Development of a Long-Term Healthcare System for Elderly Individuals with Dependency through Community Participation, Phon Thong Hospital

Abstract

Purposes: To investigate existing problems, develop a care system, and evaluate the effectiveness of a community-based long-term health care system for dependent elderly individuals at Phon Thong Hospital.

Study design: Research and Development (R&D).

Materials and Methods: The methodology of this study was structured to systematically develop and evaluate a long-term care system for dependent elderly individuals. The key informants comprised 15 members of the system development working group, while the study sample included 66 dependent elderly persons and 80 "Smart Caregivers" (Smart CG).The research process was divided into three distinct phases: the problem identification phase, the development phase, and the system evaluation phase. Data collection was conducted between October 2024 and September 2025, utilizing a suite of instruments including standardized tests, evaluation forms, and structured guidelines for focus group discussions. For the data analysis, descriptive statistics such as frequency, percentage, mean, and standard deviation were employed. Furthermore, a comparative analysis of proportions was performed using percentage differences to determine the efficacy and progress of the developed system.

Conclusion and recommendations: (1) The situational analysis revealed that long-term care in the area faces "structural barriers" that directly impede seamless care transitions. These issues are exacerbated by "clinical economic pressures" and architectural constraints inconsistent with the physical limitations of the elderly. Socially, the migration of the working-age population has accelerated the transition to "skipped-generation households," a primary factor contributing to caregiver burnout. Furthermore, a "practical gap" exists due to a lack of strategic integration among stakeholders, resulting in local care mechanisms that lack concreteness and efficiency in addressing current complex challenges. (2) The developed long-term care system comprises screening and assessment activities, a peer-support mechanism (Identification), individualized care mapping and planning, and environmental modification, and (3) Regarding the system evaluation, the caregivers in the experimental group exhibited substantial positive transitions. Specifically, there was a 66.7% increase in the high-knowledge category and a 40.0% increase in the moderate-knowledge category. Conversely, the proportion of caregivers with low knowledge levels in the experimental group significantly plummeted by 85.7%. Furthermore, the experimental group demonstrated markedly higher mean scores in practical skills across all evaluated items compared to the control group. These improvements were directly associated with superior health outcomes in the elderly participants; the proportion of those attaining functional independence (ADL 12-20) rose to 26.1% in the experimental group, significantly outperforming the 10.0% observed in the control group.

Conclusion and Recommendations: This research successfully enhanced the knowledge and skills of practitioners providing care for dependent elderly individuals, subsequently improving the functional abilities and daily living activities of the target group.