Development model of the elderly's health service system towards the excellence of tertiary hospitals attached to the Royal Thai Navy

Abstract

The development model of the elderly’s health service system towards the excellence of tertiary hospitals attached to the Royal Thai Navy used the mixed quantitative and qualitative research and aimed to 1) Study the elderly’s health service system of tertiary hospitals attached to the Royal Thai Navy 2) Compare the quality of life and demand of health service of the elderly with different abilities of daily living and seeking services of the tertiary hospitals in different areas and 3) Synthesize the development model of the elderly’s health service system of the tertiary hospitals. The sample included 308 elderly seeking services at the outpatient department of the tertiary hospitals attached to the Royal Thai Navy and there were 17 key informants, staff of the tertiary hospitals attached to the Royal Thai Navy. The descriptive statistics was employed to find frequency, percentage, mean, standard deviation, and the inferential statistics was used to compare the quality of life and demand of health service of the elderly’s different abilities of daily living and seeking services in the tertiary hospitals in different areas, by using the analysis of Two – way MANOVA with the statistical significance at the level of .05. An interviews and focus group were also carried out with 17 key informants in which the results obtained went through the content analysis by determining the content from interpretation and determining the issue framework of the development model of the elderly’s health service system. Model of the elderly’s service health system towards the excellence of the tertiary hospitals was therefore constructed.

The research results revealed the following: 1) The overall quality of life, divided by the abilities of daily living of the elderly namely the society engaged elderly, the home attached elderly, and the bedridden elderly, revealed a high level (x̄ = 97.86) and a fair level (x̄ = 76.71 and 77), respectively. The elderly seeking services at different hospitals overall had different quality of life with the statistical significance at the level of .05 and the elderly’s different abilities of daily living overall had different quality of life with the statistical significance at the level of .05. The two pairs with different quality of life included the society engaged elderly and the home attached elderly, and the society engaged elderly and the bedridden elderly 2) The elderly seeking services in tertiary hospitals in different areas and the elderly’s different abilities of daily living overall had different demand of health service but there was no statistical significance 3) There was no interaction between the variables of the elderly seeking services in the tertiary hospitals and the elderly’s abilities of daily living on overall quality of life and overall demand of health service 4) Model of health service system of the society engaged elderly, the home attached elderly and the bedridden elderly in the perspective of efficient operation was developed activities towards the excellence namely clear policy of health service system, establishment of committee on the elderly, operation handbook such as annual medical checkup, health promotion and the long-term elderly care network; management of the society engaged elderly such as support of the elderly’s self-reliance, support of the elderly’s knowledge source, development of knowledge source and the potential of the club for the elderly; management of the home attached elderly such as home visits, health promotion of specific diseases, support of participation from families, clubs, temples; management of the bedridden elderly such as development of knowledge and innovation, home visit, rehabilitation of specific diseases, development of potential of the caregivers of the bedridden elderly, and overnight center of the care of the elderly, and 5) Guideline of development elderly’s health service system by establishing the Geriatric Medical Center, would serve as the center of operation on the elderly, the administrative center of control, supervision, follow-up, and coordination of network, regular up to date risk management of the elderly, assessment of performance of the elderly’s health service system, and linkage of works on the elderly of hospitals attached to the Royal Thai Navy by using telemedicine network system.