Exploring Constraints in Logistics Operations of Public Hospitals in Mountainous Areas of Northern Thailand

Abstract

Background: Thai public hospitals in highland rural areas are experiencing difficulties in logistics operations due to the mountainous geography and scarcity of resources compared to hospitals in the city center.

Objective: This paper aims to explore the constraints in logistics operations that Thai public hospitals located in rural mountainous areas are experiencing. Materials and Method: A qualitative study using 3 case study hospitals from three highland border cities in northern Thailand was conducted in this study. The onsite observation and interviews were conducted at the hospital to explore operational constraints in seven logistics activities based on the framework of the World Health Organization. Results: All sample hospitals have no centralized logistics coordination system, while I.T. systems cannot integrate the data between front and back-office systems. The inventory system of all hospitals cannot access the actual use rate of medicines and medical supplies. The systematic forecasting procedure of future consumption and the warehouse storage system does not exist. Lastly, transportation operations are faced with long driving times on dangerous roads, and there is a risk of landslides when servicing patients’ referral systems to the urban hospital. Conclusion: The result of this paper is an initial step in an attempt to reduce the gap between populations in the rural-urban quality of life through better hospital operations by exploring and understanding constraints experienced by mountainous public hospitals.