Association Between Hospital Accreditation and Outcomes: The Analysis of Inhospital Mortality From the National Claims Data of the Universal Coverage Scheme in Thailand

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

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Inferior progression-free survival for Thai patients with diffuse large B-cell lymphoma treated under Universal Coverage Scheme: the impact of rituximab inaccessability

Leukemia & Lymphoma ◽

10.3109/10428194.2012.698739 ◽

2012 ◽

Vol 54 (1) ◽

pp. 83-89 ◽

Cited By ~ 9

Author(s):

Tanin Intragumtornchai ◽

Udomsak Bunworasate ◽

Noppadol Siritanaratkul ◽

Archrob Khuhapinant ◽

Weerasak Nawarawong ◽

...

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Progression Free Survival ◽

B Cell Lymphoma ◽

Universal Coverage ◽

Free Survival ◽

Large B Cell Lymphoma ◽

The Impact ◽

Universal Coverage Scheme ◽

Large B Cell

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Access to and price trends of antidiabetic, antihypertensive, and antilipidemic drugs in outpatient settings of the Universal Coverage Scheme in Thailand

PLoS ONE ◽

10.1371/journal.pone.0211759 ◽

2019 ◽

Vol 14 (2) ◽

pp. e0211759

Author(s):

Chulaporn Limwattananon ◽

Onanong Waleekhachonloet

Keyword(s):

Universal Coverage ◽

Price Trends ◽

Outpatient Settings ◽

Universal Coverage Scheme

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Husband’s willingness-to-pay for HIV and syphilis screening at antenatal care clinic under the Thai universal coverage scheme

BMC Public Health ◽

10.1186/s12889-020-08613-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Orawan Anunsittichai ◽

Krit Pongpirul ◽

Thanyawee Puthanakit ◽

Koranit Roowicha ◽

Jirarat Kaewprasert ◽

...

Keyword(s):

Willingness To Pay ◽

Antenatal Care ◽

Universal Coverage ◽

Care Clinic ◽

Syphilis Screening ◽

Universal Coverage Scheme

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Association between Health Insurance and Incidence of Death in Stateless Children in Tak Province, Thailand

Journal of Health Management ◽

10.1177/0972063420937930 ◽

2020 ◽

Vol 22 (3) ◽

pp. 348-362

Author(s):

Proloy Barua ◽

Kanida Narattharaksa

Keyword(s):

Health Insurance ◽

Universal Coverage ◽

Outcome Variable ◽

Risk Of Death ◽

Study Results ◽

Public Health Office ◽

Tak Province ◽

Uninsured Children ◽

Death Cases ◽

Universal Coverage Scheme

This study assesses the association between health insurance and incidence of death in stateless children compared with uninsured children in Tak Province in Thailand. The study used electronic medical records of children aged between 0 and 15 who registered with selected health facilities between 01 January 2013 and 31 December 2017. The required data was obtained from ‘43-files database’ through the Provincial Public Health Office. The death case was used as a binary outcome variable while the exposure was three types of insurance: uninsured, stateless and the Universal Coverage Scheme (UCS). The age, sex and domicile of the children were used as covariates in the multivariate logistic regression. Of 164,435 registered children, 824 death cases were found during the study period. The study results suggest that insurance is associated with the reduced risk of deaths in stateless children. The odds of death is 86 per cent lower in the stateless insurees than in the uninsured children (adjusted odds ratio [AOR] = 0.242, 95% confidence interval [CI] = [0.136,0.403]; p < 0.001). The death is 69 per cent lower in the UCS beneficiaries than in the uninsured children (AOR = 0.385,95 per cent CI = [0.308,0.489]; p < 0.001). Age, sex and domicile of the children were independently associated with a varying risk of death.

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Rehabilitation service development for Sub-Acute and Non-Acute Patient (SNAP) under universal coverage scheme in Thailand

BMC Health Services Research ◽

10.1186/1472-6963-12-s1-o6 ◽

2012 ◽

Vol 12 (S1) ◽

Author(s):

Orathai Khiaocharoen ◽

Supasit Pannarunothai ◽

Preeda Taearak ◽

Wachara Riewpaiboon ◽

Chairoj Zungsontiporn

Keyword(s):

Universal Coverage ◽

Service Development ◽

Rehabilitation Service ◽

Acute Patient ◽

Universal Coverage Scheme

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Indonesian General Practitioners’ Experience of Practicing in Primary Care under the Implementation of Universal Health Coverage Scheme (JKN)

Journal of Primary Care & Community Health ◽

10.1177/21501327211023707 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110237

Author(s):

Fitriana Murriya Ekawati ◽

Mora Claramita

Keyword(s):

Primary Care ◽

General Practitioners ◽

Universal Coverage ◽

Care Practice ◽

Health Coverage ◽

Structured Interviews ◽

Access To Primary Care ◽

Universal Health ◽

Maximum Variation Sample ◽

Universal Coverage Scheme

Introduction The Indonesian government has been implementing Jaminan Kesehatan Nasional (JKN) as the national universal coverage scheme to help Indonesian citizens affording medical care since 2014. However, after a few years of its implementation, a very limited study has been conducted to explore general practitioners’ (GPs) views and experiences of practicing in primary care under JKN implementation. Methods The study applied semi-structured interviews with GPs from January to February 2016, guided by a phenomenology approach in Yogyakarta province, Indonesia. The GPs were recruited using a maximum variation sample design. The interviews were recorded and transcribed, and the data were analyzed thematically. Result A total of 19 GPs were interviewed. Three major themes emerged, namely: powerlessness, clinical resources, and administration. Transition to the JKN system has improved patient access to primary care without significant economic barrier, however, GP participants experienced a sense of powerless practice during JKN implementation. They also commented on limited clinical resources and claimed that JKN administration was complicated and burdened their practice. Conclusion This study identifies various perspectives from GPs practicing in primary care under JKN implementation. The JKN improves access to primary care practice, but there are limited supports for GPs to practice optimally and maintain their relationships with patients. Extensive improvements are needed to upgrade the GP practice in primary care.

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Promoting universal financial protection: how the Thai universal coverage scheme was designed to ensure equity

Health Research Policy and Systems ◽

10.1186/1478-4505-11-25 ◽

2013 ◽

Vol 11 (1) ◽

Cited By ~ 39

Author(s):

Viroj Tangcharoensathien ◽

Siriwan Pitayarangsarit ◽

Walaiporn Patcharanarumol ◽

Phusit Prakongsai ◽

Hathaichanok Sumalee ◽

...

Keyword(s):

Universal Coverage ◽

Financial Protection ◽

Universal Coverage Scheme

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Trend of Cesarean Section Rates and Correlations with Adverse Maternal and Neonatal Outcomes: A Secondary Analysis of Thai Universal Coverage Scheme Data

American Journal of Perinatology Reports ◽

10.1055/s-0039-1697656 ◽

2019 ◽

Vol 09 (04) ◽

pp. e328-e336

Author(s):

Tippawan Liabsuetrakul ◽

Jarawee Sukmanee ◽

Jutatip Thungthong ◽

Pisake Lumbiganon

Keyword(s):

Cesarean Section ◽

National Level ◽

Secondary Analysis ◽

Birth Asphyxia ◽

Perinatal Outcomes ◽

Universal Coverage ◽

Joinpoint Regression ◽

Rate Of Increase ◽

Maternal And Neonatal Outcomes ◽

Universal Coverage Scheme

Abstract Objectives The main purpose of this article is to estimate the trend and projection of cesarean section rates (CSRs) and explore correlations between CSRs with adverse maternal and perinatal outcomes, namely maternal mortality ratios (MMRs), rates of postpartum hemorrhage (PPH), neonatal mortality rates (NMRs), and birth asphyxia per 1,000 live births across all regions of Thailand. Study design A secondary analysis of the hospital-based database of pregnant women and newborns under the Thai Universal Coverage Scheme between January 2009 and December 2017 was conducted. Results Overall annual CSR significantly increased from 23.2% in 2009 to 32.5% in 2017. With the same rate of increase, the CSR of 59.1% was projected by the year 2030 that could be reduced to 30.0% if an annual rate of CS reduction of 1% was assumed using Joinpoint regression. The increasing CSRs were significantly correlated with higher MMRs (r= 0.20, p = 0.03) and birth asphyxia (r= 0.39, p < 0.001). The correlation trends were similar when the analyses were stratified by year in the majority of years. Overall correlations between CSRs and rates of PPH or NMRs were not statistically significant. Conclusion CSRs in Thailand continuously increased and were correlated with adverse maternal and perinatal outcomes. More effort at the national level to reduce unnecessary CS is urgently required.

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