Development of Participation of the Network Partners for Intermediate Care from Hospital to Community: Thabo Crown Prince Hospital Network

Abstract

Introduction: Intermediate care patients require continuous rehabilitation from a multidisciplinary team. However, current care model often lacks effective networks connecting hospitals and communities.

Research objectives: To develop collaboration among network partners to improve the quality of intermediate care from the hospital to the community. 

Research methodology: A participatory action research was conducted from March to November 2025 in Thabo District, Nong Khai Province, Thailand. This study involved 55 participants in total: 15 intermediate care patients, 15 caregivers or relatives, and 25 healthcare providers. Research instruments included semi-structured interview guide, participation observation guideline, intermediate care plan, and the Barthel Index for Activities of Daily Living (ADL). Data were analyzed using descriptive statistics and content analysis.

Results: The development of network participation comprised five main components: screening and assessment system, an integrated care plan, team capacity development, an information system, and community participation. Collaborative network teams were established, consisting of a hospital team, a sub-district health promoting hospital team, and a community team. Following the implementation of this model, the mean Barthel Index for ADL score increased from 6.80 (SD = 2.90) to 11.40 (SD = 3.20).

Conclusions: Improving network partner collaboration for intermediate care from the hospital to the community enhanced patient functional outcomes and established effective networks.

Implications: This model should be expanded to other community hospitals. Additionally, an information system linking intermediate care patient data across the entire system should be developed, alongside long-term follow-ups exceeding six months to assess care sustainability.