Evaluation of Elderly Health Care Policy Implementation in Health Region 1

Abstract

This qualitative research aimed to evaluate the effectiveness of Thailand’s elderly health care policy implementation in Health Region 1 during the 2025 fiscal year. Data were collected through document analysis and interviews with key informants selected by purposive sampling until data saturation, totaling 40 participants. These consisted of 24 administrators and health professionals involved in elderly health care implementation across all levels of health services and diverse local contexts, and 16 older adults who had received services under the policy, selected to represent community-dwelling, homebound, and bedridden older persons in all eight provinces of Health Region 1. Data were analyzed using content analysis. The findings revealed that the effectiveness of policy implementation still exhibited gaps in several indicators that did not achieve the intended outputs and outcomes, particularly geriatric syndrome screening and home-based inpatient care (Home Ward). Key facilitating factors included strong administrative support, robust community health networks, and increased public awareness. Major barriers comprised resource constraints, discontinuity of service delivery, coordination gaps among local-level agencies, insufficient coverage of screening in remote areas, and the absence of a systematic monitoring and evaluation system. Recommended strategies to enhance policy management effectiveness include ensuring adequate and sustainable resource allocation, establishing clear inter-agency coordination mechanisms, strengthening monitoring and evaluation systems, and promoting meaningful stakeholder participation in the design of service delivery systems.