การประเมินผลเบื้องต้น: ประสบการณ์การได้รับการดูแลแบบบูรณาการโดยยึดประชาชนเป็นศูนย์กลางของผู้ป่วยเบาหวาน/ความดันโลหิตสูง

Samrit Srithamrongsawat; Paibul Suriyawongpaisal; Vorasith Sornsrivichai; Santi Lapbenjakul; Duangdao Sriyakun

Authors

Samrit Srithamrongsawat Faculty of Medicine Ramathibodi Hospital, Mahidol University
Paibul Suriyawongpaisal Faculty of Medicine Ramathibodi Hospital, Mahidol University
Vorasith Sornsrivichai Faculty of Medicine, Prince of Songkla University
Santi Lapbenjakul Thawung Hospital, Lopburi Province
Duangdao Sriyakun Phetchabun Hospital, Phetchabun Province

Keywords:

primary care cluster, patient-doctor/family care team relationship, diabetes, hypertension

Abstract

An implementation research on the development of integrated-people centered care started a pilot reform of service delivery system in 20 primary care clusters (PCCs). Patients with diabetes and/or hypertension were employed in this pilot test model. An initial assessment was taken after a 4-months implemention on patient’s experiences on receiving integrated people-centered care comparing between PCC under the project with other primary and ambulatory care facilities in the same district. A community survey of 200 samples was conducted from each district. There were totally 4,071 samples, 1,311 samples from hospital DM/HT clinics, 1,721 from PCCs in the project, 823 from other PCCs, and 216 samples from health centers.

Results showed that PCCs in the project had significantly better patient-family care team relationship compared with other types of health facilities, a greater proportion of patients knew the name of family physician, family care team, and had more convenient communication channel. However, the target of receiving care from the same family doctor and team needed further improvement. The PCCs in the project achieved significantly greater proportions of patients receiving care according to the guideline for chronic illness care in most of the 5 dimensions (knowing health determinant factor, care plan, goal setting, health behavior, and care result) compared with other types of facilities. However, the dimension on health behavior modification got relatively low score compared with other dimensions. It is noticeable that the other PCCs did not perform any better than hospital DM/HT clinics either in terms of patient-doctor/family care team relationship or care for chronic illness. Further implementation research is needed to evaluate implementation outcomes and service outcomes of the model.

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