Development and Implementation of a Prototype Centre of Excellence in Integrated Cancer Services in Thailand: A Feasibility Study
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
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
Inclusion Criteria:
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 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