Development of an Outpatient Care Model to Support Tele-Urology Services at Phayakkhaphum Phisai Hospital, Maha Sarakham Province.
Article Sidebar
Main Article Content
Abstract
This study aimed to develop and evaluate an outpatient care model to support Tele-Urology services at Phayakkhaphum Phisai Hospital, Maha Sarakham Province. This research and development approach was employed a quasi-experimental design with two nonconcurrent comparison groups using a historical control. The study was conducted in four phases between October 2024 and July 2026. The sample comprised 162 patients aged 18 years or older who attended the Tele-Urology clinic and had ICD-10 diagnostic codes N20–N23 or N40. Participants were assigned to pre-implementation and post-implementation groups, with 81 patients in each group. The research instrument was the seven-component TELE-URO Nursing Model, integrated with the BMS–HOSxP Dashboard, Fund Management system, and Smart COC Platform. Data were analyzed using descriptive statistics, chi-square tests, independent-samples t-tests, and logistic regression.
Results: Following implementation of the model, the completeness rate of pre-consultation data increased from 65.43% to 85.19% (adjusted OR = 4.03). The rate of preventable repeat visits within 90 days decreased from 49.38% to 14.81% (adjusted OR = 0.17), while the success rate of closed-loop continuity-of-care coordination increased from 58.33% to 87.50% (adjusted OR = 7.18). No severe complications were reported. Patient and staff satisfaction were both rated at the highest level, with mean scores of 4.65 ± 0.42 and 4.58 ± 0.38, respectively.
Conclusion: The TELE-URO Nursing Model improved the efficiency of pre-consultation data preparation, reduced unnecessary repeat visits, and enhanced continuity of care. The model should be considered for wider implementation in community hospitals with comparable service contexts.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The owner (Research and Development Institute, Kalasin University), the authors agree that any copies of the article or any part thereof distributed or posted by them in print or electronic format as permitted will include the notice of copyright as stipulated in the journal and a full citation to the final published version of the contribution in the journal as published by Research and Development Institute, Kalasin University.
References
1. World Health Organization. WHO guideline: recommendations on digital interventions for health system strengthening. Geneva: World Health Organization; 2019. [cited 2024 Nov 20]. Available from: https://iris.who.int/server/api/core/bitstreams/c3c53f30-23cc-48d0-a3b5-c05ddd7f5349/content
2. แพทยสภา. ประกาศแพทยสภา ที่ 54/2563 เรื่อง แนวทางปฏิบัติการแพทย์ทางไกลหรือโทรเวช (telemedicine) และคลินิกออนไลน์. ราชกิจจานุเบกษา 2563;137(ตอนพิเศษ 166 ง). https://www.ratchakitcha.soc.go.th/DATA/PDF/2563/E/166/T_0052.PDF
3. Zayar NN, Kittiratchakool N, Saeraneesopon T, Butchon R, Dabak SV, Namahoot P, Kaewchompoo T, Kingkaew P, Teerawattananon Y, Isaranuwatchai W. Telemedicine utilization patterns and implications amidst COVID-19 outbreaks in Thailand under public universal coverage scheme. Inquiry. 2024; 61: 1-11. https://doi.org/10.1177/00469580241246466
4. นิตยา คล่องขยัน. การพัฒนารูปแบบบริการผู้ป่วยนอกโรงพยาบาลพรเจริญด้วยระบบ Telemedicine. วารสารสำนักงานสาธารณสุขจังหวัดนครพนม 2567; 2(1): 1-19. https://he02.tci-thaijo.org/index.php/nkp/article/view/267809/183686
5. World Health Organization. Continuity and coordination of care: a practice brief to support implementation of the WHO framework on integrated people-centred health services. Geneva: World Health Organization; 2018. [cited 2024 Nov 20]. Available from: https://iris.who.int/server/api/core/bitstreams/7c938c63-5570-4c0e-95f2-d310bb647704/content
6. Donabedian A. The quality of care: how can it be assessed? JAMA. 1988; 260(12): 1743-1748. [cited 2024 Dec 21]. Available from: https://www.law.uh.edu/faculty/jmantel/health-regulatory-process/Donabedian-The-Quality-of-Care.pdf
7. Jaspreet S. Sandhu, Brooke R. Bixler, Philipp Dahm, Ramy Goueli, Erin Kirkby, John T. Stoffel, Timothy J. Wilt. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023. Linthicum (MD): American Urological Association; 2023. [cited 2024 Dec 21]. Available from: https://doi.org/10.1097/JU.0000000000003698
8. A. Skolarikos, N.F. Davis, G. Gambaro, R. Geraghty, H. Jung, G.M. Kamphuis, M. Lardas, A. Neisius, A. Petřík, B. Somani, T. Tailly, L. Tzelves, S. Croghan, F. Esperto, R. Lombardo, I. Manolitsis, R. Shepherd. EAU guidelines on urolithiasis. Arnhem: European Association of Urology; 2026. [cited 2026 Jan 21]. Available from: https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-Guidelines-on-Urolithiasis-2026.pdf
9. Ong CSH, Lu J, Tan YQ, Tan LGM, Tiong HY. Implementation of a ureteric colic telemedicine service: a mixed methods quality improvement study. Urology. 2021; 147: 14-20. https://www.goldjournal.net/article/S0090-4295(20)31266-8/fulltext
10. ศันยวิทย์ พึงประเสริฐ. ประสิทธิผลของระบบบริการการแพทย์ทางไกลในการส่งต่อผู้ป่วยกลุ่มโรคช่องทางด่วน จังหวัดสุรินทร์. วารสารการแพทย์โรงพยาบาลศรีสะเกษ สุรินทร์ บุรีรัมย์ 2567; 39(2): 369-379. https://he02.tci-thaijo.org/index.php/MJSSBH/article/view/269499/184467
11. นิยม ประโกสันตัง. ผลของการใช้รูปแบบการพยาบาลทางไกลกับการควบคุมระดับน้ำตาลในเลือดของผู้ป่วยเบาหวานชนิดที่ 2. วารสารวิจัยและพัฒนานวัตกรรมทางสุขภาพ 2567; 5(2): 100-111. https://he01.tci-thaijo.org/index.php/jrhi/article/view/271079/182416
12. Naik N, Hameed BMZ, Nayak SG, Gera A, Nandyal SR, Shetty DK, Shah M, Ibrahim S, Naik A, Kamath N, Mahdaviamiri D, D'costa KK, Rai BP, Chlosta P, Somani BK. Telemedicine and telehealth in urology-what do the patients think about it? Front Surg. 2022; 9: 863576. https://doi.org/10.3389/fsurg.2022.863576