A Causal Relationship Model of Factors Influencing Excellence in the Elderly Care Service Business in Thailand

Background and Aims: Thailand is facing significant demographic changes as it transitions to a completely aged society, with projections indicating that by 2030, the elderly population will account for 30 percent of the total population. This situation has led to a rapid increase in demand for elderly care services, including care centers, specialized healthcare services, and residential facilities for the elderly. However, the elderly care service industry in Thailand still faces several challenges, particularly inconsistent service quality, a lack of standardization, and insufficient human resource development. This research aimed to 1) analyze factors influencing excellence in elderly care services, 2) develop a causal relationship model of these factors, 3) test the validity of the model and analyze the impact of key factors, and 4) propose guidelines for developing and improving elderly care services in Thailand. Methodology: The study employed a mixed-methods approach, with quantitative research using a 5-point Likert scale questionnaire to collect data from a sample of 400 entrepreneurs, medical personnel, and service users through multi-stage sampling, analyzed using Structural Equation Modeling and Path Analysis. Qualitative research involved in-depth interviews with 20 key informants divided into 4 groups, with data analyzed using Content Analysis. Results: The research findings indicated that service quality (mean 4.52), human resource development (mean 4.37), and knowledge management (mean 4.16) were the factors with the highest influence on excellence in elderly care services. The causal relationship model developed was consistent with empirical data (Chi-square/df = 2.21, CFI = 0.94, RMSEA = 0.055), with internal organizational factors, especially service quality, having the highest direct influence (β = 0.42). Additionally, qualitative research revealed differences between the perspectives of entrepreneurs who emphasized cost management and technology, and service users who prioritized safety and staff attitudes. Appropriate guidelines for developing elderly care services should include establishing joint public-private working groups to design service standards, developing digital platforms for knowledge exchange, and formulating a 5-year action plan that integrates all 6 key factors. Conclusion: The knowledge gained from this research is that creating excellence in elderly care services in Thailand requires the development of systematically interconnected factors, particularly enhancing service quality and continuous human resource development, which must be supported by government policies and appropriate technology applications. The causal relationship model developed can serve as a framework for elevating service standards and creating sustainability for the elderly care service industry in Thailand effectively.