Effect of doctor allocation policies on the equitable distribution of doctors in Thailand

Abstract

Background: Equitable geographic distribution of doctors is crucial for the provision of an accessible and efficient health service system. This study aimed to assess the effects of doctor allocation by the Thai Ministry of Public Health (MoPH) in relation to equity distribution.Methods: This descriptive study compared secondary data on the number of doctors, gross provincial products (GPP), and populations of 76 Thai provinces for the years 2017 and 2021. The ratio of doctors to 1,000 population was used to measure the spatial distribution of doctors by province. Lorenz curves and the Gini coefficient were used to determine the equity of doctor distribution.Results: The results showed that the Gini coefficient decreased from 0.191 in 2017 to -0.03 in 2021 indicating that the equitable distribution of doctors improved after the MoPH commenced allocating newly graduated doctors according to health utilization in 2017. Compared to 2017, the percentage changes in the number of doctors were higher in provinces with lower doctor densities and in provinces with higher GPPs.Conclusion: The equitable distribution of doctors in Thailand was affected by two main causes: the allocation of newly graduated doctors by the MoPH and the turnover rate of existing doctors.