Development of a Long-Term Care System and Access to Service for Dependent Elderly in Buriram Province

Abstract

This research and development project aimed to develop and evaluate the effectiveness of the long-term care (LTC) system for dependent elderly in Buriram province. The study was implemented during January 2017 and September 2020 with the following five steps: 1) studying and analyzing of problems according to PIRAB framework, 2) designing and developing a system based on system-theory concepts, 3) piloting the developed system, 4) evaluating and making adjustments to improve the system, and 5) implementing the system and evaluating on effectiveness of the system and key success factors. The samples were health care providers, responsible persons at local administrative organizations, and dependent elderly. The data were collected through care plan reports, LTC data based on sub-district criteria, activities of daily living (ADL) assessment forms, and a qualitative questionnaire. The collected data were analyzed using descriptive statistics and content analysis. The results showed that (1) Input process included the fiscal and financial system, resource management, manpower management, management and service arrangement and database system; (2) Operation process was consisted of mechanism at the local levels, providing services at the service center and in the communities, and mentoring system; (3) Evaluation process showed that (a) elderly in LTC had ADL increased from 14.29% to 33.27%, (b) the LTC program at sub-district operations passed the criteria at 99.47% (188 out of 189 districts), (c) dependent elderly receiving services from the LTC program had increased from 373 to 6,307 individuals, and (d) local administrative organization joining LTC Fund increased from 51 to 207 sites. Success factors included 1) mechanism to improve the quality of life through District Health Board, 2) improvement of caregivers’ confidence in taking care of the elderly, 3) having a mentoring system in counseling, and 4) continuous follow-up of site visits. It was recommended from this study that, the development of the LTC system for elderly should be cooperated with all sectors and manpower in caring for the elderly should be supported for the elderly to have good care and reach quality of life.