Development of a model to promote access to health services for the elderly with dependency in the elderly clinic Laem Sing Hospital, Chanthaburi Province

Abstract

This action research aimed to develop a model to promote access to health services for the elderly who are dependent at the elderly clinic of Laem Sing Hospital, Chanthaburi Province. The target group that participated in the development were 26 people, consisting of doctors, nurses, and staff of the sub-district health promotion hospital, and the group that services providing at Laem Sing Hospital were 60 dependent elderly people. The development process involved 4 steps: planning and developing the model, implementing the model for service provision, evaluating the results, and reflecting on the results. The tools were questionnaires, a forum for participation in problem solving and model development, and an assessment form of access to services and ADL screening. Data was analyzed with descriptive statistics and Paired Sample t-test.

The results were found the dependent elderly in the clinic were mostly females, 66-70 years old (53.3%), primary school level (45.0%), have chronic diseases such as high blood pressure (23.3%), renal disease (16.7%), have caregivers (80.0%), work in income-generating occupations (53.3%), have universal health coverage UC (80.0%). The problem of accessing services was lack of the one bring them to the hospital clinic. The service channel that the elderly do not know is ECG. The service model name is the integrated elderly service model in the elderly clinic. Model evaluation after 3 months of implementation found the elderly could access health services by 91.66 percent. The score of the assessment of the ADL was increased with an average of 10.58, the ability to perform daily activities increased by 5 people, and the ability to sit from bed or bed to chair 4 people. It was found that the elderly were satisfied with the service model before and after, with statistical significance at > 0.001.