BackgroundThailand’s policy to promote long-stay tourism encourages Japanese retirees to relocate to Thailand. One concern of such an influx is the impact of these elderly foreign residents on the Thai health system. This study aims to reveal the current use of and needs for health services amongst Japanese retirees residing in various locations in Thailand.MethodsIn collaboration with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket, questionnaire surveys of Japanese long-stay retirees were conducted from January to March 2015. The inclusion criteria were being ≥ 50 years of age and staying in Thailand for ≥30 days in the previous 12 months while the main exclusion criteria included relocation by company, relocation due to marriage, or working migrants.ResultsThe mean age of the 237 eligible participants was 68.8, with 79.3% of them being male, 57.8% having stayed in Thailand for ≥5 years, 63.3% having stayed in Thailand for ≥300 days in the previous 12 months and 33% suffering from chronic diseases or sequelae. Of the 143 who had health check-ups in the previous 12 months, 48.3% did so in Thailand. The top 3 diseases treated either in Thailand or Japan in the previous 12 months were dental diseases (50 patients), hypertension (44 patients), and musculoskeletal disorders (41 patients), with the rate of treatment in Thailand standing at 46.0, 47.7, and 65.9%, respectively. Of the 106 who saw a doctor in Thailand in the same period, 70.8% did so less than once a month. Only 23.2% of the participants preferred to receive medical treatment for serious conditions in Thailand. However, this number rose to 32.9% for long-term care (LTC) use.ConclusionThe usage of Thai health services amongst Japanese long-stay retirees is currently limited as they prefer going back to Japan for health screenings and treatment of chronic or serious diseases. However, the number of Japanese residents requiring health services including LTC and end-of-life care is expected to increase. The potential impact of promoting long-stay tourism on the Thai public health should be acknowledged and investigated by the Thai government, including the tourism authority.
Background Despite widespread cross-border migration of retirees, little is known about their healthcare seeking behavior in a destination country. This study explores factors related to the use of health services in Thailand by Japanese long-stay retirees. Methods A survey of Japanese long-stay retirees aged 50 and older was conducted in cooperation with nine Japanese self-help clubs in Bangkok, Chiang Mai, Chiang Rai, and Phuket. The dependent variable was receiving medical treatment in Thailand in the previous 12 months. People who did not receive treatment in Thailand were divided into two groups; those who had treatment only in Japan and those who did not have treatment anywhere. Independent variables included i) predisposing factors: age, sex, years lived in Thailand, ii) enabling factors: marital status, adjusted annual household income, and iii) need factors: existence of chronic diseases, and health related Quality of Life. Results Of 226 eligible participants, 106 persons (47%) received medical treatment in Thailand, 41 (18%) received treatment only in Japan, and 79 (35%) did not in either country in the previous 12 months. The multivariate analysis identified that Japanese retirees who stayed in Thailand less than five years were less likely to see doctors in Thailand. Retirees who had no chronic diseases and did not return to Japan tended not to receive treatment anywhere while those who were covered by Japan’s national health insurance and stayed in Thailand for shorter periods in the past 12 months were more likely to get treatment only in Japan. Conclusion Thai government’s retirement tourism promotion policy should encourage sharing of transparent medical quality and pricing information by medical facilities to promote the trust in Thai medical services. Further studies are required on the impact of the 2017 and 2019 government policy on mandatory health insurance for retirees on their health seeking behaviors. It is also important to explore possible long-term impacts of the COVID-19 pandemic on the international retirement migration trends including on the Japanese and other retirees in Thailand.
Partnerships, particularly, South-South and Triangular Cooperation play an important role in the 2030 Agenda for Sustainable Development. The Partnership Project for Global Health and Universal Health Coverage (UHC) between Japan and Thailand (the Project) was launched in 2016 as a four-year flagship project for Triangular Cooperation and continued to the second phase in 2020. Participating countries include Asian and African countries who are striving to drive global health and to move towards UHC. However, the COVID-19 pandemic has made coordination of partnerships more difficult. The Project needed to find a "new normal" approach to conduct our collaborative work. Struggling with public health and social measures for COVID-19 has made us more resilient and has increased opportunities to collaborate more closely. In the past year and a half, during the COVID-19 pandemic, the Project successfully conducted a number of online activities between Thailand and Japan and with other countries on global health and UHC. Our "new normal" approach led continuing dialogue of networking both at the project implementation and policy levels, focusing on desk-based activities regarding the targets and the objectives of the project and creating a golden opportunity for pursuing a timely second phase. Our lessons learned include as follows: i) Closer prior consultation is required to hold satisfactory online meetings; ii) Effective "new normal" approaches include emphasizing practical and interactive discussions on each country's priority issues and expanding target participants; iii) Commitment, trust, teamwork, and sharing common goals can enhance and sustain partnerships, especially amid the pandemic.
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