Evaluating the System of Community and Religious Palliative Care Centers in the 9th Health Region

Abstract

The objectives of this evaluation research were to evaluate the long-term care and palliative care system in the community and the religious palliative care centers in the 9^th Health Region using the CIPP Model and to examine the issues, challenges and recommendations related to palliative care centers that successfully passed the assessment and received certification as palliative care centers. Quantitative data were collected using the palliative care center assessment form, while qualitative data were collected using in-depth interviews and focus group discussions with palliative care administrators, care providers, and care receivers, along with representatives of the community networks from 8 palliative care centers, 2 centers from each province in the health region. Data were analyzed using descriptive and content analyses for quantitative and qualitative data, respectively. Results showed that 9 palliative care centers (18.75%) received certification at a “good” level, while the remaining 39 centers (81.25%) received a “standard” level. The context evaluation indicated the centers were founded to reduce burdens on the public health system with an additional focus on spiritual care for patients. Input evaluation showed the need for “man, money, and materials” in setting up the centers, while the National Health Security Office (NHSO)’s compensation per head was often insufficient and full funding required donations from the communities. The number of care providers was sufficient, but their reported compensation was misaligned with their workloads. Process evaluation showed different policies in admitting patients across the centers, while many complained the paperwork was a barrier to quality patient care. Product evaluation revealed that the centers improved the patients’ quality of life and helped them prepare the patients for the end of life. The results from this study can guide policy in improving both the quantity and quality of care among palliative care centers in the future.