Search
  Advanced Search
 
Chapter search
Book cover: Advances in Health Economics and Health Services Research

Advances in Health Economics and Health Services Research

ISSN: 0731-2199
Series editor(s): Prof. Michael Grossman, Prof. Bjorn Lindgren, Prof. Robert Kaestner, Prof. Kristian Bolin

Subject Area: Health Care Management/Healthcare

Content: Series Volumes | icon: RSS Current Volume RSS

 

Previous article.Icon: Print.Table of Contents.Next article.Icon: .

Document request:
The equity impact of the universal coverage policy: Lessons from Thailand


Document Information:
Title:The equity impact of the universal coverage policy: Lessons from Thailand
Author(s):Phusit Prakongsai, Supon Limwattananon, Viroj Tangcharoensathien
Volume:21 Editor(s): Dov Chernichovsky, Kara Hanson ISBN: 978-1-84855-664-5 eISBN: 978-1-84855-665-2
Citation:Phusit Prakongsai, Supon Limwattananon, Viroj Tangcharoensathien (2009), The equity impact of the universal coverage policy: Lessons from Thailand, in Dov Chernichovsky, Kara Hanson (ed.) Innovations in Health System Finance in Developing and Transitional Economies (Advances in Health Economics and Health Services Research, Volume 21), Emerald Group Publishing Limited, pp.57-81
DOI:10.1108/S0731-2199(2009)0000021006 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Article type:Chapter Item
Abstract:

Objective – This chapter assesses health equity achievements of the Thai health system before and after the introduction of the universal coverage (UC) policy. It examines five dimensions of equity: equity in financial contributions, the incidence of catastrophic health expenditure, the degree of impoverishment as a result of household out-of-pocket payments for health, equity in health service use and the incidence of public subsidies for health.

Methodology – The standard methods proposed by O’Donnell, van Doorslaer, and Wagstaff (2008b) were used to measure equity in financial contribution, healthcare utilization and public subsidies, and in assessing the incidence of catastrophic health expenditure and impoverishment. Two major national representative household survey datasets were used: Socio-Economic Surveys and Health and Welfare Surveys.

Findings – General tax was the most progressive source of finance in Thailand. Because this source dominates total financing, the overall outcome was progressive, with the rich contributing a greater share of their income than the poor. The low incidence of catastrophic health expenditure and impoverishment before UC was further reduced after UC. Use of healthcare and the distribution of government subsidies were both pro-poor: in particular, the functioning of primary healthcare (PHC) at the district level serves as a “pro-poor hub” in translating policy into practice and equity outcomes.

Policy implications – The Thai health financing reforms have been accompanied by nationwide extension of PHC coverage, mandatory rural health service by new graduates and systems redesign, especially the introduction of a contracting model and closed-ended provider payment methods. Together, these changes have led to a more equitable and more efficient health system. Institutional capacity to generate evidence and to translate it into policy decisions, effective implementation and comprehensive monitoring and evaluation are essential to successful system-level reforms.


Fulltext Options:

Login

Login

Existing customers: login
to access this document

Login


- Forgot password?

- Athens/Institutional login

Purchase

Purchase

Downloadable; Printable; Owned
HTML, PDF (415kb)

Due to our platform migration, pay-per-view is temporarily unavailable.

To purchase this item please login or register.

Login


- Forgot password?

Recommend to your librarian

Complete and print this form to request this document from your librarian


Marked list


Bookmark & share

Reprints & permissions