Development to Expand the Community Health System Model into a Seamless Health Care Service among Geriatrics People Integrative Cardiovascular Disease Risk Group, Rasi Salai Hospital, Sisaket Province

Abstract

This mixed-methods research aimed at developing a model of a community health system integrated
into a seamless healthcare service for older adults at risk of cardiovascular disease, while also evaluating
its impact on clinical outcomes, access to emergency healthcare services, health literacy, and quality of
life. The research tools included: (1) an in-depth interview guide; (2) a quality of life questionnaire;
(3) a general and clinical data collection form; and (4) a health literacy questionnaire for stroke and
ischemic heart disease. The participants were 332 geriatrics. Data were collected between December
2023 and July 2024. The qualitative data were analyzed using content analysis; and the quantitative
data were analyzed using descriptive statistics, inferential statistics, and paired t-test. The results revealed
problems in (1) geriatrics and caregivers, (2) stakeholders, and (3) health service systems. An integrated
approach involving public health and other supporting organizations was needed for disease prevention,
health promotion, treatment, and rehabilitation. After implementing the developed model, health literacy
and quality of life significantly improved (p<0.05). The percentage of geriatrics receiving thrombolytic
medication within 4.30 hours for stroke and 30 minutes for acute myocardial infarction increased to
89.19% and 81.10%, respectively. The emergency medical service utilization increased to over 50%,
and the continuous administration rate of thrombolytic drugs was higher at 97.11 percent. Therefore,
further development to expand the community health system model into a seamless health service system
for the geriatrics at risk of cardiovascular disease, with cooperation from health organizations and support
organizations in the community, can create good health outcomes for the geriatrics at risk of cardiovascular
disease.