Advancing Perioperative Medicine for Frail Older Adults in Thailand: A Strategic Perspective from Anesthesiology

Abstract

Thailand has officially entered an aged-society phase: people ≥ 65 years already constitute > 14% of the population. This demographic transition strains surgical services; frail older adults face disproportionately high perioperative morbidity, prolonged recovery, and functional decline. Yet, perioperative care delivery in Thailand remains fragmented, with sporadic frailty screening, inconsistent multidisciplinary collaboration, and rudimentary transitional care pathways. Using the Business Model Canvas to map current service gaps, this review delineates strategic levers for reform. At high-volume centers such as Siriraj Hospital, nearly 40% of surgical patients are aged ≥ 65 years, positioning anesthesiologists to champion frailty screening, preoperative risk optimization, and postoperative recovery planning. Inspired by models from Singapore, the UK, and the US, we propose a four-phase, anesthesiologist-led perioperative care model spanning pre- to post-surgery. Prioritizing safety, recovery, and continuity of care, it is supported by workforce development and policy action. To manage implementation costs, a Business Model Canvas is recommended. This scalable strategy aims to enhance perioperative care for Thailand’s aging population.