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. 2016 Nov 10;5(1):1952.
doi: 10.1186/s40064-016-3665-4. eCollection 2016.

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

Seung Chun Paek  1 , Natthani Meemon  1 , Thomas T H Wan  2
Affiliations

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

Seung Chun Paek et al. Springerplus. .

Abstract

Background: Thailand'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.

Results: The 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.

Conclusions: This 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.

Keywords: 30-Baht Scheme; Health-seeking behavior; Out-of-pocket payment; Thailand; Universal Coverage Scheme.

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References

    1. Aday LA, Andersen RM. A framework for the study of access to medical care. Health Serv Res. 1974;9(3):208–220. - PMC - PubMed
    1. Andersen RM, Davidson PL (2001) Improving access to care in America: individual and contextual indicators. In: Andersen RM, Rice TH, Kominski GF (eds) Changing the U.S. Health Care System: key issues in health service policy and management, 3rd ed. Jersey-Bass, San Francisco
    1. Antos JR (2007) Health care financing in Thailand: modeling and sustainability. mission report to the world bank. World Bank, Washington, DC. http://documents.worldbank.org/curated/en/2007/08/15622368/health-care-f.... Accessed 25 Aug 2015
    1. Bradley EH, McGraw SA, Curry L, Buckser A, King KL, Kasl SV, Andersen R. Expanding the Andersen model: the role of psychosocial factors in long-term care use. Health Serv Res. 2002;37(5):1221–1242. doi: 10.1111/1475-6773.01053. - DOI - PMC - PubMed
    1. Case A, Paxson C. Parental behavior and child health. Health Aff (Millwood) 2002;21(2):164–178. doi: 10.1377/hlthaff.21.2.164. - DOI - PubMed

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