เรื่องเล่าจากออสเตรเลีย (32.5)

3. Issues and Challenges
-   Complex adaptive system
-   Government Policy:
-   Inadequate Health Funding (approximately 4%GDP)
-   Aspiration of Universal Coverage (capped budget  but unmet demand)
-   Life expectancy (Male 70 Yrs; Female 75 Yrs)
-   Infrastructure needs improvement
-   Low socioeconomic status
-   Health services management : poor coordination
-   Financial management needs development
-   Quality accreditation (multiplicity), different standards
-   Education and service delivery separated and not-well coordinated
-   Recruitment and retention of rural doctors
-   High workload (average 1 doctor per 3500 population, Bangkok 1:950, others 1:5000)
4. Comparisons
Advantage ( + )
1.       Rural medical school (undergraduate)
2.       Greater range and volume of clinical teaching materials
3.       Doctor : high valued career choice
4.       Better use of teleconference technology
5.       Less medical-legal cases
6.       Better flexibility in workforce
Disadvantage ( - )
1.       Thai hospitals assigned to be comprehensive care providers without adequate primary care services
2.       Poor coordination of medical education and health services
3.       Finance: 1 bucket for all health services
(+/-)
l     No GP gatekeeper role (self-referred by patients)
5. Future directions/ strategies
1.       Recruitment and retention of rural medical workforce
-   Improve rural recruitment by involving local government through funding of undergraduate rural students to stay in rural areas
-   Move the emphasis of clinical training from university and regional hospitals to community hospitals and primary care
-   Promote career paths and continuing professional development for rural doctors
                2.  Develop concept of GP role
·        Domain of GP in undergraduate education
·        Gatekeeper
·        Specialist status
·        Potential Division of GP
·        Better coordination approach to rural medical education
-   Link National health priorities to medical education
-   Demonstrate those initiatives through local pilots, models and action research
-   Publish achievements
-   Set up rural medical school club
-   Establish similar colleges to Australian and International networks
Special Thanks to:
-   Mr. David Briggs
-   Prof. John Fraser
-   University of New England
-   Hunter New England Area Rural Training Unit
-   Hunter New England Area Health Services
-   ACHSE
-   RACGP
-   ACRRM
-   Aboriginal Medical Centre
Members of the study tour
-    Professor  Boonchob  Pongpanich
-    Professor  Paichit  Pawabutra
-    Dr. Suwanna  Teerawanit
-    Dr. Krish  Charuchart
-    Dr. Seri  Wuttinunchai l      
-    Dr. Chaiwetch  Thanapaisan
-    Dr. Phichet  Banyati
-    Dr. Sawitree  Tunjaroen
         เท่าที่สังเกตดู การนำเสนอนี้เป็นที่สนใจของผู้เข้าฟังอย่างมาก และมีการถาม 4-5 คำถาม