Health ministry to set up tertiary referral centres countrywide

The Public Health Ministry is planning to set up the tertiary referral centre across the country to provide acute medical care and transport to definitive care to patients with emergency illnesses and injuries in a bid to save lives.

Under this plan, Health Ministry deputy permanent secretary Dr Siriporn Kanchana, who chairs the referral centre management committee, said about 19 referral centres will be established nationwide and located at the provincial hospital.

At each regional referral centre, the Health Ministry will establish an online system to collect all databases about the number of hospitals in the local area, the number of patient beds in the hospitals, operating rooms, emergency rooms and surgeons. These databases will help the referral centre's staff to determine which hospital the patient should be admitted to receive emergency medical treatment.

Patients or their relatives can just call the referral centre and inform staff about the patient's condition and other basic information. The staff will then send the patient's basic database such as health condition to the emergency medical unit after which they will send the ambulance to assist the patient. The response goal for ambulances is an hour.

During this process, the physician will plan the medical treatment based on the patient's profile sent by the referral centre to assist the patient immediately after being admitted to the hospital.

However, to ensure that there is enough bed and room for patients within the area, the Health Ministry will set up a committee to manage the referral system at the provincial level. The committee comprises the director of hospital, the head of provincial public health office, the head of provincial emergency medical service centre, the chief of provincial administration organisation and governor.

This committee will look at the development of referral system in the local area and also take responsibility to provide enough bed and room for patients in the area.

In the past, there were many problems with the patient referral system among community hospitals and provincial or bigger hospitals due to lack of good management. Many patients from community hospitals could not be transferred to the secondary hospitals due to unavailability of patient beds and operating rooms in the secondary hospital.

Siriporn expected this new referral centre will reduce the imbalance in the healthcare system.

"The rapid response to provide emergency medical service can mean the difference between life and death," she said.

Ubon Ratchathani province's Sappasitthiprason Hospital is one of the most successful in managing the regional referral system to assist patients needing emergency treatment.

With the computer online system based on real-time patient data and hospital data, staff could know about the patient's health condition and the number of beds and operating rooms in the hospital in the local and nearby areas. Then they could make a decision to send the ambulance to assist the patient and transfer the patient to definitive care.

 "The hospital could send the ambulance to help a patient within 82 minutes after the patient calls the referral centre on 1669 for emergency medical service," the hospital's director, Kavee Chaisiri, said.

 He said the hospital has succeeded in developing the referral system to help patients because of the collaboration between the National Health Security Office (NHSO), Provincial Administration Organisation (PAO) and hospitals in local areas .

 NHSO and PAO had supported the budget to develop the referral system and purchased the ambulance to provide emergency care while the hospital provides manpower, medical workers and medical equipment to assist patients.

Under this collaboration, the hospital is now upgrading itself from the local referral centre to the regional referral centre to provide emergency medical services to the four neighbouring provinces of Yasothon, Si Sa Ket, Mukdahan, and Amnat Chareon.

NHSO secretary-general Dr Winai Sawasdivorn said this centre would be a model to manage the referral system for other hospitals across country.