A Model for Providing Healthcare Services Through the Medical Rehabilitation Fund with Community Engagement

Abstract

This mixed-methods research aimed to study and develop a model for organizing healthcare services under the Medical Rehabilitation Fund with community participation. The study was conducted in a Northeastern province of Thailand (October 2023 – April 2024). The research employed three phases: 1) Assessing the situation and healthcare needs of people with disabilities; 2) Analyzing the Fund’s service provision process; and 3) Developing a model. The sample included 991 service recipients, 3 administrators, 5 providers, and 5 network organizations. Key findings: The majority of recipients were females (average age 63, SD=20.41), primarily with mobility impairment (67.90%) and hypertension 27.5%. The existing services covered medical equipment, rehabilitation access, physical therapy, environmental adjustments, and follow-up. Outcomes showed that people with disabilities gained greater service access, reduced family burden, and improved coping skills and community participation. The developed service guidelines comprised five components: 1) Promoting service accessibility; 2) Developing network collaboration; 3) Developing a service recipient database; 4) Developing caregivers/attendants; and 5) Building community participation. Recommendation: To ensure sustainable and integrated service delivery, the study recommends developing collaborative mechanisms for the Medical Rehabilitation Fund at provincial and community levels, involving the Provincial Administrative Organization (PAO), Sub-district Health Promoting Hospitals (HPH), and provincial/community hospitals.