ผลกระทบของการติดตามนัดกับแพทย์เฉพาะทางหลายสาขาต่อผู้สูงอายุในเขตกรุงเทพฯ และปริมณฑล

Methawee Sathawaranon; Saipin Hathirat; Supak Sanguansap

doi:10.33165/rmj.48.02.e272087

Authors

Methawee Sathawaranon Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0009-0000-1316-8783
Saipin Hathirat Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Supak Sanguansap Department of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand https://orcid.org/0009-0006-8636-9547

DOI:

https://doi.org/10.33165/rmj.48.02.e272087

Keywords:

Follow-up, Specialists, Effect, Quality of life, Elderly, Continuity of patient care

Abstract

Background: The elderly often have complex illnesses, requiring specialized treatment and follow-up care from doctors in various fields. It has impacted their abilities to adapt to increasing health challenges, and there are few studies about this dimension.

Objectives: To study the prevalence and impact of follow-up with multiple doctors on the lives of the elderly in Bangkok and surrounding areas.

Methods: An exploratory sequential mixed-methods study based on Ramathibodi Hospital outpatient visits, data included from July 2022 to June 2023. We studied the prevalence of elders having multiple follow-ups in Bangkok and surrounding areas. Then, we used purposive sampling for face-to-face, semi-structured in-depth interview and chart review.

Results: The prevalence of elders having multiple follow-ups with specialist doctors was 36.4%. Of the 12 interviewed participants, the median age was 70 and the average number of visits was 39 times per year. Findings from the interviews showed that the impact of multiple diseases could lead to negative feelings such as limitations in activities, shattered dreams, despair, and hopelessness. Patients may have faced difficulties accessing the healthcare system. On the other hand, there were positive feelings such as finding a meaningful life, strengthening family relationships, feeling at home, and feeling valued as teachers by students. Patients may have encountered doctors with varied experiences and frequent changes, which could lead to a lack of trust. It was crucial for patients to learn to manage their conditions. Building a good relationship with their doctor could help patients trust them more.

Conclusions: Elders with multiple follow-ups were primarily found in Bangkok and surrounding areas. This issue arose from both disease-oriented care and discontinuity of care. With multiple diseases and doctors involved, it affected the lives of the elderly both positively and negatively.

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