POWER IN THE ADMINISTRATION IN PUBLIC GENERAL HOSPITAL: A COMPARATIVE CASE STUDY
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Abstract
This article is resulted from a multiple case study research with qualitative methodology which is aimed at studying power of the related parties in the administration of public general hospital, identifying key factors supporting and constraining the exercising those powers in a sustainable way, and suggesting useful implications about the power and the exercise of the power in the administration of public general hospital. Data were collected from in-depth interviews with three participants: a medical professor, a medical doctor and a medical instrument seller and also from in-depth interviews, focused interviews, documents, statistical records, and observations on the sites of three case studies. Together thirty-one informants included overseeing officials,former and present executives, and current personnel in hospitals. The three case studies must operate with 200-500 beds, have and least one medical specialization. One was a public hospital under the Officeof Permanent Secretary of the Ministry of Public Health, another was a public hospital under Bangkok Metropolitan Administration and the other was the only public organization hospital under the supervision of Ministry of Public Health. Data, then, were individually and cross analyzed. It is found out that no one case studied was totally separated from power outside and; hence, it is confirmedthat the administration of public general hospital can never deliver health services efficientlywithout sufficientresources for the services to growing population with ever more complicated diseases. The administration that obtains those resources with full support and collaboration from their owners shall be well capable for responding to any health situations and for re-establishing extensive service deliveries as long as the resources may allow. The acquisition of resources must be realized by sharing power between public general hospital and the owners of resources without any interferences to the administration. Instead, a scrutiny mechanism participated by the owners of resources must be imposed to ensure the sustainable administration of public general hospital at all levels.
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