BACKGROUND :

Primary care is considered one of the high-leverage points in health systems to address the increasing challenges of non-communicable diseases (NCDs) in the population. But absence of effective strategies for primary care reforms can limit how low- and middle-income countries (LMICs) sustain and improve its care deliveries. In Thailand, even with its success of implementing Universal Health Coverage (UHC) since 2002, research suggests that insufficient of primary care delivery has limited the effectiveness of the first decade of Thailand’s UHC. Thus, redesigning primary care, with a solid integration with existing hospital care, can play an essential role in the recent health systems reforms. To better cope with NCDs and further advance UHC, Thailand recently started to adopt and apply the WHO’s integrated people-centered health service (IPCHS) and Michael E. Potter’s value-based health care delivery (VBHC) concepts and tools for modernizing its primary care and strengthening the whole healthcare delivery systems. Creating an integrated practice unit (IPU) is a crucial first step, and lessons learned can be taken from such efforts. Besides measuring each patient’s outcomes and true costs as a routine part of care and modifying payment systems, it is crucial that primary care teams should be integrated with relevant specialty providers, that care delivery organized around subgroups of patients with similar needs, and that team-based services are provided to each patient subgroup over its full care cycle. In this PMAC side meeting, we will be exploring the structural and operational integrations of care delivery systems aiming to address the challenges of NCDs in LMICs. Progress on how LMICs such as Thailand assessing the operational integration (e.g. integrated care pathways, care delivery platforms) and the structural integration (e.g. integrated care organizations and networks, integrating vertical programs into health systems strengthening) of the existing health care delivery systems will be reported and discussed. Strategies to advance both operational and structural integrations and relevant implications for health systems reforms in other LMICs will be synthesized and shared.