Abstract
The research purpose was to explore the lessons learned of COVID-19 patients journey in providing health care Services in health region 9. Data were collected using mixed methods, starting with a qualitative methodology and supplemented by a quantitative methodology. The sample groups in qualitative research were health care providers and health service recipients selected using purposive sampling: director of the Bureau of Communicable Disease Control, director of the 9th Public Health Region, hospital director, deputy director of Medical Affairs, head of Nursing Mission Group, group head director of Tambon Health Promoting Hospital by choosing two persons per group, a total of 12 persons: plus selecting six persons from each group of doctors, nurses, health workers, EMS, EMT, and health service volunteers from the top two areas of each province in the 9th Public Health Region with the high covid infection: and twenty health service recipients who experienced receiving health care services and recovering from Covid-19. The instrument used was an interview from the sample group in quantitative research who were the health care providers at both administrator and operational levels and health service recipients by purposive sampling, 384 persons per group. Data were analyzed using descriptive statistics, frequency, percentage, mean, and standard deviation, content analysis, and COVID -19 patients journey in providing health care Services in health region 9. The results of the study were as follows: 1) The perception of information from the public health unit for use in family and community disease prevention found the main issues as follows; (1.1) Promotion strategies, the perception of information from public health agencies for preventing diseases in families and communities consisted of the use of digital technology, direct communication with the public, forward authoritative documentation from governments, community leaders and health volunteers knock on the door, and Covid-19 Information Center (1.2) Build awareness of information for sustainable disease prevention, create an understanding not to panic but to be aware, promote knowledge, competence, self-care, creating awareness of information correctly, and creating responsibility for a new norm of life; 2) Access to the first point of receiving health services for patients with Covid-19 infection, operates services in a proactive and reactive form through an integrated network of government, local and private sectors, transferring patients to hometown, proactive in the area, receive health care services at the first pick-up point of the nearest hospital, and receive health services through the call center; 3) Assessment and detection of pathogens of patients with Covid-19 infection, two main types of assessment were carried out for pathogens: Antigen Test Kit (ATK) and RT-PCR, ATK test for initial screening, Confirmation of COVID-19 infection with RT-PCR at provincial hospitals or districts that have only RT-PCR machines, the journey of receiving the Covid-19 testing service is the respiratory clinic, visiting the area to check in the community and referral for infection detection at network hospitals; 4) Receiving care from medical and public health personnel for patients with Covid-19 infection in compliance with the guidelines of the Medical Department; The first wave were hospitalized, and the second wave were divided according to the severity of the disease; 5) Planning for patient discharge to go home follow by providing care information, coordination, referral, preparation of patients and their relatives, and community preparation 6) Ongoing care at home for patients with Covid-19 infection visit in the area public health volunteers follow up to visit areas of responsibility. Local authorities are responsible for the service. Factors contributing to the health services received for patients with Covid-19 infection from the perspective of service providers found that the social media usage like line, facebook, website, were at the highest level (mean = 4.34; SD = .683). Followed by initial screening with Antigen Test Kit or ATK (mean = 4.28; SD = .718), and RT-PCR verified for high-risk groups (mean = 4.25; SD = .722). Obstacle factors of receiving health services for patients with Covid-19 infection from the perspective of service providers reveal that the multi-step process of transmitting information was at the highest level (mean = 3.65; SD = .830). Receiving unfiltered data from social media (mean = 3.65; SD = .931) and receiving rumors from neighbors (mean = 3.56; SD = .918), respectively. Factors contributing to the reception of health services for patients with Covid-19 infection from the service recipients’ perspective like Line, Facebook, and websites were at the highest level (mean = 4.27; SD = .763). Followed by having the patient take a fever test, high blood pressure, and oxygen send information about symptoms during treatment to the staff as scheduled (mean = 4.23; SD = .762). Initial screening with Antigen Test Kit (ATK) (mean = 4.22; SD = .791). RT-PCR assays for high-risk groups (mean = 4.22; SD = .783) and compliance with the Covid-19 treatment guidelines of the Department of Medical Services (mean = 4.22; SD = .798). Obstacle factors receiving health services for patients with Covid-19 infection in the view of the service recipient overall revealed that the multi-step process of information transmission was at the highest level (mean = 3.73; SD = .907). A limited number of personnel to provide health services at the first point of admission (mean = 3.66; SD = .986). The process to access health services is a multi-step process (mean = 3.63; SD = .944). Getting unfiltered information from social media (mean = 3.63; SD = 1.042) and having limited skills in using technology to access and receive news (mean = 3.63; SD = .990), respectively. The results recommended that (1) health services during the Covid-19 epidemic situation should use digital technology to assist in service dimensions of promotion, prevention, treatment, and rehabilitation: (2) There should be an integrated government network with the private and local operation; and (3) Supporting the use of ATK initial screening kits and enhancing health literacy, and creating responsibility for a new norm of life and sustainable lifestyle for the people.
