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Home-based care gains momentum
Home-based care gains momentum
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Dr Jadej Thammatach-Aree
Secretary-General of National Health Security Office (NHSO)
In the pre-pandemic, home-based care hardly got patients’ buy-in. But it is gradually gaining momentum in Thailand as more people have adopted telemedicine and self-care at home to avoid COVID-19 exposure.
Previously, most patients preferred seeing doctors or visiting hospitals whenever they or their family members were ill.
Face-to-face consultation was believed to be the only way to get adequate care and treatment although many health problems can be treated at home, or patients can simply consult pharmacists, get the right medicine, and recover.
For many years, the National Health Security Office (NHSO) has tried to break the bias against home-based care.
We introduced specific types of home health care services into the benefits package of the Universal Coverage Scheme (UCS). One of the examples is the provision of technical support and medical supplies for patients living with kidney failure, allowing them to perform peritoneal dialysis at home.
We foresee that if we let all patients unnecessarily crowd at hospitals, it will lead to resource constraints and undermine the quality of health services.
Patients who need intensive and emergency care may not adequately access the services or resources they need. Healthcare workers may experience over workload and not perform their tasks well or feel burned out eventually.
On the other hand, the lack of home-based care support may burden patients who must take time consuming and costly trips to hospitals.
We have observed the travel difficulties, especially in rural communities, forcing many patients to quit medical treatment at the end.
Keeping people out of hospitals is inevitable if we want to sustain the healthcare system and improve the livelihood of patients.
Fortunately, the COVID-19 pandemic has changed people’s perception of home care services.
Although rising coronavirus cases put constraints on healthcare resources, it also provides opportunities for people to experiment with home-based care.
Many patients and health professionals have discovered that the approach is possible and practical if good management and a support system are put in place.
For example, COVID-19 patients with mild symptoms have experimented with self-care at home or community facilities through home/community isolation programs implemented by the NHSO, Public Health Ministry, and partners.
Self-care in this sense doesn’t mean leaving patients to their fate. They receive support from multi-organizations soon after reporting their cases through the NHSO hotline.
Patients who can’t isolate at home will be put at community isolation facilities.
Each patient will be matched with a local clinic or hospital partnered with the NHSO.
Then the health provider will deliver medical devices, medicines, and meals to patients, and monitor them via phone or video call. The NHSO will cover all incurred costs.
The collaboration across organizations and the setting up of patients’ monitoring systems make home isolation possible and effective.
For non-COVID patients with stable conditions can request telemedicine service from hospitals to avoid exposure to the virus.
After consulting with physicians online, hospital staff will send medicines to the patients by post or place medicine at local partnered pharmacies where patients can pick up their packages.
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We found that many patients had adopted telemedicine and medicine home delivery service quickly. They have realized that this approach is more convenient than commuting to hospitals.
They became aware that they have abilities to take care of themselves and no need to depend on hospital-based services solely.
We must keep this momentum by continuing home care services and improving them to serve patients’ needs even in the post-pandemic.
The NHSO plans to extend eligible patients for home care, including palliative patients whose families can consult doctors via video calls and receive medicines and necessary medical devices via postal services.
However, home-based care will require capacity building for local communities, leaders, and village health volunteers who should collaborate with hospital staff to monitor and assess patients’ conditions in resource-limited settings.
Health information access must also be improved. Patients and their families must be equipped with health literacy so they can perform self-care.
The NHSO developed and launched a mobile application and social media pages to fill the public knowledge gap.
Last but not least, we are upgrading our financial mechanism to incentivize health providers to introduce home care initiatives and assure them that all incurred costs will be covered.
These are some steps that will improve the quality and effectiveness of home care services soon. We believe more people will adopt this approach.
Dr Jadej Thammatach-Aree
Secretary-General of National Health Security Office (NHSO)
In the pre-pandemic, home-based care hardly got patients’ buy-in. But it is gradually gaining momentum in Thailand as more people have adopted telemedicine and self-care at home to avoid COVID-19 exposure.
Previously, most patients preferred seeing doctors or visiting hospitals whenever they or their family members were ill.
Face-to-face consultation was believed to be the only way to get adequate care and treatment although many health problems can be treated at home, or patients can simply consult pharmacists, get the right medicine, and recover.
For many years, the National Health Security Office (NHSO) has tried to break the bias against home-based care.
We introduced specific types of home health care services into the benefits package of the Universal Coverage Scheme (UCS). One of the examples is the provision of technical support and medical supplies for patients living with kidney failure, allowing them to perform peritoneal dialysis at home.
We foresee that if we let all patients unnecessarily crowd at hospitals, it will lead to resource constraints and undermine the quality of health services.
Patients who need intensive and emergency care may not adequately access the services or resources they need. Healthcare workers may experience over workload and not perform their tasks well or feel burned out eventually.
On the other hand, the lack of home-based care support may burden patients who must take time consuming and costly trips to hospitals.
We have observed the travel difficulties, especially in rural communities, forcing many patients to quit medical treatment at the end.
Keeping people out of hospitals is inevitable if we want to sustain the healthcare system and improve the livelihood of patients.
Fortunately, the COVID-19 pandemic has changed people’s perception of home care services.
Although rising coronavirus cases put constraints on healthcare resources, it also provides opportunities for people to experiment with home-based care.
Many patients and health professionals have discovered that the approach is possible and practical if good management and a support system are put in place.
For example, COVID-19 patients with mild symptoms have experimented with self-care at home or community facilities through home/community isolation programs implemented by the NHSO, Public Health Ministry, and partners.
Self-care in this sense doesn’t mean leaving patients to their fate. They receive support from multi-organizations soon after reporting their cases through the NHSO hotline.
Patients who can’t isolate at home will be put at community isolation facilities.
Each patient will be matched with a local clinic or hospital partnered with the NHSO.
Then the health provider will deliver medical devices, medicines, and meals to patients, and monitor them via phone or video call. The NHSO will cover all incurred costs.
The collaboration across organizations and the setting up of patients’ monitoring systems make home isolation possible and effective.
For non-COVID patients with stable conditions can request telemedicine service from hospitals to avoid exposure to the virus.
After consulting with physicians online, hospital staff will send medicines to the patients by post or place medicine at local partnered pharmacies where patients can pick up their packages.
We found that many patients had adopted telemedicine and medicine home delivery service quickly. They have realized that this approach is more convenient than commuting to hospitals.
They became aware that they have abilities to take care of themselves and no need to depend on hospital-based services solely.
We must keep this momentum by continuing home care services and improving them to serve patients’ needs even in the post-pandemic.
The NHSO plans to extend eligible patients for home care, including palliative patients whose families can consult doctors via video calls and receive medicines and necessary medical devices via postal services.
However, home-based care will require capacity building for local communities, leaders, and village health volunteers who should collaborate with hospital staff to monitor and assess patients’ conditions in resource-limited settings.
Health information access must also be improved. Patients and their families must be equipped with health literacy so they can perform self-care.
The NHSO developed and launched a mobile application and social media pages to fill the public knowledge gap.
Last but not least, we are upgrading our financial mechanism to incentivize health providers to introduce home care initiatives and assure them that all incurred costs will be covered.
These are some steps that will improve the quality and effectiveness of home care services soon. We believe more people will adopt this approach.
