Development of long-term care services for patients and the elderly who are dependendent on Nong Wa Subdistrict Health Promoting Hospital. Benchalak District Sisaket Province

Abstract

This research was aimed at: 1) studying the situation and needs for long-term care services, 2) analyzing factors affecting service provision, 3) developing appropriate service models, 4) evaluating the effectiveness of the developed model, and 5) proposing sustainable development approaches. The study employed a mixed-methods research design, utilizing Participatory Action Research (PAR), which was conducted in three phases over a period of nine months. The sample included 68 patients and elderly with dependency, 68 family caregivers, 8 medical and public health personnel, and 30-40 other stakeholders.

Results showed that most participants were female (60.30%), aged over 50 years (92.60%), with severe dependency (47.06%) and complete dependency (26.47%). The research developed a "Community-Integrated Long-term Care Model" comprising five main components: 1) Long-term care coordination center, 2) Multidisciplinary long-term care team, 3) Comprehensive home visit services, 4) Family and community support system, and 5) Information and monitoring system. Effectiveness evaluation revealed significant improvements: Barthel Index scores increased from 42.35 to 58.24 points (p<0.001), overall quality of life improved from 2.41 to 3.22 (p<0.001), caregiver burden decreased from 3.25 to 2.18 (p<0.001), hospital admissions and emergency service use reduced by 50.0%, and home visit services increased by 740.0%. The model demonstrated economic value with a return on investment ratio of 2.45:1. The Community-Integrated Long-term Care Model proved effective in improving care situations for patients and the elderly with dependency and can be scaled up in areas with similar contexts.