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

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

New year 2017 has just arrived. I really hope it will be very happy and productive new year for all of you. My research interest is in the field of health services research with interdisciplinary focus, particularly health policy and health system management. Currently, I am studying Thailand’s health system, particularly the Universal Coverage Scheme (UCS, also known as the 30-Bath Scheme). I would like to share a study that I conducted recently.

Thailand achieved universal health coverage through the implementation of the UCS in 2002. Since then, approximately 75% of the entire population (approximately 47 million people) have had almost free access to healthcare. However, interestingly, a substantial portion of beneficiaries has still utilized care outside the UCS boundary. Some people might use informal care (e.g., buying over-the-counter (OTC) drugs of traditional Thai medicine) due to accessibility problems of the UCS services (e.g., long wait times of transportation). Other people might use private care facilities due to acceptability problems of the UCS services (e.g., low quality of dissatisfaction with needed services).

Because the low utilization may be an indication of a policy gap between people’s health needs and the services available to them, the study investigated the pattern of health-seeking behavior and its social/ contextual determinants (i.e., investigating where/ why such policy gap occurs). The study findings showed that the UCS was adequately responsive to the needs of beneficiaries from a vertical equity perspective. Particularly, for the low-income group, we found that they (1) had more health care needs, (2) received a larger number of services from designated facilities, and (3) paid the least for both inpatient and outpatient services.

Nevertheless, the study also found that a substantial proportion of beneficiaries (approximately 45%) still utilized out-of-network services, which could imply 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.

This study was published in SpringerPlus (2016) 5:1952 “Thailand’s universal coverage scheme and its impact on health-seeking behavior”. Now, I am planning to conduct cost efficiency/ effectiveness analysis of the UCS. I hope I can share this with you in the future. Once again, happy new year 2017. Thank you