Development of an Elderly Health Service Model at the Primary Care Unit of Muang Khum Subdistrict, Phan District, Chiang Rai Province

Abstract

Older adults are a vulnerable population with specific healthcare needs, particularly in health promotion and supportive living environments. However, access to primary healthcare remains limited due to constraints in service delivery, coordination, and health information management, leading to gaps in continuous and preventive care. This study employed a research and development design using a mixed-methods approach to develop and evaluate an elderly healthcare service model emphasizing health promotion and environmental health. The study was conducted from October 2024 to April 2025 at the Primary Care Unit of Muang Khum Subdistrict, Phan District, Chiang Rai Province. The sample consisted of 68 older adults receiving care at the geriatric clinic. The research process comprised three phases: (1) situation analysis; (2) development of a health service model based on the World Health Organization’s Six Building Blocks framework integrated with healthcare service guidelines of the Department of Medical Services; and (3) outcome evaluation. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics and inferential tests. The results revealed that the situation analysis identified issues including limited access to health promotion services, unclear referral pathways, and insufficient integration of health and environmental data. The developed service model comprised Comprehensive Geriatric Assessment (CGA), a mobile geriatric clinic, integration of health information through the HOSxP system, telemedicine, access to medications and medical supplies through the Health Rider delivery system, multidisciplinary team collaboration, and support from local administrative organizations. Evaluation results showed that the model improved access to healthcare and enhanced health behaviors among older adults. The overall mean health behavior score increased from 26.07 (±0.8) before implementation to 27.98 (±2.8) after implementation, with a statistically significant difference (p < .001). These findings demonstrate the effectiveness of the model and its potential as a prototype for implementation in areas with similar contexts.