Abstract
The Universal Health Coverage (UHC) program is a project that enables everyone to access medical services, with a particular emphasis on the importance of promoting health and disease prevention (P&P) services. This is the benefit within the national health insurance system provided to all Thai citizens, aimed at reducing health risk factors, disease morbidity/mortality rates, and promoting health. However, a weakness is the lack of knowledge, understanding, and the low coverage rate of accessing services under the P&P benefit package for health promotion and disease prevention. Telehealth tools have been utilized to care for the public's health, reducing disparities in accessing services and benefiting in connecting service recipients with healthcare providers. Therefore, the Department of Health, Ministry of Public Health recognizes the importance of the study for using Telehealth as a tool to promote access to services under the benefit package for health promotion and disease prevention, promoting quality access to healthcare services. This study aims to developing a model to enhance access to services under the benefit package for health promotion and disease prevention. The research process is divided into four phases. Phase 1 is the necessity and perception analysis, consisting of a systematic document review and a study of the problems and limitations of perception and access to services. Cross sectional research was introduced with 394 participants and focus group discussions. Phase 2 is the design and development phase, which involves creating a service platform for the benefit package for health promotion. Phase 3 is the platform's pilot testing, utilizing a cross-sectional research process with 331 participants and focus group discussions. Phase 4 is the evaluation phase, comparing the perception of services received under the benefit package when using the platform. This involved a quasi-experimental study comparing an experimental group and a control group. Each phase involves four sample groups: pregnant women, children aged 0-5 years, children aged 6-24 years, and adults aged 25-59 years. Data analysis includes descriptive statistics, such as percentages, means, standard deviations, and inferential statistics, such as chisquare tests, independent t-test, and paired t-test. Results of the research study are divided into phases 1, 3, and 4 as follows: Phase 1: The sample group consisted of a total of 394 individuals. The majority utilized healthcare services under the universal health coverage at 68%. Additionally, 79.9% were aware of the benefits of health promotion and disease prevention services under the national health insurance system. Statistical analysis revealed associations between gender, education level, travel expenses to the nearest public health facility, and perception of health promotion and disease prevention benefits. Accessing the health promotion and disease prevention benefit package was associated with gender and primary healthcare utilization (p-value < 0.05). During the focus group discussions on the perception and experiences of utilizing quality health promotion and disease prevention services, it was found that there was a lack of awareness regarding the rights to quality health promotion and disease prevention services. However, there were some instances where individuals had experiences of accessing quality health services under certain benefits but were unaware to those rights. Phase 3 of the study involved a sample group of 331 individuals, with 32.0% having completed high school education. Within this group, 74.9 % were aware of the benefits of health promotion and disease prevention services under the national health insurance system. Children aged 0-5 years mostly intending to use online platform 90.24 %, while young adults aged 6-24 years smallest intending to use online platform 68.67 %. Young adults aged 6-24 years 73.5 % and Pregnant women 67.5 % mostly intending to use The online platform aimed to provide health knowledge. Adults aged 25-59 years 75.6 % and 70.7% of children aged 0-5 years intending to use health services to seek doctors for treatment. From the focus group discussions, it was found that the majority had experiences using online resources such as Google to search for information about healthcare facilities and using apps to schedule vaccination appointments. The advantages of online health services were ease of use, convenience, speed, and cost effectiveness. However, the disadvantages included varying and unreliable information. In Phase 4, among the control group, it was found that the perception of benefits from using the online platform and attitudes toward utilizing services through the online platform significantly increased in pregnant women, children aged 0-5 years, and adults aged 25-59 years. Pregnant women, children aged 0-5 years, and adults aged 25-59 years realized the importance of health services through the online platform. Adolescents and young adults aged 6-24 years saw that the online platform provided better access to services. Within the experimental group, pregnant women, children aged 0-5 years, and adults aged 25-59 years mostly recognized the importance of health through Line-Telehealth. However, adolescents and young adults aged 6-24 years were more inclined to recommend Line-Telehealth to friends and relatives. The preand post-evaluation of Line-Telehealth usage in the experimental group showed a significant increase in attitudes towards using online health services, perception of using services under the health insurance scheme, and trends in online service usage in all age groups (p-value < 0.001). Similarly, in the control group, significant statistical differences were found in attitudes towards using online health services and perceptions of using services under the health insurance scheme before and after using the online platform (p-value < 0.001). In conclusion, the Line-Telehealth model effectively increased the perception of accessing services under the health promotion and disease prevention benefit package. When comparing pre- and post-usage rates in all age groups, both Line-Telehealth and the online platform together were effective in promoting attitudes towards using online health services and increasing awareness of using services under the health insurance scheme. Therefore, enhancing the perception of accessing services under the health promotion and disease prevention benefit package with quality can be achieved through the combined utilization of Line-Telehealth and the online platform.
