Developing the model hospital of geriatric and palliative care in Bangkok

Objective: The purpose of this research was to explore the factors to develop the model hospital of geriatric and palliative care in Bangkok.

Material and Method: This study was a qualitative study by apply in the Delphi technique. There were 6 groups of experts, totaling of 24 experts consisting of experts in health policy, hospital administrators, geriatric/palliative academics, geriatric doctors/nurses, and multidisciplinary professionals. The methodologies can be divided into 3 phases: 1) Interview the experts about the factors to develop the model hospital of geriatric and palliative care in Bangkok. 2) Construct a questionnaire based on the results of the interview so that the experts can rank the importance of the questions. 3) Analyse the data by using the median, quartile range and adding the answers obtained from the second phase, so that each expert can go through the answers one more time. The information obtained from the third phase was analyzed. Information with a median greater than 3.50 and interquartile range less than 1.00 was included in this study.

Results: It was found that there are 6 factors in developing the model hospital of geriatric and palliative care. 1) Policy factors consist of service system, human resource development and accessibility to health services policy. 2) Structural factors consist of physical, management and service structure.

3) Resource and financial factors which should be supported by the government and the public.

4) Human resource and development factors which involve short-term and long-term plans to develop the skills for taking care of the elderly. 5) Health service factors which involve take care of patients holistically through a multidisciplinary team. A standardized service system should include evaluation, technology applications, and patient-centered services in order to improve elderly’s quality of life. 6) Community participation factors which concern cooperation between hospital and public health center for the patient’s continuous care.

Conclusions: Factors for developing the model hospital as per the results of this study can be used for the hospital administrators to set up health service of geriatric and palliative care in Bangkok. Nevertheless,  the government can formulate a national geriatric and palliative care strategy or a policy framework to shape the health service for the elderly’s quality of life.

Key word: the elderly, geriatric and palliative care, the model hospital of geriatric and palliative care.