Estimating Service Demand for Intermediary Care at a Community Integrated Intermediary Care Center among Family Caregivers of Older Adults Residing in Chiang Mai, Northern Thailand

Abstract

Background: Thailand’s population is currently the third most rapidly aging in the world, with an estimated 20 million ageing population by 2050. Sustainability of the family based long-term care model is challenged by the chronic burden on family caregivers and by smaller family sizes. We aimed to introduce a new service model, Community Integrated Intermediary Care (CIIC), TCTR20190412004, including free of charge intermediary care services at CIIC centers in the local community, to help older adults whose caregivers are temporarily unable to sustain care at home. Since Thai society upholds values of gratefulness, it is better to estimate willingness to use such an intermediary care service first, before introducing the service. Methods: A total of 867 pairs of senior citizens and their family caregivers were interviewed with structured-questionnaires in 2019. Descriptive analysis and binary logistic regression were applied to determine the predictors of family caregivers’ willingness to use the CIIC service, guided by Anderson’s model of health services use. Results: About 26.8% of elderly participants and 24.0% of family caregivers were willing to use an intermediary care service. The family caregiver determinants of predisposing factors (kinship: spouse caregivers, other relatives, maid or friends; job types: own business and private company staff), enabling factors (original community residents and monthly income ≤9000 baht), and need factors (caregiver burden total scores ≥24, taking leave for caregiving, and having diabetes), were found to be significantly associated with willingness to use the CIIC service. Conclusions: The baseline survey data noted that caregivers’ sociodemographic factors and burden determined their willingness to use the intermediary care service, although the dependency of care recipients was low in this study. This, nonetheless, indicated that there is need for a backup respite care to strengthen current family based long-term aging care in Thailand.

Effectiveness of a community-integrated intermediary care (CIIC) service model to enhance family-based long-term care for Thai older adults in Chiang Mai, Thailand: a cluster-randomized controlled trial TCTR20190412004

“…Moreover, caregiver burden measurement of the family caregivers can be applied as a screening tool to assess long-term care needs, complementing the routine dependency assessment of care recipients using ADL scoring [ 11 , 14 ]. In many developing countries, studies increasingly have reported the long-term care need among older persons [ 34 , 35 ].…”

“…The CIIC model is a novel prevention-based, long-term care model created to enhance the family-based long-term care system (Fig. 2 ) which has traditionally been practised in Thailand and its neighbouring Asian countries as well as many low- and middle-income countries globally [ 14 , 29 ]. Conceptually, it is a combination of formal care and informal care in a district, subdistrict or a city.…”

“…Eligibility criteria were set by the city stakeholders. In this study, the eligibility criteria for the CIIC temporary respite care service was for applicants with full-time, unpaid family caregivers caring for dependent individuals over 60 years of age and meeting the eligibility as assessed using the ADL and CBI measures [ 14 ].…”

“…The median income of the study participants was ฿9000 (Thai bahts). Respite service, in the form of CIIC, can be offered to family caregivers who become extremely burdened [ 14 , 15 ]. A recent analysis showed that more than a quarter of family caregivers were willing to use respite services if they were accessible [ 14 ].…”

Impact of Socioeconomic Environment on Home Social Care Service Demand and Dependent Users

“…This study explored which sociodemographic features may influence this phenomenon. Previous research has pointed out features that have an impact on the demand for social services [ 36 , 37 , 38 , 39 ]. Therefore, we analyzed demographic and economic data divided geographically by CSS coverage area.…”