Installment techniques for medical coverage framework in Thailand

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Installment techniques for health care coverage framework in Thailand Samrit Srithamrongsawat Health Insurance System Research Office Samrit.strsw@yahoo.co.th

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Outline of presentation Overview of installment strategies for the Thai health care coverage plans Universal Coverage Scheme Civil Servant Medical Benefit Scheme Social Security Scheme Effects of installment strategies: the Thai experiences

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Thailand: chronicled improvement Establishment of prepayment plans User charges Informal exclusion 1945 Expansion of prepayment plans 1970 1975 LIC 1980 CSMBS 1-3 rd NHP 1962-76 Provincial clinics 1983 CHF 1990 SSS 1980 SSS CSMBS LIC ��  MWS Universal Coverage 4 th - 5 th NHP (1977-86) District doctor's facilities Health focuses 1990 1994 PVHI SSS 2000 2001 Universal Coverage CSMBS Health Infrastructure 2001

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Coverage of medical coverage: 1991-2003 Source: HWS 1991, 1996, 2001, 2003

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Age appropriation by protection plot

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Civil Servant Medical Benefit Scheme (CSMBS)

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Social Security Scheme (SSS)

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Universal Coverage Scheme (UCS)

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Historical advancement: installment strategies

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Aim and targets of obtaining Ensuring great quality and proficient administrations are given to recipients Aim To guarantee great wellbeing To take care of wellbeing issues Response to social desire To control cost O bjectives

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Payment techniques and supplier hazard Per Discharged Per part IP and OP DRGs Retrospective Full cost Full Capitation Bundled Hospital - MD DRGs Discount routine set of expenses Hospital IP DRGs Minimum Maximum Provider Risk

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Payment & supplier conduct WHR 2000

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Effects of installment strategies: the Thai encounters

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DALYs 1999: 2004

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Use of walking consideration Use of sick people Use of sick people secured by the plan Source: 2005 HWS

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Use of delegated administrations of patients with interminable conditions Take-up of advantages Use administrations Source: 2005 HWS

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Hospitalization Days of stay Being conceded Take-up of advantages Number of affirmation Source: 2005 HWS

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Responsiveness Enabling access Equal treatment Financial assurance Prompt treatment* ABAC (2006)

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Responsiveness Equal treatment* Financial difficulties* Good quality* Satisfaction ABAC (2006)

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FFS: CSMBS encounters Cabinet determination, full pay for non ED, confine roof LOS of private R&B and stringent private confirmation

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SSS: Per capita uses 1998-2005

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UCS: endorsed capitation spending plan and assessed costs 2002 - 2006

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Conclusions There were both enhancing and intensifying wellbeing issues among Thai populaces . Supplier's inclination in administration arrangement was clear by protection conspire, especially for constant conditions and hospitalization. Remaining issues of concern Quality of medicinal are Outcome of treatment

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Conclusions Health protection frameworks in Thailand give decently responsiveness to their recipients and need encourage change. Close-end installment strategies are more successful in controlling expenses than open-end installment technique.

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