TPS-Based Evaluation Framework for Financial–Fiscal Performance in Health Region 4 Service Units, Fiscal Years 2022–2024

Abstract

This study aimed to evaluate and compare the financial and fiscal performance of
health service units under the Office of the Permanent Secretary, Ministry of Public Health,
Health Region 4, Thailand, using the Total Performance Score (TPS) as the primary analytical tool.
The descriptive study was conducted using secondary data from TPS assessment reports
for fiscal years 2022–2024. The analysis covered 72 health service units across three levels of care:
regional hospitals, general hospitals, and community hospitals. Descriptive statistics and
year-to-year comparative analyses were applied.
The findings revealed a marked decline in financial and fiscal performance in fiscal year 2023,
with the proportion of units failing the criteria (Level F) increasing to 38.89%. Although performance
indicators showed partial improvement in fiscal year 2024, persistent structural risks within the
health service system remained evident. In the community hospital group, the bed occupancy rate
dropped from 55% to 10%, and the profitability rate dropped from 98.33% to 21.67%.
Pathum Thani Province consistently recorded an increasing number of Level F units throughout
the study period. Key contributing factors included discrepancies in financial planning,
ineffective management of current assets and liabilities affecting organizational liquidity,
and declining bed occupancy rates reflecting suboptimal resource utilization. Strengthening
financial planning capacity, improving resource utilization efficiency, and establishing
proactive regional monitoring mechanisms are therefore essential to enhance the long-term
fiscal sustainability of the health service system.

Keywords: Financial and fiscal performance; Total Performance Score