Evaluation of Care Service Provision to Dependent Elderly by Family Care Team Following the Primary Care Cluster Policy in Nam Phong District, Khon Kaen Province

Abstract

Objectives: To evaluate the care service provision for dependent elderly by the family care team of Sa-ard subdistrict following the primary care cluster policy in Nam Phong district, Khon Kaen province. Methods: This research used the mixed method including: 1) qualitative research method using data derived from both in-depth interview and group discussion with 3 key informant groups composing of 37 dependent elderlies (Barthel Activity of Daily Living:  ADL ≤ 11), 10 family care team members of Sa-ard subdistrict, i.e., 1 family doctor, 1 pharmacist, 5 nurses, 1 occupational therapist, and 2 public health technical officers, and 1 officer from local administrative organization, and also using data from meeting minutes, reports on service provision and other related documents; and 2) quantitative research method using clinical data derived from medical records from long-term care center and Nam Phong Hospital with a total sample 37 dependent elderlies. For qualitative data analysis, thematic analysis was conducted following the research objectives. Results: Care service provision to dependent elderly by the family care team in Sa-ard subdistrict was highly patient-centered with a collaboration between multi-disciplinary team and the community for the effective service provision and coverage. Thirty-seven dependent elderlies in the study were accounted for 24.83% of all elderlies in the community. The majority of dependent elderlies were home-bounded elderlies (78.38%), aged 80.81 years on average, being female (62.61%) and living with grandchild or grandchildren (97.90%). Regarding outcomes, the dependent elderlies reported a statistically significant increase in ADL scores from 6.78 (±3.20) before the service provision to 10.68 (± 6.08) after service provision. Key success factors included systematic service provision, effective resource utilization, and having community nurses. These were the key for community works leading to capability in service provision following current primary care cluster policy. Conclusion: Care service provision to dependent elderlies in Nam Phong district was considered as a model of effective care service provision with harmonization between institutional care and community care. Therefore, the model needs to be continuously implemented and applied to other areas.