ArticleHealth policy and planning2026
Community caregivers and innovative financing: a qualitative analysis of Thailand's Ubolratana Hospital model using the consolidated framework for implementation research.
Article in Health policy and planning, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
Thailand's healthcare system faces challenges in delivering effective community-based care for dependent patients in rural areas; while access has expanded over more than four decades, services remain fragmented and effective coverage from community to higher-level care is still lacking. The Ubolratana Hospital model in Khon Kaen Province represents an innovation, combining a full-time 24-hr community caregiver cadre integrated within a hospital-led local healthcare team with five adaptive diversified funding streams. This qualitative implementation research, guided by the Consolidated Framework for Implementation Research (CFIR), examined the determinants of adoption and sustainment of the model over its 6-year operation. The CFIR-informed interview guide was used as the key data collection and analytical framework across its five domains [innovation, outer setting, inner setting, individuals (roles and characteristics), and implementation process]. We conducted semi-structured interviews with key informants spanning hospital administrators, physicians, nurses, community caregivers, sub-district primary care unit personnel, local government officials, community leaders, and family members between March and May 2025. Data were analysed using framework analysis combining deductive CFIR coding with inductive sub-coding. Adoption was facilitated by a hospital-initiated caregiver role, sustained inner-setting leadership embodied in a long-tenured 'social engineer' hospital director and his successor team, a three-stage community-led caregiver selection process, and Buddhist-integrated spiritual care; sustainment relied on a coordinated multi-level care process and the continuity of care centre's reflective evaluation. Outer-setting barriers included fragmented public health financing, the 2022 decentralization of sub-district primary care units to provincial administrative organizations, and donor-funding uncertainty. Since 2020 the model has been progressively scaled under Ramathibodi Faculty of Medicine sponsorship to 22 districts across 15 provinces (53 villages, cumulative investment >10 million baht). The Ubolratana experience therefore offers a practical, rather than directly replicable, framework whose diffusion depends on cultivating local leadership, building trust, and adapting innovation components to local conditions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.