A Comparative Study of Elderly Healthcare Models between Mainland and Island Areas in Satun Province, Thailand

JITRAVEE CHEYCHOM; Suratsawadee Saetae

Authors

JITRAVEE CHEYCHOM Program of Public Health, Faculty of Science and Technology, Songkhla Rajabhat University, Songkhla Province, Thailand
Suratsawadee Saetae Program of Public Health, Faculty of Science and Technology, Songkhla Rajabhat University, Songkhla Province, Thailand

Keywords:

Elderly, Healthcare, Mainland areas, Island areas

Abstract

Background: Satun Province, located along Thailand’s Andaman Sea coast, has a growing elderly population comprising 14.27% of its total residents, distributed across both mainland and island communities. Objective: This study aims to examine elderly healthcare models in contextual differences. Methods: A descriptive cross-sectional study was conducted among 400 older adults in Satun Province, selected via multi-stage sampling. Data were collected using a validated structured questionnaire (CVI = 0.91; Cronbach’s alpha = 0.87). Statistical analyses comprised descriptive and inferential methods. Results: Results revealed no overall difference in healthcare models between the mainland and island elderly populations. However, dimension-specific differences were evident: mainland participants exhibited greater self-reliance in healthcare, whereas island residents demonstrated stronger mutual reliance facilitated by community and primary healthcare networks (p < 0.001). Reliance on professional healthcare services did not differ significantly between the two groups. Conclusion: These findings underscore the necessity of context-specific healthcare models for aging populations. Interventions should focus on strengthening self-care among the mainland elderly and enhancing community-based mutual care in island areas. Furthermore, improving the accessibility and responsiveness of formal health services across both settings will support healthy aging outcomes.

References

Institute for Population and Social Research, Mahidol University, Thailand. Thai Health Report: The Future of Thai Elderly. Available from: https://www.thaihealthreport.com/th/ articles_detail.php?id=155, accessed 26 Mar, 2023.

Secretariat of the Senate, Thailand. Report on the healthcare service system for the elderly to support an aging society. Bangkok: Secretariat of the Senate; 2023. (In Thai)

Tanglakmankhong K, Songsri C, Posri S, Thongphao P, Nilrach W, Fuongtong P. The Implementation of a Community-Based Elderly Health Care Model through Network Participation. Journal of Nursing and Public Health Research 2025; 5(2): e271116. (In Thai)

Kleinman A. Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press; 1980.

World Health Organization. Ottawa Charter for Health Promotion. Geneva: World Health Organization; 1986. Report No.: WHO/HPR/HEP/95.1.

Orem DE, Taylor SG, Renpenning KM. Nursing: concepts of practice. 6th ed. St. Louis: Mosby; 2001.

World Health Organization. Long-term care for older people: Pakse packages and guidelines. Geneva: World Health Organization; 2023.

Su C, Liu Y, Zhang X. Family support and its determinants among older patients with chronic non-communicable diseases: a mixed-methods study. BMC Public Health. 2025; 25(1): 145-56. DOI: 10.1038/s41598-025-08354-y

Patterson S, Fingerman KL. Family ties, geographic proximity, and well-being among older adults. The Journals of Gerontology: Series B. 2023; 78(11): 1924-35.

Patterson, S, Margolis R. Family ties and older adult well-being: Incorporating social networks and proximity. The Journals of Gerontology: Series B, 2023; 78(11), 2080–9.

DOI: 10.1093/geronb/gbad139

Bureau of Registration Administration, Department of Provincial Administration, Thailand. Population statistics structure [Internet]. 2023. Available from: https://stat.bora.dopa.go.th/ new_stat/webPage/statByYear.php, accessed 31 Mar, 2023.

Phavakanan U, Thiratitsakul B, Korsanan S. The contexts of elderly social adaptation in urban community and rural community (activity 1). Journal of Social Science Panyapat

; 4(4): 173–88. (In Thai)

Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970; 30(3): 607-610. DOI: 10.1177/001316447003000308

World Health Organization. WHO guideline on self-care interventions for health and well-being. Geneva: World Health Organization; 2022.

Bureau of Health Promotion, Department of Health, Ministry of Public Health. Thailand. Manual for long-term care management for dependent elderly in the National Health Security Fund. Nonthaburi: Bureau of Health Promotion; 2019.

Wong AKC, Liu T, Liu LZ, Bayuo J, Tao X, Wong FKY. Healthcare and Social Needs of Older Adults in Underserved Urban Communities: Insights from Community Health Workers. J Urban Health. 2025; 102(5): 1057-1068. DOI: 10.1007/s11524-025-01011-9

World Health Organization. Social isolation and loneliness among older people: advocacy brief. Geneva: World Health Organization; 2021.

Lewczak ZA. The Future of Aging in Place: Bridging Infrastructure Gaps and Building Intergenerational Support. Available from: https://foundation.caionline.org/wp-content/ uploads/2025/07/Hanke25FinalReport.pdf, accessed 23 Nov, 2025.

Ide K, Ueno S, Tsuji T, Kawachi I. Participation in community gathering place and social capital: A longitudinal study of older adults. SSM Popul Health. 2025; 31: 101828. DOI: 10.1016/j.ssmph.2025.101828

Ward M, Donnelly S, O'Shea E. Social isolation and loneliness among older adults living in rural environments. Ageing Soc. 2023; 43(4): 890-912.

Li H, Wang X. Association between social capital and informal care among community-dwelling older adults in resource-constrained environments: The role of bonding social capital. Int J Environ Res Public Health. 2022; 19(24): 16789.

Ho IS, McGill K, Malden S, Wilson C, Pearce C, Kaner E, et al. Examining the social networks of older adults receiving informal or formal care: A systematic review. BMC Geriatr. 2023; 23(1): 531. DOI: 10.1186/s12877-023-04190-9

Pender NJ. Health promotion in nursing practice. 3rd ed. Stamford (CT): Appleton & Lange; 1996.

Bureau of Primary Health Care Support. Manual for quality standards of primary health services 2023. Nonthaburi: War Veterans Organization Printing Press; 2022. (In Thai).

Gangopadhyaya A, O'Brien G, Johnston KJ. Configuration and delivery of primary care in rural and urban practices. Am J Manag Care. 2022; 28(12): e441-8. DOI: 10.37765/ajmc.2022.89189

Agustina R, Dartanto T, Sitompul R, Thabrany H, Suparmi S, Sudarmono P, et al. Universal health coverage in Indonesia: Concept, progress, and challenges. Lancet. 2019; 393(10166): 75-102. DOI: 10.1016/S0140-6736(18)31647-7