Evaluation of Comprehensive System on Health Care for Older Adults in Health Region 9

Abstract

This study utilized both quantitative and qualitative research methods. Its objectives included to evaluate the comprehensive system on health care and to provide suggestions for the improvement of health promotion and care system for older adults in health region 9. The study was conducted in health region 9 which included 4 provinces: Nakhon Ratchasima, Chaiyaphum, Buriram and Surin provinces. Populations and samples were members from health care for older adult committee at the district level and older adults from all 4 provinces. Instruments used in this study included older adults’ health promoting activities among village health volunteer survey, desirable health behaviors among older adult survey, and focus group questions. The data were collected using surveys and focus group discussions during January 2017-May 2018.

Results from the study can be presented in 4 aspects. 1) Contextual Evaluation: There was a continuum in health care policies for older adults at both national and regional levels with focus on both promoting health among healthy independent and dependent older adults. Each area had qualified professionals to care for older adults with health problems. District Health Board played active roles in the development of health programs for older adults as well as collaborated with networks at the district level. 2) Evaluation of Inputs: Each area reported having adequate health personnel but insufficient resources, budgets, materials and locations. 3) Evaluation of Process: Areas reported having plans and implementations according to the plans. The works were done with committees formed at the local levels with collaborative efforts from local authorities, district health promoting hospitals, network hospitals, health volunteers or elderly care volunteers, elderly clubs and communities in discussing, role settings, supporting for services and screenings, etc. 4) Evaluation of Outcomes: According to the evaluations of health promoting activities among health volunteers, distributions of health messages through public services announcements were done least frequently at 48.5 percent while screening for blood pressure and urine glucose were done more frequently at 70.3 percent. Older adults received income from government’s monthly allowance and from their children. Only 37 percent reported having regular BMI and only 20 percent reported engaging in 15 to 30-minute exercises for at least 5 days per week. About 34 percent ate fresh fruits and vegetables regularly (3-4 days per week) while 36.2 percent drank at least 8 glasses of water daily (5-7 days per week).

It was suggested from this study that the comprehensive system for health promotion and care for older adults in health region 9 included national and regional policies that focused on older adults of all groups (both independent and dependent older adults). Situations and access to care as well as input factors such as health volunteers needed to be evaluated for their qualifications and readiness. Health professionals should also played a key role in managing and supporting health promotion activities. Essential inputs also included resources, budgets, materials and locations or settings to conduct activities. Planning, implementation and evaluation of the programs were three integral parts of successful programs. It was also suggested that discussions of older adults’ health problems among health personnel and volunteers, supports in grant writing in order to secure funding from local agencies, and activities that could reach both independent and dependent older adults in the communities would contribute to the success in health promotion programs in the communities, leading to the desirable health among older adults in the future.