The Evaluation of Service Development for Cleft Lip and Palate Patients at Buri Ram Hospital

Abstract

Background: Cleft lip and palate are common congenital defects of the oral and maxillofacial that requires complex, multidisciplinary, and long-term management. This study aims to investigate the challenges in caring for patients with CLP and to evaluate the development of the CLP patient care system at Buri Ram Hospital, Thailand. The evaluation was conducted using the CIPP (Context, Input, Process, Product) Model, a comprehensive framework for program evaluation.
Methods: This study is evaluation research that collected data through questionnaires and focus group discussions. The sample consisted of 92 parents of children with cleft lip and palate who brought their children for treatment at Buri Ram Hospital, and 13 staff members and healthcare professionals from Buri Ram Hospital. Data were collected between January 2 and March 31, 2024. Quantitative data were analyzed using descriptive statistics, including percentages, means, and standard deviations. Qualitative data from focus group discussions were analyzed using content analysis.
Results: The study found: 1) Context: The implementation aligned with the department and hospital's goals. The plans and projects showed high potential for addressing health issues. However, there was a lack of budgetary planning for service development. The location for activities was suitable, but there were insufficient waiting seats. 2) Input: The hospital had a policy to partially assist with treatment costs beyond dental care rights. There was collaborative work and diverse services including tooth brushing training, pediatric dentistry, orthodontics, referrals, and participation from provincial Red Cross staff. Regular meetings were held with appropriate timing, but there was a lack of data collection for individual health promotion, child nutrition promotion, and psychological support from medical teams for some children. 3) Process: The project goals were achieved at a high level, but inter-departmental communication was lacking. 4) Output: The operation achieved its objectives. Staff participation led to high satisfaction and pride in their work. Service recipients reported high satisfaction (mean 4.1, standard deviation 0.4), with a satisfaction percentage of 80.9%. Barriers to accessing services included difficulty in traveling for continued care, and nearby healthcare facilities' inability to provide adequate information and treatment for children with cleft lip and palate.
Conclusion: This evaluation highlights ongoing challenges in service access, including budget planning, data collection for individual health promotion, child nutrition promotion, coordination with medical teams for mental health care, and the development of a dental patient referral system to ensure appropriate care from nearby healthcare facilities.