Development of Asthma Patient Care Model through Participation of Health Network in Wapipathum Hospital, Mahasarakham Province, Thailand

Abstract

The objectives of the study were to develop a model for asthma care through participation of health networkand study the effectiveness of the model implementation. It was conducted in Wapipathum hospi-tal, Mahasarakham province during October 2012 to September 2015, comprising of 3 stages. The first stage was to analyse context and conditions of care for asthma patients through literature search; the stage 2 was the development of the asthma patient care model; and the stage 3 assessed the effectiveness of the model. The studied population were 1,517 asthma patients who attended the asthma clinic during October 2012 to September 2015. As for the results, the proposed asthma care model was developed as a 10step program which included (1) registration, (2) preparation of clinical practice guideline, (3) coordination with physicians for proper diagnosis, (4) provision of treatment according to the treatment guideline, (5) training each patient for self-care, (6) following-up for continuous care by multidisciplinary team, (7) tracing patients who failed to follow-up, (8) creating local health network for community care, (9) capacity building of asthma team members, and (10) analyzing data for monitoring and evaluation. After implementing the model, significant improvement was observed. The admission rate, the re-admision and the ER visits among pediatric patients declined by 8.4, 2.7 and 12.9 percent, respectively; and the declining rate for adult patients was 7.4, 1.0 and 19.0 percent, respectively. In addition, there was no case of patient with respiratory failure. In summary, the 10-step asthma model with health network participa-tion was found to be effective in achieving better treatment outcomes for asthma patients resulting in holistice and continuum care as well as improving quality of life for the patients.