Community Healthcare Promotion: Preparing for Aged Society - รูปแบบการส่งเสริมสุขภาพโดยชุมชน เพื่อรองรับสังคมผู้สูงอายุ

บทคัดย่อ

The healthcare promotion for rapidly growing of elderly population has been an important public
health challenge in Thailand since it became an aged society in 2009. Healthcare system has been
reoriented and a fast track elderly clinic project has been launched to better serve the elderly. However,
concerted effort from other agencies besides public health sectors has not yet been well observed.
Subdistrict Administrative Organizations (SAOs) lack information and firm evidence for sound investment
in the community health. The objectives of this study were to analyze the costs for such projects
and to provide initial costing for SAO’s policy decision making in order to justify appropriate healthcare
promotion programs for the elderly in context of Thailand’s community settings. The study began from
April to September 2013 with a systematic review of both Thai and international literature. Standard
costing method was applied for the assessment of the program costs. It was found that the health
promotion services for elderly could be categorized into 3 groups in accordance with the three groups of
elderly based on their Barthel activities of daily living index (ADL). A preferable project for sociallybound
elderly was an establishment and participation in elderly clubs to maintain self capacity and good
health; a project for home-bound elderly was home visits to assist some daily activities; and a project
for bed-bound elderly was home care by care givers to relief burden on families. For the cost analysis,
the overall cost could be calculated by using the following equation: Full cost = 73,030 + 78.82*elder1#
+ 71.36*elder2# + 919*elder3#, of which the elder(n)# is number of elderly in each group (n
= 1, 2 or 3). This calculation did not include capital cost and indirect cost allocation. In conclusion, this
study could be a useful guidance on appropriate local services for the elderly as well as data on tangible
and clearer investment recommendation.
Key words: Community healthcare promotion, elderly, costing, subdistrict administrative organization