Development of Rational Laboratory Use Guidelines (RLU Hospital) For Diabetic Patients in the Health Service Network of Phipun District Nakhon Si Thammarat Province

Abstract

This Action Research is aimed to develop the diabetes patient healthcare quality of the Healthcare Service Network of Phipun District, Nakhon Si Thammarat Province in accordance with the Guidelines for Rational Laboratory Use (RLU Hospital) of the Department of Medical Sciences, Ministry of Public Health. According to the research result, it was found that (1) Under the Guidelines for Rational Laboratory Use (RLU Hospital) of diabetes patient groups, it was being piloted in the retrospective blood glucose level checklist (HbA1C) by using the information technology in the alert system (IT Pop Up) in 3 steps and paired t-test statistical analysis, it was found that the number of orders for testing has increased by 14.29%, and after using the Guidelines for the Year 2025 on Overutilization, the percentage of diabetes patients who have undergone the repeated test of HbA1C within 90 days was equal to 86.00% without significant statistical difference (p>0.05) resulting from the alert system; however, after the second circle of development, there was no increase in repeated test.  Regarding the underutilization, the percentage of diabetes patients who have undergone the repeated test of HbA1C at least once a year was equal to 2.00%, showing the positive trends of laboratory healthcare covering local people; (2) Despite an increase in the overall expenses of HbA1C test resulting from the increasing number of diabetes patient groups’ access to HbA1C test service, these guidelines caused a decrease in the expense per case, and the percentage change rate was equal to 21.59%, reflecting the cost-efficiency.  In addition, it was found that the Multidisciplinary Team of Healthcare Service Network of Phipun District was highly satisfied with the Guidelines for Rational Laboratory Use (RLU Hospital) of diabetes patient groups; as a result, the hand-over of the diabetes patient healthcare quality of local people was safe, proper, worthy and at the full potentials of community hospitals of Nakhon Si Thammarat Province, and it might be used as a model for RLU operation for community hospitals at the same level. In addition, it would be effective in achieving the goals of the Ministry of Public Health.