Development of a Home Ward Patient Care Model Based on Ministry of Public Health Policy in the Context of Ubon Ratchathani Province.

Abstract

      This research is a Research and Development (R&D) study with the objectives of (1) studying the policies, guidelines, and operational context of Home Wards in Ubon Ratchathani Province, (2) developing a service delivery model appropriate to the local context, (3) evaluating the effectiveness in terms of care quality, satisfaction, and policy alignment, and (4) synthesizing policy recommendations for expansion throughout the province. The study was conducted in 27 hospitals in Ubon Ratchathani Province between April 2024 and September 2025. The sample consisted of (1) 215 practitioners (30 before development, 185 after development) and (2) 799 patients/caregivers (292 before development, 507 after development). Research instruments included questionnaires, in-depth interviews, and document analysis. Data were analyzed using descriptive statistics, paired t-test, and content analysis.

      The research findings showed that 1) the situation and context... Ubon Ratchathani Province has 38 hospitals. Home Ward operations began in 2022, covering 10 disease groups. Six main problems were identified: (1) the service system lacks clarity; (2) there is insufficient personnel and a lack of specialized skills; (3) the data system is incomplete; (4) equipment and technology are not yet complete; (5) reimbursement of medical expenses is not in full; and (6) strong leadership and governance are needed. 2) The developed model includes: (1) a multidisciplinary team structure with 7 specialties; (2) three service models (Step down, Refer back, Start at home); (3) clear patient screening criteria; (4) a follow-up system via A-MED and Telehealth; and (5) a fair compensation mechanism. Outcomes: 3) After development, the quality of care and hospital stay duration decreased from 10 days to 1 day. The readmission rate decreased by 43.7%. Treatment costs decreased by 37.7%. Satisfaction: Patient/relative satisfaction increased (from (=4.50 to (==4.52). Practitioners... Satisfaction was high regarding organizational policies ((=4.53) and the success in policy implementation (=4.34)