Main Article Content
This research was a cross-sectional study. The objectives of this research were to evaluate health need assessment and accessibility to health services of rural elderly and analyse the relationship between personal characteristics, activities of daily living, social support, and accessibility to health services of rural elderly in Wihandaeng district, Saraburi province. The sample of this research was 299 rural elderly. The data were collected by interview and observation between November 2016 - January 2017. The reliability values of interview health need, social support and accessibility to health services were 0.91, 0.86, and 0.96, respectively. Data were analyzed using descriptive statistics and binary logistic regression.
The results of this research found that overall health need assessment was at a moderate level 49.50%, the overall accessibility to health services was at a high level 55.52%, activities of daily living found that well elder group was 91.30%, home bound elder group 6.68% and bed bound elder group 2.00%. Overall social support was at a moderate level 59.20%. The factors related to the accessibility to health services of rural elderly in Wihandaeng district, Saraburi province were high level of the emotional social support (Adj. OR = 2.36; 95% CI 1.24 – 4.51), appraisal social support at a high level (Adj. OR = 2.10; 95% CI 1.19 – 3.70) and informational social support at a high level (Adj. OR = 1.91; 95% CI 1.01 – 3.60). Personal characteristics, activities of daily living and instrumental social support did not relate factors.
Suggestions: Increasing the performance of health facilities, such as staff nurses with expertise elderly care, the appropriate appointments and giving health information to elders will help them more easily access to healthcare services.
2. National Statistical Office, Ministry of Information & technology. Elderly population survey in Thailand 2014. Bangkok: Tex and Journal Publication; 2014.
3. National Health Security Office. Strategic plan for long-term care system implementation for the elderly in dependence 2014 - 2018. [Internet]. [cited 2015 September 7]. Available from: http://shi.or.th/upload/Download%20File/%E0%B8%A8%E0%B8%B8%E0%B8%81%E0%B8%A3%E0%B9%8C%E0%B9%80%E0%B8%AA%E0%B8%A7%E0%B8%99%E0%B8%B2%2056/FridaySem57/5_plan%20LTC.pdf.
4. Yingtaweesak T, Yoshida Y, Hemhongsa P, Hamajima N, Chaiyakae S. Accessibility of health care service in Thasongyang, Tak province, Thailand. Nagoya J Med Sci 2013;75(3-4):243-50.
5. Information systems and public health information offices in Saraburi province. [Internet]. [cited 2016 March 6]. Available from: http: //126.96.36.199/report datacenter/report2.php?id=19.
6. Aday LA, Andersen RM. Framework for the study of access to medical care. Health Serv Res 1974;9(3):208–20.
7. Aday LA, Andersen RM. Equity of access to medical care: a conceptual and empirical overview. Medical Care 1981;19(12):4-27.
8. Penchansky R, Thomas JW. The concept of access definition and relationship to consumer satisfaction. Med Care 1981;19(2):127-40.
9. Department of Health, Ministry of Public Health. Guidelines for elderly caregivers training course 70 hours. Bangkok: National Buddhism Printing Office; 2013.
10. House JS. Work stress and social support. Philadelphia: Addison Wesley; 1981.
11. Daniel WW. Biostatistics: a foundation for analysis in the health sciences. 9th ed. United States of America: John Wiley & Sons Inc; 2009. p. 205.
12. Wanichbancha K. Advanced statistical analysis with SPSS for Windows. 5thed. Bangkok: Faculty of Commerce and Accountancy, Chulalongkorn University; 2006. (in Thai).
13. Pongdee J, Kuhirunyaratn P. Problems and health needs of the elderly in the area of responsibility of the Muang Baeng Tambon Health Promotion Hospital, Nong Ya Phung sub-district, Wang Sa Phung district, Loei province. Journal of Community Health Development Quarterly Khon Kaen University 2015;3(4):561-76. (in Thai).
14. Jeosoh J. Health service needs and health service patterns of the elderly at health promotion and rehabilitation center, faculty of nursing. [Master’s Thesis, Faculty of Nursing]. Prince of Songkla University; 2013. (in Thai).
15. Singkheaw P. Health behavior, social support and health care service request of elderly at Muang Phitsanulok district, Phitsanulok province. Naresuan University Journal Science and Technology 2015;23(3):46-59. (in Thai).
16. Elderly Health Department, the Department of Health, Ministry of Public Health. Important issues related to the national elderly plan No. 2. [Internet]. [cited 2015 September 7]. Available from: http://hp.anamai.moph.go.th/soongwai/statics/about/network/topic001.php.
17. Maslow AH. Motivation and Personality. 2nd ed. New York: Harper & Row PublishersInc; 1970.
18. Jitamai P. The study of supply chain management for elderly home care service Suranaree University, Nakhon Ratchasima Province; 2013. (in Thai).
19. Khuha O, Chaturawit P, Nathamonworakun A. Research report: the study and development of the model of access to health service systems of Thai elderly in each service area under the sufficiency economy philosophy. The Institute of Epidemiology for the Elderly (Institute of Geriatric Medicine) Department of Medical Services, Ministry of Public Health; 2015. (in Thai).
20. Pongsaweth P. Accessibility to curative care services for the elderly in Damnoen Saduak, Ratchaburi Province. [Master’s Thesis, Faculty of Pharmacy]. Silpakorn University; 2008. (in Thai).
21. Chamchan C. Equity and accessibility to needed health services of the elderly in Bangkok and Ayudhaya province. 2011 [Internet]. [cited 2016 March 6]. Available from: http://www.thaitgri.org/images/document/Relative_work/MRG5380111_full.pdf.
22. Lecovich E, Carmel S. Differences in accessibility, affordability and availability (AAA) of medical specialists among three ages-groups of elderly people in Israel. J Aging Health 2009;21(5):776-97.
23. Yang YT, Iqbal U, Ko HL, Wu CR, Chiu HT, Lin YC, et al. The relationship between accessibility of healthcare facilities and medical care utilization among the middle-aged and elderly population in Taiwan. Int J Qual Health Care 2015;27(3):222-31.
24. Huang X, Yang H, Wang H, Qiu Y, Lai X , Zhou Z, et al. The association between physical activity, mental status, and social and family support with five major non-communicable chronic diseases among elderly people: a cross-sectional study of a rural population in Southern China. Int J Environ Res Public Health 2015;12(10):13209–23.
25. Nijananchai S, Santithirisak M. Social and environmental support that affects self-care of the elderly in Samut Prakan province. Journal of Nursing Division 2010;37(2):64-76. (in Thai).
26. Nakubon A, Boongird C, Hathirat S, Tiengsompong N. Thai elderly people’s experiences of moving through journeys of dependences in long-term care facilities. Journal of Health Systems Research 2015;9(3):269-78. (in Thai).