The evolution of outpatient dispensing services in Thailand's hospitals: what has been done and where are we heading?

Abstract

Background: Outpatient pharmacy dispensing services in Thailand require patients to fill prescriptions at hospital pharmacies for reimbursement.

Objective: This study explored hospital outpatient dispensing services in Thailand before, during, and after the COVID-19 pandemic. Characteristics of most frequently used alternative services were described. The study further explored the challenges and enablers associated with continuation of alternative hospital outpatient dispensing services.

Methods: This study utilised a telephone survey targeting management-level hospital pharmacists from various hospital types and sizes. A stratified random sample of 305 hospitals was drawn from 1,471 hospitals. Data was collected using a validated semi-structured interview questionnaire between June-October 2022. Descriptive statistics and content analysis were used for data analysis.

Results: Data from 189 public hospitals were analysed. Before COVID-19, 38.6% of hospitals implemented at least one type of alternative outpatient dispensing service to reduce overcrowding and waiting times. During the pandemic, 97.4% of hospitals implemented alternative services with drug delivery service being most popular among large hospitals. Primary hospitals utilised other services such as subdistrict hospital network which better suited their contexts. Post-pandemic, many large-sized hospitals planned to continue drug delivery service. Enabling factors included reducing overcrowding and supporting patients, while challenges were workload and patient willingness to pay.

Conclusion: The COVID-19 pandemic has redefined outpatient dispensing services in Thailand, making drug delivery a new norm. Hospitals should evaluate current situations and adjust criteria and workflows to sustain these services.