Patient Centred Initiative and Integrated Health Services Management Research in the Provinces of Thailand

Abstract

Research objectives: To developing a multi-disciplinary research proposal and identifying the key elements and evidence base of patient-centred initiative for patients and health professionals as well as health service providers with chronic disease.
Nature of research: This study used a qualitative research design to developing a patient- centred care model applicable across chronic illness in the rural Thai; Nakhonratchasima province is located in the north-eastern region of Thailand.
Research Method: The Participatory Action research design and focus group discussion were applied. There are 3 groups of stakeholders involve in this PCI research namely Chronic disease group, Dengue hemorrhagic fever group and Traffic accident group. Stakeholders are district leader, health volunteer, health officer, patient, teacher, police and monk.
Findings: The themes emerged from the data as follows :
1. People at the Centre of Care Initiative in WHO collaboration aspects was divided into 4 aspects; Individual/family and community, Workforce health professionals, Health organization and Supporting health system aspects. In this research, we were focus on three aspects such as Individual/family and community, Workforce health professionals, Health organization.
2. Individual/family and community aspect is defined into 5 elements : 1. Individual awareness of health status and problems, 2. Empowerment social responsibility social value and social rules in community for social civilization, 3. Building community participation - networking within community, 4. Development of community learning and 5. Supporting from local government-budget and teamwork.
3. Workforce health professionals are defined into 2 elements :
1. The core value of health professionals and paradigm shifting.
2. The competency of interdisciplinary team; People-centred clinical method : six interactive components.
4. Health organization is defined into 6 elements : 1. Adjustment of the structure of organization, 2. Developing of the Quality system and management system, 3. Developing of the Model of Service system, 4. Adjustment of Incentive and motivation system includes human resource development system, 5. Development of the communication system and 6. Development Management Information system and network.
5. Suggestion from focus groups in final meeting- 6 months later.
5.1 Implementation of this concept will be careful due to the Thai policy and culture.
5.2 Time-limited and work overload were main cause of project limitation.
5.3 People and community don't understand their right and rule.
Conclusion: Providing patient-centred care beyond to the "30-baht uc program" in Thailand has been improvement of health care system. Not only training methods but also other innovative approaches are required, in order to raise, adapt, and implement the concept with concern for feasibility and sustainability. Therefore it requires multidisciplinary and interdisciplinary approaches including History of patients and their families, related psycho-social factors to the illness, and medical education and health services system. The future research should be designed as action PCI research, PCI research for chronic care in PCU or PCI in community etc.
Key words: Patient Centred Initiative, Innovative