Thailand’s universal coverage scheme and its impact on health-seeking behavior

Abstract

BackgroundThailand’s Universal Coverage Scheme (UCS) has improved healthcare access and utilization since its initial introduction in 2002. However, a substantial proportion of beneficiaries has utilized care outside the UCS boundaries. Because low utilization may be an indication of a policy gap between people’s health needs and the services available to them, we investigated the patterns of health-seeking behavior and their social/contextual determinants among UCS beneficiaries in the year 2013.ResultsThe study findings from the outpatient analysis showed that the use of designated facilities for care was significantly higher in low-income, unemployed, and chronic status groups. The findings from the inpatient analysis showed that the use of designated facilities for care was significantly higher in the low-income, older, and female groups. Particularly, for the low-income group, we found that they (1) had greater health care needs, (2) received a larger number of services from designated facilities, and (3) paid the least for both inpatient and outpatient services.ConclusionsThis pro-poor impact indicated that the UCS could adequately respond to beneficiaries’ needs in terms of vertical equity. However, we also found that a considerable proportion of beneficiaries utilized out-of-network services, which implied a lack of universal access to policy services from a horizontal equity point of view. Thus, the policy should continue expanding and diversifying its service benefits to strengthen horizontal equity. Particularly, private sector involvement for those who are employed as well as the increased unmet health needs of those in rural areas may be important policy priorities for that. Lastly, methodological issues such as severity adjustment and a detailed categorization of health-seeking behaviors need to be further considered for a better understanding of the policy impact.

Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes

“…At Ramathibodi Hospital, the majority of devices that increased were PPM. The marked increased rate of implantation might be the result of the start of Thailand's Universal Coverage Scheme in 2002, which covered approximately 75% of the entire Thai population, making more patients able to access the appropriate treatment . Our study demonstrated that the annual incidence of CIED infection at Ramathibodi Hospital was stable at approximately 0.9% despite a continuous rise in CIED implantation.…”

Burden of atopic dermatitis in Asia

“…To understand the economic burden that AD poses in Asia, it is important to first be aware of the varied medical reimbursement systems used in different Asian countries. For the most part, many Asian countries, including South Korea, Thailand and Taiwan, pay for health care primarily through government‐funded or subsidized basic universal health care, although many also include a smaller private insurance sector (Table ) . Others may have a mixture of public and private health‐care systems, such as in India or Malaysia.…”

“…For the most part, many Asian countries, including South Korea, Thailand and Taiwan, pay for health care primarily through governmentfunded or subsidized basic universal health care, although many also include a smaller private insurance sector (Table 1). [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81] Others may have a mixture of public and private health-care systems, such as in India or Malaysia. There are some notable nuances among Asian countries when it comes to paying for AD treatment.…”

Capacity and Utilization of Blood Culture in Two Referral Hospitals in Indonesia and Thailand

“…In Thailand, the cost of bacterial culture was covered by the national health-care system even before the implementation of Thailand’s Universal Healthcare Coverage Scheme in 2002. 10 In Indonesia in 2015, the cost of bacterial culture was covered by the government only if bacterial culture was included within the package of fee for service for the final diagnosis. 11 Thailand also has a strong infectious disease society and the importance of blood culture prior to the initiation of parenteral antimicrobials has been supported widely by the society, which probably contributes to the increased utilization of clinical microbiology laboratories in Thailand compared with that observed in Indonesia.…”