Evaluation of the development of a Home ward care system for diabetic patients with hyperglycemia without acute complications through the application of medical technology: A case study at Phan hospital, Chiang Rai province
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Abstract
BACKGROUND: Diabetes mellitus is a chronic disease with an increasing prevalence, leading to a growing number of hospital admissions. In response, a home-based inpatient care model has been developed, supported by a multidisciplinary health team in collaboration with families and communities. This approach aims to meet the essential treatment needs of patients while reducing inpatient bed occupancy rates within the healthcare system.
OBJECTIVE: To evaluate the outcomes of developing a Home ward care system for diabetic patients with hyperglycemia without acute complications, through the application of medical technology at Phan Hospital, Chiang Rai province.
METHODS: The evaluation research studied 9 personnel from Phan Hospital and a sample of 235 diabetic patients receiving “Home ward” care at Phan Hospital, Chiang Rai province, between October 1, 2023, and September 30, 2024. The evaluation was conducted using the CIPP Model framework, which consists of four aspects: context, input, process, and product. Research tools included personal questionnaires based on the CIPP Model and diabetic patient satisfaction surveys. Clinical outcomes were evaluated based on data recorded in the HOSxP system and the DMS Home ward system. The collected data were analyzed by using descriptive and inferential statistics.
RESULTS: It was found that (1) Context: The implementation was consistent with the hospital’s policies and the current public health issues. (2) Input Factors: There was support from management at all levels, including medical technology, personnel, and equipment (3) Development Process: The Chronic Care Model with its six components was applied. (4) Product Evaluation: The overall evaluation revealed that the average score across all dimensions was at a high level (𝑥̅ =4.30, S.D.=0.54). The diabetic patients reported the highest level of satisfaction with the service system (𝑥̅ =4.56, S.D.=0.61). In terms of clinical outcomes, the mean capillary blood glucose level (DTX) of diabetic patients before and after discharge from the Home ward program decreased significantly (p<0.001). Similarly, the mean glycated hemoglobin (HbA1c) levels at either 3 months or 6 months after discharge also showed a statistically significant reduction (p<0.001). When comparing data from 2023 to 2024, the incidence of acute complications among diabetic patients decreased from 3.93% to 2.63%, and the bed occupancy rate declined from 84.56% to 78.25%.
CONCLUSIONS AND RECOMMENDATIONS: Home-based inpatient care has been shown to improve clinical outcomes among patients with diabetes mellitus by reducing hospital bed occupancy and minimizing complications. It is recommended that the Home ward model be integrated into primary healthcare services to enhance the continuity and sustainability of care for patients with chronic illnesses through a collaborative, community-based approach.
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