Study of service system model for patients with transfusion-dependent thalassemia for community hospitals in Udon Thani Province

Abstract

Background: Thalassemia is a hereditary disorder caused by gene mutations, leading to congenital anemia. Severe forms of thalassemia require regular blood transfusions. Current treatment includes blood transfusions and appropriate iron chelation therapy. In Udon Thani Province, there are 287 children with transfusion dependent thalassemia, with half residing in areas served by community hospitals. This research aims to study the service system for pediatric thalassemia patients in community hospitals in Udon Thani.

Objectives: To examine the service system for transfusion-dependent thalassemia in pediatric patients at community hospitals in Udon Thani Province and to identify key success factors influencing the service system

Methodology: This qualitative study utilized research tools including closed-ended and open-ended questionnaires, along with focus group discussions involving a multidisciplinary team, conducted from June to September 2024.

Results: The study identified 18 community hospitals participating in the program. Key findings included: 1) Establishment of dedicated clinics for pediatric transfusion-dependent thalassemia, staffed by physicians and nurses, achieving 100% operational capacity. 2) Effective coordination within the multidisciplinary team was observed in 66.7% of cases. 3) Blood transfusions were completed within the same day at 100% of the hospitals. 4) Standardized blood products (LPRC type) were sourced in 83.3% of cases, with 77.8% meeting scheduled appointments. Factors contributing to the success of the service system included: 1) A model leadership team at the provincial level, 2) Coordination between the provincial team and community hospitals, 3) Efficient operations within community hospitals, 4) Regular monitoring of hospitals performance, and 5) Creation of collaborative learning environments between provincial and community hospitals.

Conclusion: The study of the service system for pediatric transfusion-dependent thalassemia in community hospitals was found that the service system developed with the prototype system for providing services, was adjusted according to the context of each community hospital to be able to work appropriately and efficiently. The study found extract lessons from key success factors that affect the service system for thalassemia patients in children who depend on blood in community hospitals.