Community Care in Thailand: A Fresh Look at a Hospital Innovation
The Thai health system has struggled to keep people in rural areas healthy when they need help at home. Even after many years of improvement, care often jumps from one level to another and patients are left in gaps.
In Khon Kaen Province a new idea was tried: a hospital that works closely with local caregivers who are on call 24 hours a day. These helpers belong to the hospital team and receive money from five different sources, so they can keep working without relying on a single fund.
Researchers used the Consolidated Framework for Implementation Research (CFIR) to ask why this model started and stayed in place. They spoke with doctors, nurses, caregivers, village leaders, government staff and families from March to May 2025.
Key Findings
- Hospital‑led creation of the caregiver role made it easier for staff to accept the position.
- A strong, long‑term leader and a new team that followed his guidance were critical.
- Caregivers were selected through a three‑step community process that included Buddhist spiritual support.
- Care flowed smoothly from the village to higher‑level hospitals, and regular reviews kept everyone on track.
External Challenges
- Split public health budgets.
- 2022 changes that moved local care units under provincial control.
- Uncertain donor funding.
Expansion
Since 2020 the model has grown beyond one hospital to 22 districts in 15 provinces, covering 53 villages and spending more than ten million baht.
Lessons Learned
The experience shows that such a model can be copied only if:
- Local leaders are trusted.
- The community is actively involved.
- Details are tailored to the place.
