Local Health Security Fund Management for Dependent Elderly Care: A Case Study of Rommuang Subdistrict Municipality, Phatthalung Province
Article Sidebar
Main Article Content
Abstract
This qualitative research examines the management of the Local Health Security Fund and evaluates its effectiveness in caring for dependent elderly individuals in Rommuang Subdistrict Municipality, Phatthalung Province, Thailand. The study applies the New Public Management (NPM) framework and Long-Term Care (LTC) concept as analytical lenses. Data were collected from 15 key informants, comprising 6 administrators and staff members and 9 relevant volunteers, between June and October 2025, through in-depth interviews using a content-validated interview guide. The data were analyzed using content analysis based on the NPM framework, and trustworthiness was established through four types of triangulation: data, method, investigator, and theory. The findings reveal that the municipality employs participatory management approaches by systematically assessing dependency levels using the Activities of Daily Living (ADL) tool, developing individualized care plans, and allocating budgets transparently. Consequently, all 44 dependent elderly individuals (100%) have accessed comprehensive care services, leading to improved quality of life, reduced caregiver burden, and the establishment of a sustainable long-term care network. However, several limitations persist, including budget constraints, shortage of specialized personnel, and lack of integrated data systems. Therefore, this study recommends developing staff capacity, increasing flexibility in fund management, and establishing a centralized database system to ensure the sustainability and scalability of the long-term care system.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Journal of TCI is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence, unless otherwise stated. Please read our Policies page for more information...
References
กองทุนหลักประกันสุขภาพท้องถิ่น เทศบาลตำบลร่มเมือง. (2568). โครงการดูแลห่วงใย ใส่ใจ ผู้ที่มีภาวะพึ่งพิง (รหัสโครงการ 68-L3360-1-03). กองทุนสุขภาพตำบล. https://localfund.happynetwork.org/project/196686
มูลนิธิสถาบันวิจัยและพัฒนาผู้สูงอายุไทย. (2565). รายงานสถานการณ์ผู้สูงอายุไทยและการดูแลระยะยาว. กรุงเทพฯ: มูลนิธิสถาบันวิจัยและพัฒนาผู้สูงอายุไทย.
สำนักงานสถิติแห่งชาติ. (2564). รายงานสถานการณ์ประชากรไทย พ.ศ. 2564. กรุงเทพฯ: สำนักงานสถิติแห่งชาติ.
สำนักงานสภาพัฒนาการเศรษฐกิจและสังคมแห่งชาติ. (2565). รายงานสังคมสูงอายุของประเทศไทย พ.ศ. 2565. กรุงเทพฯ: สำนักนายกรัฐมนตรี.
สำนักงานหลักประกันสุขภาพแห่งชาติ. (2563). คู่มือการบริหารกองทุนหลักประกันสุขภาพระดับท้องถิ่น พ.ศ. 2563. นนทบุรี: สำนักงานหลักประกันสุขภาพแห่งชาติ.
สำนักงานหลักประกันสุขภาพแห่งชาติ. (2566). รายงานผลการดำเนินงานกองทุนสุขภาพท้องถิ่น ประจำปีงบประมาณ พ.ศ. 2566. นนทบุรี: สำนักงานหลักประกันสุขภาพแห่งชาติ.
Bodenheimer, T., Wagner, E. H., & Grumbach, K. (2002). Improving primary care for patients with chronic illness. JAMA, 288(14), 1775–1779. https://doi.org/10.1001/jama.288.14.1775
Cameron, K. S., & Quinn, R. E. (1999). Diagnosing and changing organizational culture: Based on the competing values framework. Addison-Wesley.
Coleman, J. S. (1988). Social capital in the creation of human capital. American Journal of Sociology, 94(Supplement), S95–S120. https://doi.org/10.1086/228943
Conrad, K. J., Spence, R. T., & Riley, C. M. (1993). Evaluation of long-term care services. Health Services Research, 28(2), 123–145.
Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260(12), 1743–1748. https://doi.org/10.1001/jama.1988.03410120089033
Drucker, P. F. (1973). Management: Tasks, responsibilities, practices. Harper & Row.
Hood, C. (1991). A public management for all seasons? Public Administration, 69(1), 3–19. https://doi.org/10.1111/j.1467-9299.1991.tb00779.x
Hood, C., & Peters, G. (2004). The middle aging of new public management: Into the age of paradox? Journal of Public Administration Research and Theory, 14(3), 267–282. https://doi.org/10.1093/jopart/muh019
Jette, A. M., Haley, S. M., & Coster, W. J. (1999). Late-life disability and rehabilitation services. The Journals of Gerontology, 54B(4), S234–S242.
Kaplan, R. S., & Norton, D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71–79.
Knight, B. G., & Satre, D. D. (1999). Psychosocial aspects of long-term care for older adults. Springer.
Kodner, D. L., & Spreeuwenberg, C. (2002). Integrated care: Meaning, logic, applications, and implications – a discussion paper. International Journal of Integrated Care, 2, e12. https://doi.org/10.5334/ijic.67
Kouzes, J. M., & Posner, B. Z. (2017). The leadership challenge: How to make extraordinary things happen in organizations (6th ed.). Jossey-Bass.
Miller, R., De Vries, H., & Ginsburg, R. (2005). Long-term care services and supports: Future perspectives. Health Affairs, 24(Suppl1), W5-321–W5-330.
Mintzberg, H. (1979). The structuring of organizations. Prentice-Hall.
OECD. (2020). Measuring well-being and progress: Well-being research. OECD Publishing. https://www.oecd.org/statistics/measuring-well-being-and-progress.htm
Osborne, D., & Gaebler, T. (1992). Reinventing government: How the entrepreneurial spirit is transforming the public sector. Addison-Wesley.
Pearlin, L. I. (1990). The sociological study of stress. Journal of Health and Social Behavior, 31(3), 241–256. https://doi.org/10.2307/2136956
Pretty, J. (1995). Participatory learning for sustainable agriculture. World Development, 23(8), 1247–1263. https://doi.org/10.1016/0305-750X(95)00046-F
Putnam, R. D. (1993). Making democracy work: Civic traditions in modern Italy. Princeton University Press.
Putnam, R. D. (1995). Turning in, Turning out: The Strange Disappearance of Social Capital in America. PS: Political Science & Politics, 28, 664-683. https://doi.org/10.1017/S1049096500058856
Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. Simon & Schuster.
Saltman, R. B., & Ferlie, E. (2017). The new public management in health care: Current trends and future prospects. Routledge.
Stone, R. I. (2000). Long-term care for the elderly with disabilities: Current policy, emerging trends, and implications for the 21st century. The Milbank Quarterly, 78(3), 341–374. https://doi.org/10.1111/1468-0009.00206
Stuck, A. E., Siu, A. L., Wieland, G. D., Adams, J., & Rubenstein, L. Z. (2002). Comprehensive geriatric assessment: A meta-analysis of controlled trials. The Lancet, 340(8839), 179–183.
World Health Organization. (2015). World report on ageing and health. WHO. https://www.who.int/publications/i/item/9789241565042
World Health Organization. (2021). Ageing and health. WHO. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
