Operational Efficiency of Budget Revenue and Expenditure Plans for Fiscal Year 2025 in Health Service Units under the Sikhoraphum District Public Health Office, Surin Province

Abstract

This research and development study aimed to examine current operations, problems, and factors associated with the efficiency of budget revenue and expenditure plan management; develop a context-specific management model for primary health care units; and evaluate the model's effectiveness. The study comprised three phases: situational analysis, model development, and implementation evaluation. Participants included 42 personnel involved in budget management, six experts, and 24 personnel in the implementation phase. Instruments included questionnaires, semi-structured interviews, a model appropriateness assessment, and an operational efficiency assessment. Data were analyzed using descriptive statistics, multiple regression, paired t-test, and content analysis. Most units demonstrated a moderate level of implementation (73.8%), while 57.1% of respondents perceived problems and barriers at a high-severity level. Problem and barrier scores were negatively associated with operational efficiency (β = -0.595, p < .001), and the regression model explained 47.3% of the variance. The developed model integrated baseline data preparation, participatory planning, standardized forms and checklists, budget-status monitoring, interdepartmental coordination, and continuous review. Expert validation indicated the highest level of overall appropriateness (Mean = 4.58, SD = 0.15). After implementation, the overall efficiency score increased significantly from 2.69 to 4.27 (p < .001), with the greatest improvement in transparency and auditability. The model can standardize work processes, reduce dependence on individual expertise, and strengthen transparent and accountable budget management in primary health care units.