The Development of a Long Term Care Fund Management Model in Public Health for Elderly Dependents in Toei Subdistrict Administrative Organization, Muang Sam Sip District, Ubon Ratchathani Province

Abstract

          Thailand is becoming a complete aged society, in which the government increases funds to support the elderly. This action research aimed to study the situation of fund management and to develop and assess a fund management model. The research process consisted of three steps: 1) study the situation of fund management, 2) develop a fund management model, and 3) assess the fund management model. The participants in the study consisted of 40 key informants who were fund committee members and stakeholders in Toei subdistrict, Muang Sam Sip district, Ubon Ratchathani province, selected by purposive sampling. The data collection tools were: 1) a questionnaire consisting of three parts: general information, fund knowledge, and a fund management questionnaire; 2) focus group discussions; and 3) in-depth interviews. The data were analyzed by content analysis, descriptive statistics, and paired t-test.
          The results revealed that, regarding the Long Term Care (LTC) fund management, the fund has not yet approved an individual patient care plan. Caregivers have not performed their roles yet. The fund has not disbursed the budget resulting in an outstanding balance. Moreover, there is a lack of coordination and cooperation between the LTC fund subcommittee and various network partners. In this regard, fund committees still do not understand their roles and responsibilities whilst they have unclear directions for the development of the fund that are congruent with the objectives of the fund establishment. Regarding the fund management model development, the CARE TOEI model consisted of having a joint plan with clear goals and responsible leaders as well as the presence of a well-defined fund committee that employs effective monitoring and evaluation procedures. Additionally, the availability of clear and up-to-date information is evident. According to the findings, the participants had knowledge and understanding of the fund at a good level (87.50%) and overall management practice was at a high level. The format was appropriate at a high level. After using the developed LTC fund management model, the mean difference of the sample’s overall fund management score (M = 159.07, SD = 16.82) increased by 27 points (95% CI = 17.33-36.66). For performance, the average score (M = 33.87, SD = 4.73) was considered the most appropriate with an increase of 7.37 points (95% CI = 4.59 -10.15), and organizational leadership had an average score (M = 41.9, SD = 5.56) with an increase of 6.55 points (95% CI = 3.70 - 9.39).
          The findings of this study are beneficial to the fund committee members who can apply this fund management model so that elderly with dependents can receive comprehensive and quality health care, ensuring fairness.