Evaluation of Long - Term Care to Provide public Health Services for the Dependent Older Adults under Universal Coverage Scheme in Phuket Province
Keywords:Evaluation, Long-term care, Dependent elderly
The aims of thisstudy were to study the performance of the health Long-Term Care Systemfor dependent elderly inthe communityandthe barriers for LTC implementation, and recommendations for improving . The quantitative method, 195 samples were included, who had the Barthel ADL 11 and care plan. The instruments were Barthel ADL index and Typology of age with illustration, the evaluation form according to National Health Security Office indicators, the performance outcome, older adults or family caregivers satisfaction in health long-term care questionnaire. Analyzes data by frequency, percentage, mean and standard deviation. The qualitativemethod, participants were 14 subcommittees of health long-term care and orcare managers, 10 caregivers, and 5 family caregivers or older adults. In-depth interview and focus group discussions were used to collect the data. Data were analyzedusing content analysis. The results revealed that the implementation of long-term care was at a good level ( = 3.88, S.D. = 0.45). The finding showed that process dimension didn't meet National Health Security Office indicators that they did not have the Center for Development of quality of life for the elderly. The satisfaction of the elderly was at a high level ( = 4.14, S.D. = 0.39). This service reduced the complication of bed sore and changed the health status of the elderly. Obstacles in operating the case were 1) disruption of regulations and procedures, 2) care manager must perform procurement tasks which were not good, 3) some of the family caregiver didn't cooperate to visit the elderly, and 4)TAI didn't comply with disbursement. The suggestions from key informants were 1) to improve the LTC system for easy use, 2) to clear specific medical material items that can be disbursed for elderly, 3) local governments should carry out procurement and establishment of long-term care of medical materials, 4) to consider selecting only the elderly that need help, 5) caregivers should have traffic accident insurance, and 6) to refresh caregivers' knowledge.
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