Health Care Services for the Elderly: Legal Issue for Consideration - บริการสุขภาพผู้สูงอายุ: ประเด็นทางกฎหมายทีควรพิจารณา

Abstract

                The purposes of this study were to explore the laws with regard to the elder, the opinions about health care services for the elderly: legal issue for consideration; services and the problems of health care services; and the recommendations on policy and law that promoted health care services for the elderly. It was conducted as a documentary research on law related to elderly care and a qualitative and quantitative survey. Altogether 655 subjects including the older people, caregivers, and multidisciplinary stakeholders were selected by cluster sampling from 4 regions of Thailand: North, Northeast, Middle, and South; then the 4 provinces in each region and subjects were selected by purposive sampling. Statistical analyses employed were content analysis, percentage, mean, and standard deviation. The findings demonstrated that many countries had legislate the laws for the older people, provided the elderly health care and financial system. In Thailand, there were many levels of legislation regarding elderly health care services. The study of opinions about health care services for the elderly showed that Constitution of the Kingdom of Thailand and the Act on Older Person could affect health care services for the elderly at the moderate level. The National Health Security Act, the National Health Act, the Notification of Ministry of Public Health RE: Elderly Service, and the Determining Plans and Process of Decentralization to Local Government Organi-zation Act had an effect on health care services for the elderly at the low level. Services and the problems of health care service related to the laws were (1) low quality elderly health care services; (2) lack of the expert personnel; (3) caregiver and volunteers were lack of knowledge, had other job, and had problems on expenses; (4) the elderly were lack of knowledge, experiencing inequity, and inaccessible to the health services; and (5) unclear co-operation between the agencies and inappropriate of spending procedure. Recommendations of policy and law that promoted health care services for the elderly included: (1) the government should developed integrated strategic plan include all dimensions of care; (2) government financing should be revised; (3) the Act on Elderly Person and related subordinate legislations should be added about the expenditure of caregivers; (4) Ministry of Public Health should collaborated with Ministry of Social Development and Human Security, Ministry of Interior and related agencies in order to improve the Act on Elderly Person, and associated ministerial regulations and notifications; (5) the caring of older people should be integrated; and (6) the strategic plan of elderly health care system should be brought to practice.

Key words: health care, elderly, legal framework, financing source