Utilisation, out-of-pocket payments and access before and after COVID-19: Thailand's Universal Health Coverage Scheme.

The goal of Universal Health Coverage (UHC) is that everyone needing healthcare can access quality services without financial hardship. Recent research covering countries with UHC systems documents the emergence, and acceleration following the COVID-19 pandemic of unapproved informal payment systems by providers that collect under-the-table payments from patients. In 2001, Thailand extended its '30 Baht' government-financed coverage to all uninsured people with little or no cost sharing.

Payment mechanism and hospital admission: New evidence from Thailand healthcare reform.

In 2007, Thailand's Civil Servant Medical Benefit Scheme (CSMBS), one of the three main public health insurers, adopted a new payment mechanism for hospital admission. There has been a shift from fee-for-service toward Diagnostic Related Group (DRG)-based payment that transfers financial risk from the government to health care providers. This study investigates the effects of this policy change on hospital admission, frequency of admission, length of stay (LOS), type of hospital admitted, and out-of-pocket (OOP) inpatient medical expenditure.

Billing system and health care utilization: Evidence from Thailand.

We examined the role of billing processes in health care utilization by exploiting a shift in provider payment from fee-for-service reimbursement towards fee-for-service direct disbursement for outpatient services in Thailand. Specifically, prior to October 2006, affected patients had to pay the full cost of outpatient treatment and subsequently received reimbursement; thereafter, these payments can be sent directly to the providers, without patients having to pay anything upfront. By using nationally representative micro-data and a difference-in-difference methodology, we show that the direct disbursement policy leads to an increase in outpatient utilization among the sick.

Healthcare utilization, bypass, and multiple visits: the case of Bhutan.

This paper uses the Bhutan Living Standards Survey 2012 to assess factors that affect the decision to use outpatient care when ill, outpatient utilization choice, and bypassing decision. Our attention is placed on geographical factors because of the unique geographical landscape in Bhutan, which may act as an important barrier for access to care in the country. We further analyze the pattern of multiple healthcare visits of individuals with the same health symptom.

Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

Background: In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality.

Objective: We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments.

Expanding health insurance to increase health care utilization: will it have different effects in rural vs. urban areas?

Objectives: This study investigates the importance of medical fee and distance to health care provider on individual's decision to seek care in developing countries.

Methods: The estimation method used a mixed logit model applied to data from the third wave of the Indonesian family life survey (2000). The key variables of interest include medical fee and distance to different types of health care provider and individual characteristic variables.

Early results from Thailand's 30 Baht Health Reform: something to smile about.

Efforts by countries to attain universal coverage are often hampered by supply constraints that can reduce access to care for those already in the system and, in many Asian and developing countries, by the emergence of informal payment systems that extract under-the-table payments from patients. In 2001, Thailand extended government-financed coverage to all uninsured people with little or no cost sharing. We found that Thailand has added nearly fourteen million people to the system and achieved near-universal coverage without compromising access for those with prior coverage; we also found that, to date, no informal payment system has emerged.