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Abstract

Background: The increasing population aging worldwide poses challenges to accessibility to dermatological care, especially in rural areas with limited dermatologist availability. Establishing dermatological primary health care (PHC) services for older adults is crucial for improving access, efficiency, and equity. However, no study has systematically explored such a system.

Method: This mixed-methods study employed a participatory action research (PAR) model to identify structural and procedural requirements, patient journeys, health needs, and expectations. Data were collected through focus groups, in-depth interviews, and surveys. Design thinking workshops, guided by PAR principles, were used to develop dermatological PHC services. A survey was conducted across all health regions in Thailand to assess the feasibility and impact of PAR methods and dermatological PHC services.

Results: The qualitative and quantitative analyses identified eight key components of dermatological PHC services: screening, appropriate care, provider capacity building, referrals, consultations and networking, follow-up, self-care, and facilities. The questionnaire received responses from 397 of 576 PHC hospitals (68.9%), with 71% confirming the feasibility of PAR implementation and 96% recognizing its benefits over a 12-month timeline. Moreover, 82% and 98% of the responses agreed regarding the feasibility and benefits of developing dermatological PHC services, respectively, indicating a need for a longer timeline to achieve full implementation.

Conclusion: Establishing dermatological PHC services for the elderly is imperative, supported by widespread agreement among PHC hospitals regarding the feasibility and benefits of providing such services.

Keywords: Aging, Dermatology, Healthcare, Older Adults, Participatory action research, Primary health care, Thailand

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