Financial risk protection of Thailand’s universal health coverage: results from series of national household surveys between 1996 and 2015

Tangcharoensathien, Viroj; Tisayaticom, Kanjana; Suphanchaimat, Rapeepong; Vongmongkol, Vuthiphan; Viriyathorn, Shaheda; Limwattananon, Supon

doi:10.1186/s12939-020-01273-6

Cited by 40 publications

(45 citation statements)

References 14 publications

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“…Despite its very small amount, it can result in underestimation of national spending. However, evidence shows that implementing UHC in Thailand resulted in a significant decline in the incidence of catastrophic health spending and impoverishment which accounted for 2.0% and 0.4% in 2015 respectively [35]. OOP for HIV/AIDS can be very small and not affect the results of this study.…”

Section: Discussionmentioning

confidence: 64%

The Impact of HIV Spending on Health Outcomes in Thailand

Viriyathorn¹,

Sachdev²,

Wanwong³

et al. 2021

WJA

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Background: The Sustainable Development Goals commitment to Ending HIV/ AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. Methods: A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. Results: HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across uppermiddle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. Conclusion: Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.

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Section: Discussionmentioning

confidence: 64%

The Impact of HIV Spending on Health Outcomes in Thailand

Viriyathorn¹,

Sachdev²,

Wanwong³

et al. 2021

WJA

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“…In 1965, statistical data from the O ce of the Civil Service Commission identi ed that 52% of new graduate doctor students have emigrated working abroad. As a result, in 1967, the MoPH introduced a three-year mandatory rural health service placement policy, and the rst graduate medical student began working in the rural area in 1972 (13,14). The rural doctor federal established in 1976; after the 6 October 1976 event, the federal government has to stop its operation.…”

Section: Resultsmentioning

confidence: 99%

Universal Health Coverage Development in Thailand: How Global Ideas and a National Medical Professional Movement Made a Difference

Sukhampha

2021

Preprint

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Background: Universal health coverage is endorsed as the global development agenda in the 2015 SDGs for global achievement by 2030 and is expected to build national policymaking agendas. Common research often focuses on national processes in the first place. For example, accounts of Thailand's health system development mostly emphasise domestic factors and influences rather than the linkage of external/global health ideas. The paper questions how external/global health ideas influence national health policymaking and the linkage between them in achieving Thailand's universal health coverage policy.Methods: A qualitative method was employed to capture complex and historical narratives of the national medical professional movement for Thailand's health system reform through the lens of a global social policy approach for exploring external and global health ideas transfer. Moreover, the actor- and policy entrepreneur approaches would be employed to investigate national health policymaking and examine how ideas from the external and global levels have improved national equity in health. Results: The research locates the narratives on global ideas and practices that influence a national health system reform. This highlights the impact/role of global ideas on national professional movements, i.e. the rural doctor movement in Thailand mobilising the health system reform for all. The study found that national equity in health could not be achieved without external/global health ideas transfer. Such a case of national universal health coverage achievement in Thailand happened with the effort of the rural doctor movement and individual agency as policy entrepreneurs in translating external/global ideas and practices for their movement and mobilisation. The case contributed to a better understanding of the global process regarding ideas and practices that can be transferred directly and indirectly to the national level. Conclusions: Global ideas transfer can also happen in different aspects such as it can be seen the ideas transfer from developed to developed countries; from developed to developing countries. Besides, the author witnessed that the IOs ideas can also be transferred to developing countries or reverse, and again, between developing countries themselves.

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“…Thailand achieved high level of health development as reflected by near 100% population coverage by three insurance schemes [ 17 ], low incidence of catastrophic health spending [ 9 ], better health outcomes [ 19 ] such as life expectancy increased from 71 years in 2001 to 77 years in 2019, decreased under-five mortality from 22 per 1000 live births in 2000 to 9 per 1000 live births in 2019, decreased maternal mortality ratio from 43 per 100,000 live births in 2001 to 37 per 100,000 live births in 2017.…”

Section: Discussionmentioning

confidence: 99%

“…The comprehensive benefit package by all three scheme and no copayment at point of service result in low incidence of catastrophic health spending, as measured by out-of-pocket payments exceeding 10% of household total consumption expenditure. It reduced from 6.0% in 1996 to 2.2% in 2017 [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Annual prevalence of unmet healthcare need in Thailand: evidence from national household surveys between 2011 and 2019

Vongmongkol

Viriyathorn

Wanwong

et al. 2021

Int J Equity Health

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Background Extending Universal Health Coverage (UHC) requires identifying and addressing unmet healthcare need and its causes to improve access to essential health services. Unmet need is a useful monitoring indicator to verify if low incidence of catastrophic health spending is not a result of foregone services due to unmet needs. This study assesses the trend, between 2011 and 2019, of prevalence and reasons of unmet healthcare need and identifies population groups who had unmet needs. Method The unmet healthcare need module in the Health and Welfare Survey (HWS) 2011–2019 was used for analysis. HWS is a nationally representative household survey conducted by the National Statistical Office biennially. There are more than 60,000 respondents in each round of survey. The Organisation for Economic Co-operation and Development (OECD) standard questions on unmet need and reasons behind were applied for outpatient (OP), inpatient (IP) and dental services in the past 12 months. Data from samples were weighted to represent the Thai population. Univariate analysis was applied to assess unmet need across socioeconomic profiles. Results The annual prevalence of unmet need between 2011 and 2019 was lower than 3%. The prevalence was 1.3–1.6% for outpatient services, 0.9% - 1.1% for dental services, and lower than 0.2% for inpatient care. A small increasing trend was observed on dental service unmet need, from 0.9% in 2011 to 1.1% in 2019. The poor, the elderly and people living in urban areas had higher unmet needs than their counterparts. Long waiting times was the main reason for unmet need, while cost of treatment was not an issue. Conclusion The low level of unmet need at less than 3% was lower than OECD average (28%), and was the result of UHC since 2002. Regular monitoring using the national representative household survey to estimate annual prevalence and reasons for unmet need can guide policy to sustain and improve access by certain population groups.

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Financial risk protection of Thailand’s universal health coverage: results from series of national household surveys between 1996 and 2015

Cited by 40 publications

References 14 publications

The Impact of HIV Spending on Health Outcomes in Thailand

The Impact of HIV Spending on Health Outcomes in Thailand

Universal Health Coverage Development in Thailand: How Global Ideas and a National Medical Professional Movement Made a Difference

Annual prevalence of unmet healthcare need in Thailand: evidence from national household surveys between 2011 and 2019

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