Defining specific problems in the thai government hospital buildings. A study of architectural planning and space management of maharaj hospital, Chiang Mai Thailand

摘要

The purpose of this paper is to present and analyse the preliminary results of field work observation in one of the biggest government hospitals in Thailand – the Maharaj Hospital, Chiang Mai, Thailand. Hospitals in Thailand are the result of the imported concept from the European and American hospitals. The ideas of hospital architecture from Western countries have been adopted since nineteenth century until the contemporary period. Many of the Thai government hospitals constructed between 1960s and 1970s are still in use. The government hospitals are expanding (incremental development) without considering long term effects in the hospital planning. Therefore, this study investigated what are the factors that cause the incremental development of medical buildings in the Thai government hospitals. Moreover, this study investigated the current situations in a Thai government hospital (Maharaj hospital) where the hospital spatial arrangement is effected by the incremental development. The methodology of this study is done by reviewing literature of the Thai hospital landscape, building assessment tools such as Usability, Space management, and USEtool concepts. Later, an empirical survey (walk-through observations) is conducted to explore daily situations in the Maharaj Government hospital where the hospital is facing the incremental development. Data was collected by documentation such as architectural drawings and photographs and architectural plan analysis was implemented to analyse the spatial arrangement of the Maharaj Hospital planning and identify problems caused by the incremental development. This paper synthesize the findings from literature review of the Thai healthcare context and a walk-through observation in Maharaj hospital. According to the review of the Thai healthcare general context, there are three main factors that cause the incremental development of the hospital buildings (1) the lack of local general practitioners and poor services of primary care offered by community healthcare centers (2) limited number of government hospital (3) the implementation of Thailand’s universal coverage scheme. These three factors resulted in an easy access to government hospitals and dramatically increase of patient number. Therefore, hospitals need to expand to enabler sufficient services for the high number of patients. Walk-through observations identify and emphasis the effects caused by the incremental development of hospital buildings. The results from empirical survey show that confusion of way-findings and the overlapping between waiting areas and non-clinical areas are the problems caused by the incremental development. The problems caused by incremental development was created by two factors (1) the lack of planning in hospital architecture (2) the lack of integration of the Thai culture in hospital design.