ปัจจัยทางสังคมและการสนับสนุนจากอาสาสมัครสาธารณสุขที่มีผลต่อการเข้าถึงการดูแลสุขภาพ ของผู้ป่วยโรคเรื้อรังในกลุ่มประชากรเปราะบาง ในตำบลนาฝาย อำเภอเมือง จังหวัดชัยภูมิ

Yuwadee Boonnao

Authors

Yuwadee Boonnao Faculty of Nursing, Chaiyaphum Rajabhat University

Keywords:

healthcare access, social support networks, chronic disease patients, village health volunteers

Abstract

Globally, non-communicable diseases (NCDs) are the leading cause of death, especially in vulnerable populations facing the obstacle of healthcare access. Village Health Volunteers (VHVs) play a crucial role as coordinators between communities and health systems. The purpose of this study was to examine social factors and support from VHVs that affected healthcare access among patients with chronic disease in vulnerable populations in Na Fai Subdistrict, Mueang District, Chaiyaphum Province. A cross-sectional survey study was established on 255 patients with chronic diseases in vulnerable populations, selected through proportional stratified random sampling. Data were collected using a questionnaire covering demographics, social factors, VHV support, and healthcare access. Data analysis employed descriptive statistics and stepwise multiple linear regression.

The results showed that the majority of participants were female (76.47%), had an average age of 69.85 years, had primary education (85.88%), were employed in agriculture (50.59%), and earned less than 5,000 baht per month (88.63%). The most chronic disease cases were hypertension (74.12%) and diabetes (56.86%), respectively. Social factors, VHV support, and healthcare access had high mean scores (mean = 4.01, SD = 0.47; mean = 3.82, SD = 1.17; and mean = 4.61, SD = 0.24, respectively). Multiple regression analysis revealed that three significant predictors of healthcare access were access to health information (β = 0.257), care coordination and referral to the healthcare system by VHVs (β = 0.208), and community environment (β = 0.160). These factors could predict 20.6% of the variance in healthcare access.

In conclusion, the factors that influenced the access to health services for patients with chronic diseases in vulnerable populations were access to health information, followed by the coordination of public health volunteers and the community environment. Thus, community health information systems should be developed, VHV referral capacity strengthened, and a supportive community environment provided.

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