Integrated Cancer Services in Thailand: A Prototype for Excellence (CEICS)
Development and Implementation of a Prototype Centre of Excellence in Integrated Cancer Services in Thailand: A Feasibility Study
Cancer is a significant health crisis globally and specifically within Thailand, where it affects more than 122,000 individuals every year and leads to approximately 86,000 deaths. Beyond the physical and emotional toll on patients, the disease creates immense social and economic challenges.
In Thailand, cancer treatment costs exceed 26 billion baht (about $800 million USD) annually. Families often face out-of-pocket costs for cancer care that exceed 30% to 40% of their total household income. Furthermore, the aging of Thai society and lifestyle changes-such as "Westernized" diets and sedentary behavior-are expected to drive these numbers even higher. This situation has created an urgent need for new healthcare models that reduce the burden on major hospitals and make care more accessible to the public. The Project Goal: A new model of care to address these challenges: Researchers developed a prototype Center of Excellence in Integrated Cancer Services. The goal was to test whether a specialized cancer unit could be successfully integrated into a local community clinic rather than functioning as a large, separate hospital.
The study used Donabedian's model to evaluate quality, focusing on three specific areas: Structure: The physical setting, equipment, and staff. Process: How the services are actually delivered and Outcomes: The results of the care and the satisfaction of those involved. Phase of Development and Implementation The project was a three-year initiative funded by the National Science, Research, and Innovation Fund of Thailand. Phase 1: Focused on the conceptual design of the center. Phase 2: Involved detailed planning and the development of digital information systems. This is at Phase 3: Focused on the actual implementation and testing of the prototype center in Bangkok
Visão geral do estudo
Descrição detalhada
Services Provided to the Community The center followed Thailand's national "7-branch" Cancer Service Plan, focusing specifically on the first two foundational branches for this pilot phase :Cancer Prevention and Risk Reduction: Counseling on healthy lifestyle modifications. Programs to reduce tobacco and alcohol use. Education regarding the HPV vaccine. General health literacy promotion to help people understand their risks. Cancer Screening and Early Detection: Clinical breast exams to check for abnormalities. Cervical cancer screening. Colorectal cancer screening. Risk assessments and established protocols to refer patients to major hospitals if abnormalities were found.
The other five branches-diagnosis, treatment, palliative care, informatics, and research-were supported through integrated referral pathways rather than being performed directly at the community unit.
Digital Innovation and Technology: A key feature of the center was the use of health information technology to bridge the gap between patients and providers. These tools included: Mobile Health Applications: Used for tracking symptoms and providing educational outreach. Electronic Health Records (EHRs): Facilitated real-time data sharing among the care team.
Virtual Consultations: Allowed for remote support and counseling. Artificial Intelligence (AI): The center planned for future integration of AI to assist in more accurate and efficient cancer screening
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Bangkok, Tailândia, 10210
- Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Group 1: Service Recipients
This group included patients and their family members who received services at the prototype center. The criteria for inclusion were the following:
Age: Must be 20 years or older. Capacity: Must be able to express their opinions regarding the comprehensive cancer services.
Consent: Must be willing to participate in the research study. Group 2: Service Providers
This group consisted of 30 healthcare professionals (such as physicians, nurses, and pharmacists) directly involved in delivering care. The criteria for inclusion were:
,Age and Sex: Must be at least 20 years old; there were no restrictions regarding sex.
Professional Status: Must be actively providing services at the Comprehensive Cancer Centre of Excellence or its affiliated network facilities.
Knowledge Base: Must possess specific knowledge of the center's administrative and service systems.
Consent: Must express a willingness to participate in the study. Group 3: Cancer Care Experts
This group included 15 experts (administrators, academics, and researchers) who provided qualitative evaluation. The criteria for inclusion were:
Professional Experience: Must have a minimum of five years of experience in the field of cancer care.
Expertise: Must have the ability to provide deep insights into comprehensive cancer services.
Consent: Must be willing to participate in the research. Note: There were no restrictions regarding the sex or age of these experts.
Exclusion Criteria:
- Group 1 (Service Recipients): Participants were required to be at least 20 years old, have the ability to express their opinions regarding the center's services, and be willing to participate in the study.
Group 2 (Service Providers): Eligible healthcare professionals had to be at least 20 years old, be actively providing services at the prototype center or its affiliated facilities, and possess specific knowledge of the center's administrative and service systems.
Group 3 (Cancer Care Experts): These individuals were required to have a minimum of five years of experience in cancer care and the capacity to provide deep insights into comprehensive cancer services. The sources note there were no restrictions regarding the sex or age of these experts
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Pesquisa de serviços de saúde
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Prototype Centre of Excellence in Integrated Cancer Services
The intervention, as a pilot unit, was established within the Warm Community Nurse Clinic to deliver community-based cancer prevention and screening services . It highlights the model's core purpose as an integrated healthcare hub designed to test the feasibility of scaling such centres nationwide in Thailand |
The intervention in this study is the development and implementation of a prototype Centre of Excellence (COE) in Integrated Cancer Services in Bangkok, Thailand.
This model is fundamentally distinguished by its integration into a local community setting-specifically established within the Warm Community Nurse Clinic-rather than functioning as a standalone, large-scale hospital.
By leveraging the community's existing familiarity with the clinic, the intervention aims to improve accessibility and trust while reducing the financial and logistical burdens typically associated with seeking cancer care at major medical centers.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Satisfaction Levels with Service Delivery
Prazo: Data was collected over the 12-month implementation period of Phase 3, from October 2023 to September 2024
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Satisfaction is measured across three domains: Structure (the physical setting and resources), Process (the delivery of care and communication), and Outcomes (the results and perceived benefits)
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Data was collected over the 12-month implementation period of Phase 3, from October 2023 to September 2024
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Vilaivan Thongcharoen, PhD, PAFN, CRA
Publicações e links úteis
Publicações Gerais
- World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013 Nov 27;310(20):2191-4. doi: 10.1001/jama.2013.281053. No abstract available.
- Elrod JK, Fortenberry JL Jr. Centers of excellence in healthcare institutions: what they are and how to assemble them. BMC Health Serv Res. 2017 Jul 11;17(Suppl 1):425. doi: 10.1186/s12913-017-2340-y.
- Insamran W, Sangrajrang S. National Cancer Control Program of Thailand. Asian Pac J Cancer Prev. 2020 Mar 1;21(3):577-582. doi: 10.31557/APJCP.2020.21.3.577.
- Sedgewick JR, Ali A, Badea A, Carr T, Groot G. Service providers' perceptions of support needs for Indigenous cancer patients in Saskatchewan: a needs assessment. BMC Health Serv Res. 2021 Aug 21;21(1):848. doi: 10.1186/s12913-021-06821-6.
- Adams RN, Mosher CE, Cannady RS, Lucette A, Kim Y. Caregiving experiences predict changes in spiritual well-being among family caregivers of cancer patients. Psychooncology. 2014 Oct;23(10):1178-84. doi: 10.1002/pon.3558. Epub 2014 May 17.
- ACTION Study Group. Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study. Eur J Cancer. 2017 Mar;74:26-37. doi: 10.1016/j.ejca.2016.12.014. Epub 2017 Feb 6.
- Iragorri N, de Oliveira C, Fitzgerald N, Essue B. The Out-of-Pocket Cost Burden of Cancer Care-A Systematic Literature Review. Curr Oncol. 2021 Mar 15;28(2):1216-1248. doi: 10.3390/curroncol28020117.
- Reungwetwattana T, Oranratnachai S, Puataweepong P, Tangsujaritvijit V, Cherntanomwong P. Lung Cancer in Thailand. J Thorac Oncol. 2020 Nov;15(11):1714-1721. doi: 10.1016/j.jtho.2020.04.024. Epub 2020 Oct 23. No abstract available.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 50182
- 180873 (Número de outro subsídio/financiamento: Thailand Science Research and Innovation)
Plano para dados de participantes individuais (IPD)
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Descrição do plano IPD
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