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

Background Cancer is a significant global health burden. In Thailand, it affects over 122,000 individuals annually, while also being the cause of 86,000 deaths. Besides impacting patients, this disease also poses social and economic challenges due to high treatment costs and growing case numbers, especially as the aging of Thai society progresses. The cost of cancer services in Thailand also exceeded 26 billion baht (~ US$800 million) annually. Thus, there is an urgent need for policy-level responses and increased public awareness of the threats posed by cancer. To address this, Thailand’s Seamless Health Service Network proposed Comprehensive Cancer Centres of Excellence, supported by innovations such as advanced IT systems and lean management. A three-phase research project on this proposal funded by the National Science, Research, and Innovation Fund of Thailand is underway. Objective To establish a prototype Centre of Excellence in Integrated Cancer Services and assess its service outcomes based on Donabedian’s model, which categorizes healthcare quality into structure, process, and outcomes. Methods This study was designed as a research and development project employing both quantitative and qualitative approaches to evaluate the effectiveness of a prototype Comprehensive Cancer Centre of Excellence. The centre, located in Bangkok, Thailand, was developed in collaboration with healthcare providers, clients, and cancer care experts. Most of the healthcare personnel involved were faculty members from the Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy. The study population included 313 clients receiving cancer care services, 30 healthcare providers, and 15 experts in oncology. The intervention focused on implementing and evaluating service improvements at the prototype centre based on Donabedian’s model, which assesses healthcare quality through three dimensions: Structure, Process, and Outcomes. Data collection involved structured questionnaires to assess satisfaction among clients and healthcare providers, as well as in-depth interviews with experts to gain qualitative insights. The primary measures were satisfaction levels with the centre's service delivery. Quantitative data were analysed descriptively, while qualitative data from expert interviews were examined using content analysis. Results The validity of the questionnaires was confirmed, with Content Validity Indexes of 0.97, 0.96, and 0.97, respectively. Cronbach’s alpha values were 0.94 and 0.91, respectively. High levels of satisfaction were reported by clients and providers across all domains. For the structure, the mean satisfaction score was 4.05 (SD = 0.84) for both clients and providers. For Process, clients showed a mean score of 4.24 (SD = 0.91), while providers had a higher mean score of 4.40 (SD = 1.09) which were significantly different (p < 0.05). For Outcomes, clients showed a mean score of 4.07 (SD = 1.07), while providers had a mean score of 4.04 (SD = 1.09) although this did not reach significance (p > 0.05). Overall, providers reported higher satisfaction than clients, especially in the Process domain. Specifically, the highest rated aspects included polite and gentle communication (x̄ = 4.70, SD = 0.47), truthful communication (x̄ = 4.70, SD = 0.47), and encouraging client questions (x̄ = 4.67, SD = 0.55). For the report of the expert in cancer care will be report in another paper. Conclusion The prototype Centre of Excellence in Integrated Cancer Services achieved high levels of satisfaction and effectiveness. Key factors behind its success included strong community collaboration, effective multidisciplinary teamwork, clearly defined roles, and the utilization of advanced information systems. The model shows strong potential for wider implementation and sustainability. Recommendations: Future development should focus on strengthening infrastructure, equipment, and human resources, while also securing long-term financial support to effectively maintain and scale the Comprehensive Cancer Centre of Excellence model nationwide.