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

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

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.

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.

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.

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.