Faculty of Public Health, Khon Kaen University, 123 Mitraphap road, Muang, 40002, Khon Kaen, Thailand.
International Health Policy Program, Ministry of Public Health, Tiwanon road, Muang, 11000, Nonthaburi, Thailand.
Hum Resour Health. 2021 Jan 6;19(1):2. doi: 10.1186/s12960-020-00542-3.
Thailand is a rapidly aging society, which places high demand on home health care services for the elderly. The shortage of health care workforce in rural areas is a crucial obstacle to the delivery of adequate home health care services. The appropriate skill-mix between multidisciplinary health team and care givers (CGs) is an attractive solution for improving home health care services in rural Thailand. This study assessed the potential of trained CGs to provide home health care services and projected what the optimal mix for a multidisciplinary home health care team in rural Thailand would be in 2030.
Eleven pilot districts in Thailand were recruited for the study. Secondary data were collected along with surveys of home health care providers. A total of 130 care managers (nurses) and 351 care givers (CG) were recruited for the survey. Workload, skill-mix potential, and acceptance of care givers were assessed in the surveys. The results from secondary data and the survey were used to project the health workforce requirements in 2030.
It is projected that in 2030 the number of elderly living in rural areas will be 7,156,700 (27% of the projected rural population). Of this, 20.3% will be home-bound, 1.1% will be bed-ridden and 1.6% will need rehabilitation. The main members of the multidisciplinary health workforce involved in home health care were nurses, doctors, and physiotherapists. The home health care services that were provided by the multidisciplinary health workforce included patient assessment, development of a care plan and case conference, home visits, and teaching and supervision of CGs. The CGs were village health volunteers trained to carry out regular home visits to patients. The CGs provided assistance with the activities of daily living, basic health services, moral support to patients and relatives, and surveillance of the home environment during home visits. CGs were well accepted by both the health professionals and the patients. Projections showed that 16,094 nurses, 1,542 doctors, 1,022 physiotherapists and 50,148 CGs will be required in 2030 to meet the needs of the dependent elderly for home health care in rural Thailand.
With the increased need for home health care services in the future, appropriate team work between the members of the multidisciplinary health team and the CGs in the community is the appropriate solution for likely shortages of health professional workforce.
泰国正步入老龄化社会，对老年人的家庭医疗保健服务需求较高。农村地区医疗保健劳动力短缺是提供充足家庭医疗保健服务的关键障碍。多学科医疗团队和护理员（CG）之间的适当技能组合是改善泰国农村家庭医疗保健服务的一个有吸引力的解决方案。本研究评估了经过培训的 CG 提供家庭医疗保健服务的潜力，并预测了 2030 年泰国农村多学科家庭医疗保健团队的最佳组合。
该研究招募了泰国的 11 个试点地区。收集了二次数据并对家庭医疗保健提供者进行了调查。共招募了 130 名护理经理（护士）和 351 名护理员（CG）进行调查。调查评估了工作量、技能组合潜力和护理员的接受程度。二次数据和调查结果用于预测 2030 年的卫生人力需求。
预计到 2030 年，农村地区的老年人口将达到 7156700 人（占农村人口的 27%）。其中，20.3%的人行动不便，1.1%的人卧床不起，1.6%的人需要康复。参与家庭医疗保健的多学科医疗团队的主要成员包括护士、医生和物理治疗师。多学科医疗团队提供的家庭医疗保健服务包括患者评估、制定护理计划和病例会议、家访以及护理员的教学和监督。CG 是经过培训的乡村卫生志愿者，负责对患者进行定期家访。CG 提供日常生活活动协助、基本医疗服务、对患者和亲属的精神支持以及家访期间对家庭环境的监测。CG 受到卫生专业人员和患者的广泛认可。预测显示，2030 年泰国农村需要 16094 名护士、1542 名医生、1022 名物理治疗师和 50148 名 CG，以满足农村地区依赖老年人对家庭医疗保健的需求。
随着未来对家庭医疗保健服务需求的增加，多学科医疗团队成员与社区 CG 之间适当的团队合作是解决卫生专业人员劳动力可能短缺的适当解决方案。
