% of the CUPs was under an F-level-community hospital. Most of the primary care unit (PCU)’s size was at level M. Average number of PCUs under a CUP was 11.67. The province had overall 93 pharmacists who worked in primary care services. Only 5 pharmacists worked full-time and stationed at the PCU. Most of them, (37.50% ) contributed 2 day/ week workhour for primary care services. Pharmacists performs 7 jobs in primary care services, namely: ( 1) Management of pharmaceuticals, ( 2) Drug delivery and advice on drug use, ( 3) Pharmaceutical care in primary care unit, (4) Continuous care in community (5), Consumer health protection, (6) Promoting use of herbal and traditional Thai medicines, and (7) Administration and supervision on primary care service. Pharmacists provided primary care services differently depending on the CUP context, and available pharmacist workforce. Primary care pharmacists spent the largest portion of time on drug delivery and counselling. An average FTE of pharmacists in completing their primary care task was 1.05, with a range of 0.25FTE-4.72FTE. An F-levelcommunity hospital required approximately 1 FTE of pharmacists for proving all 7 tasks of primary care services, whereas an A-level provincial hospital required approximately 4 FTE. The CUP characteristics factors significantly affecting the median workload were the number of elderly people (p= 0.01) and the number of drug stores, clinics and factories in the area (p= 0.03) . In conclusion, the number of primary care pharmacist, that is allocated for 1 person per 1 CUP, is insufficient and irrelevant for achieving the desired medical services for primary care. Thus, the CUP characterization factors must be used as an additional criterion for assigning the number of pharmacist workforce for ensuring sufficient personnel for the jobs and for continuously improvement of their survices as stated in the goals of primary health care.