The Development of a Care Model for Royal Patronage Patients and Royal Support Patients for Sustainable Quality of Life through Network Partner Participation in Maha Sarakham Province.

Abstract

      This study aimed to examine the current situation and challenges, develop a care model for patients under Royal Patronage through the participation of a network of stakeholders, and evaluate this care model in Maha Sarakham Province. This study employs an action research approach, based on the framework of Kemmis and McTaggart, integrated with the World Health Organization’s "Six Building Blocks" for health systems. The study was conducted between January 2023 and September 2024. The group of informants for the situation analysis and evaluation phases consisted of 105 individuals, including 50 patients and 55 healthcare personnel and relevant stakeholders. A development team—comprising 10 experts and 8 representatives from a multidisciplinary team—collaborated to design the model. Participants were selected using purposive sampling. Data collection instruments included questionnaires, interview guides, a holistic care assessment tool, and a quality-of-life assessment tool. Data were analyzed using descriptive statistics and content analysis.

      Results: The development process resulted in the "CARE Model," which consists of: C – Case management and system coordination; A – Holistic assessment and access to services; R – Referral and resource mobilization from network partners; and E – Evaluation and empowerment. The evaluation revealed that the patients' mean quality-of-life score increased by 0.63 points, rising from 3.13 (SD = 1.02) to 3.76 (SD = 1.12). Holistic care provision was rated at a high level (Mean = 3.64, SD = 1.00), with the domain of "rights and access to services" receiving the highest mean score (Mean = 3.80, SD = 0.94), and the "medical" domain receiving the lowest (Mean = 3.42, SD = 0.98). Furthermore, the assessment of the service model’s characteristics yielded a high rating (Mean = 3.83, SD = 0.94), with key strengths identified in the coordination of service access and equity.