Universal health coverage in Thailand: ideas for reform and policy struggling

Pannarunothai, Supasit; Patmasiriwat, Direk; Srithamrongsawat, Samrit

doi:10.1016/s0168-8510(03)00024-1

Cited by 64 publications

(52 citation statements)

References 5 publications

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“…In any case, we ran the second step regressions using the ratio suggested by the referee and found no substantive difference in the results. [39] and [35] argue that the capitation rate in 2002 was not adequate. Ngorsuraches and Sornlertlumvanich [36] indicates that various managerial variables such as patients to employees ratio, service mix, and market variables were determinants of hospital loss on the first year of UC implementation.…”

Section: Identifying Sources Of Inefficiencymentioning

confidence: 99%

Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation

Puenpatom

Rosenman

2008

Health Care Manage Sci

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We investigate the impact of implementing capitated-based Universal Health Coverage (UC) in Thailand on technical efficiency in larger public hospitals during the policy transition period. We measure efficiency before and during the transition period of UC using a two-stage analysis with Data Envelopment Analysis, bootstrap DEA, and truncated regressions. Our analysis indicates that during the transition period efficiency in larger public hospitals across the country increased. The findings differed by region, and hospitals in provinces with more wealth not only started with greater efficiency, but improved their relative position during the transitional phases of the UC system.

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Section: Identifying Sources Of Inefficiencymentioning

confidence: 99%

Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation

Puenpatom

Rosenman

2008

Health Care Manage Sci

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“…84 Many microinsurers are probably unable to qualify for an insurance license due to various barriers to entry; see Devadasan et al (2004b); Dror and Armstrong (2006). 85 See Barnett and Mahul (2007); Bennett (2004); Dlugolecki (2008); Pannarunothai et al (2004). 86 See Schneider (2005).…”

Section: Discussion Of Potential Solutionsmentioning

confidence: 99%

Insurability in Microinsurance Markets: An Analysis of Problems and Potential Solutions

Biener

Eling

2012

Geneva Pap Risk Insur Issues Pract

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This paper provides a comprehensive analysis of the insurability of risks in microinsurance markets. Our aim is to enhance the understanding of impediments to and facilitators of microinsurance from an economic perspective and outline potential solutions. The motivation for conducting this analysis arises from two important aspects. (1) Despite strong growth of microinsurance markets in recent years, more than 90 per cent of the poor population in developing countries have limited or no access to insurance.(2) Industry practitioners frequently highlight problems in the insurability of risks that hinder the development of microinsurance. We review 131 papers and find that the most severe problems stem from insufficient resources for risk evaluation, small size of insurance groups, information asymmetries and the size of the insurance premium. On the basis of the analysis, we discuss a number of potential solutions such as, for example, a cooperative microinsurance architecture. The Geneva Papers (2012) 37, 77-107. doi:10.1057/gpp.2011.29 Keywords: microinsurance; insurability; moral hazard; adverse selection IntroductionThe aim of this paper is to conduct a systematic analysis of the insurability of risks in microinsurance markets, point out critical aspects that hinder their development and outline potential solutions to problems in these markets. Microinsurance is commonly defined as a financial arrangement intended to protect low-income people against specific perils in exchange for regular premium payments proportionate to the likelihood and cost of the risk involved. 1 The microinsurance industry has seen strong growth in recent years, with average annual growth rates of approximately 10 per cent. 2 Industry practitioners, however, estimate that only 5 per cent of the potential market is covered, and that there is a high degree of variability in terms of risk and geographical coverage, leaving large segments of the world's poor population with limited or no access to insurance. 3 1 See Churchill (2007). There exist two widespread definitions of microinsurance. Churchill (2007) refers to microinsurance as insurance for low-income people. Dror and Jacquier (1999) define microinsurance as financially autonomous schemes operating at the local level. Throughout this paper, we refer to the definition by Churchill (2007), but also integrate the aspect that microinsurance is typically operated in small locally focused insurance schemes. 2 See Lloyd's and Microinsurance Centre (2009). 3 See Roth et al. (2007). The Geneva Papers, 2012, 37, (77-107) Providing insurance in developing countries is subject to a large array of problems, many of which are frequently addressed in practitioner studies. 4 These studies reveal numerous problems with insurability, including moral hazard, adverse selection, correlated risks, high transaction costs and lack of data, making microinsurance challenging from an economic perspective. Whereas insurability is relevant in all insurance markets, the crucial question in the case of...

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“…Reimbursing primary care service providers on a weighted capitation basis -where reimbursements are adjusted for need for health care services -may be necessary for prioritising service provision for vulnerable groups including women and adolescents. A combination of weighted capitation and Diagnosis-related Groups for inpatient care may be one approach (Pannarunothai, Patmasiriwat, & Srithamrongsawat, 2004). .…”

Section: Uhc -The Challenge Of Path Dependencementioning

confidence: 99%

Sexual and reproductive health and rights in changing health systems

2015

Reproductive Health Matters

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Sexual and reproductive health and rights (SRHR) are centrally important to health. However, there have been significant shortcomings in implementing SRHR to date. In the context of health systems reform and universal health coverage/care (UHC), this paper explores the following questions. What do these changes in health systems thinking mean for SRHR and gender equity in health in the context of renewed calls for increased investments in the health of women and girls? Can SRHR be integrated usefully into the call for UHC, and if so how? Can health systems reforms address the continuing sexual and reproductive ill health and violations of sexual and reproductive rights (SRR)? Conversely, can the attention to individual human rights that is intrinsic to the SRHR agenda and its continuing concerns about equality, quality and accountability provide impetus for strengthening the health system? The paper argues that achieving equity on the UHC path will require a combination of system improvements and services that benefit all, together with special attention to those whose needs are great and who are likely to fall behind in the politics of choice and voice (i.e., progressive universalism paying particular attention to gender inequalities).Keywords: sexual and reproductive health and rights; universal health coverage/care; quality of care; accountability; equity Introduction Sexual and reproductive health and rights (SRHR) are centrally important to health outcomes in all countries. Sex and reproduction define unique and specific health needs for girls and women over the entire life course. Whether, how and to what extent these health needs are met by the health system depends on the extent to which girls' and women's human rights are respected, protected and fulfilled. Throughout the life course, the sexual and reproductive rights (SRR) of girls and women -to bodily autonomy and integrity, to choice in relation to sexuality and reproduction, to freedom from coercion, discrimination and violence or fear of violence, to safety, satisfaction and pleasureprofoundly shape their physical and mental health and well-being.

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Universal health coverage in Thailand: ideas for reform and policy struggling

Cited by 64 publications

References 5 publications

Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation

Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation

Insurability in Microinsurance Markets: An Analysis of Problems and Potential Solutions

Sexual and reproductive health and rights in changing health systems

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