![Siriraj_Hospital,Bangkok](https://upload.wikimedia.org/wikipedia/commons/9/95/Siriraj_Hospital%2CBangkok.jpg)
Healthcare in Thailand is overseen by the
Ministry of Public Health (MOPH), along with several other non-ministerial government agencies. Thailand's network of public hospitals provide
universal healthcare
Universal health care (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized ar ...
to all Thai nationals through three government schemes. Private hospitals help complement the system, especially in Bangkok and large urban areas, and Thailand is among the world's leading medical tourism destinations. However, access to medical care in rural areas still lags far behind that in the cities.
Infrastructure
A subdistrict health promotion clinic, the most local level of healthcare infrastructure of MOPH, this one is in
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, Thailand's population of 68 million is served by 927 government hospitals and 363 private hospitals with 9,768 primary care health units (SHPH clinics), responsible for Thai citizens’ health at the sub-district level. SHPH has played a significant role in the Thai public health. Additionally, there are 25,615 private clinics.
Universal health care is provided through three programs: the civil service welfare system for civil servants and their families, Social Security (Thailand), Social Security for private employees, and the universal coverage (Thailand), universal coverage scheme, introduced in 2002, which is available to all other Thai nationals.
Some private hospitals are participants in the programs, but most are financed by patient self-payment and private insurance. According to the
World Bank
The World Bank is an international financial institution that provides loans and grants to the governments of low- and middle-income countries for the purpose of pursuing capital projects. The World Bank is the collective name for the Interna ...
, under Thailand’s health schemes, 99.5 percent of the population have health protection coverage.
The MOPH oversees national health policy and also operates most government health facilities. The National Health Security Office (NHSO) allocates funding through the universal coverage program. Other health-related government agencies include the Health System Research Institute (HSRI), Thai Health Promotion Foundation ("ThaiHealth"), National Health Commission Office (NHCO), and the Emergency Medical Institute of Thailand (EMIT). Although there have been national policies for decentralization, there has been resistance in implementing such changes and the MOPH still directly controls most aspects of health care.
Thailand introduced universal coverage reforms in 2001, one of only a handful of lower-middle income countries to do so. Means-tested health care for low-income households was replaced by a new and more comprehensive insurance scheme, originally known as the 30
baht
The baht (; th, บาท, ; sign: ฿; code: THB) is the official currency of Thailand. It is divided into 100 ''satang'' (, ). The issuance of currency is the responsibility of the Bank of Thailand. SWIFT ranked the Thai baht as the 10th-m ...
project, in line with the small
co-payment
A copayment or copay (called a gap in Australian English) is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person ea ...
charged for treatment. People joining the scheme receive a gold card, which allows them to access services in their health district and, if necessary, to be referred for specialist treatment elsewhere.
The bulk of health financing comes from public revenues, with funding allocated to contracting units for primary care annually on a population basis. According to the WHO, 65 percent of Thailand's health care expenditure in 2004 came from the government, while 35 percent was from private sources. Thailand achieved universal coverage with relatively low levels of spending on health, but it faces significant challenges: rising costs,
inequalities
Inequality may refer to:
Economics
* Attention inequality, unequal distribution of attention across users, groups of people, issues in etc. in attention economy
* Economic inequality, difference in economic well-being between population groups
* ...
, and duplication of resources.
[World Health Organization Statistical Information System: Core Health Indicators](_blank)
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Although the reforms have received a good deal of criticism, they have proved popular with poorer Thais, especially in rural areas, and they survived the change of government after the 2006 military coup. Then, Public Health Minister, Mongkol Na Songkhla, abolished the 30 baht co-payment and made the scheme free. It is not yet clear whether the scheme will be modified further under the military government that came to power in May 2014.[G20 Health Care: "Health Care Systems and Health Market Reform in the G20 Countries." Prepared for the World Economic Forum by Ernst & Young. January 3, 2006.]
In 2009, annual spending on health care amounted to 345 international dollar
The international dollar (int'l dollar or intl dollar, symbols Int'l$., Intl$., Int$), also known as Geary–Khamis dollar (symbols G-K$ or GK$), is a hypothetical unit of currency that has the same purchasing power parity that the U.S. dollar ...
s per person in purchasing power parity
Purchasing power parity (PPP) is the measurement of prices in different countries that uses the prices of specific goods to compare the absolute purchasing power of the countries' currency, currencies. PPP is effectively the ratio of the price of ...
(PPP). Total expenditures represented about 4.3 percent of gross domestic product
Gross domestic product (GDP) is a money, monetary Measurement in economics, measure of the market value of all the final goods and services produced and sold (not resold) in a specific time period by countries. Due to its complex and subjec ...
(GDP). Of this amount, 75.8 percent came from public sources and 24.2 percent from private sources. Physician density was 2.98 per 10,000 population in 2004, with 22 hospital beds per 100,000 population in 2002.
Data for utilization of health services in 2008 includes: 81 percent contraceptive prevalence, 80 percent ante-natal care coverage with at least four visits, 99 percent of births attended by skilled health personnel, 98 percent measles immunization coverage among one-year-olds, and 82 percent success in treatment of smear-positive tuberculosis. Improved drinking-water sources were available to 98 percent of the population, and 96 percent were using improved sanitation facilities.
Hospitals
Most hospital
A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
s in Thailand are operated by the Ministry of Public Health. Private hospital
A private hospital is a hospital not owned by the government, including for-profits and non-profits. Funding is by patients themselves ("self-pay"), by insurers, or by foreign embassies. Private hospitals are commonly part, albeit in varying degr ...
s are regulated by the Medical Registration Division. Other government units and public organisations also operate hospitals, including the military, universities, local governments and the Red Cross.
Health Districts
Different provinces in Thailand are arranged into different health districts by region. Each health district is responsible for about 3-6 million people living in those provinces. It aims to provide better quality medical services for citizens within that region and increased efficiency in terms of transferring patients to other hospitals if there is a lack in capability of care within that district. Health districts in Thailand are organised into the following categories, as of August 2017:
First responders
Thailand has an unconventional approach to providing first responders in an emergency: it sends volunteers. Some 65 percent of emergency cases in Bangkok are handled by volunteers. Fully equipped ambulances with professional staff are sent only if required.
There are three levels of medical emergency help in Thailand, from first responder (FR) level to basic life support (BLS) level, and advanced life support (ALS) level. Most volunteers have attained the FR level. They are affiliated with foundations and local administrative bodies.
Thailand's Medical Emergency Hotline centre responds to about 1.5 million medical emergencies each year. About a million involved FR teams transporting patients to medical facilities. BLS and ALS teams handled about 200,000 cases each.
Two organizations, the Poh Teck Tung Foundation
The Poh Teck Tung Foundation ( th, มูลนิธิป่อเต็กตึ๊ง, from zh, t=華僑報德善堂, p=Huáqiáo Bàodé shàntáng) is a rescue foundation founded in Thailand famously known for rescuing road accident victims ...
and the Ruamkatanyu Foundation, are the two largest free first responders in Bangkok. They rely on private donations, but sometimes volunteers must use their own money to buy vehicles, gas, uniforms, and medical equipment. Volunteers are not allowed to accept money from hospitals or from victims. The volunteers say they do this to help people or as a way to earn karma for the next life. The training level of volunteers is not high, just 24 hours. The National Institute of Emergency Medicine (NIEMS) is seeking to increase minimum training to 40 hours, a move initially opposed by the Rescue Network of Thailand, an association of voluntary first responders.
Not all first responder organizations are altruistic. Significant money must be at stake as, sometimes, competition for patients between organizations leads to turf wars and even gun play.
Urban-rural divide
in Nakhon Nayok Province">HRH Princess Maha Chakri Sirindhorn Medical Centre in Nakhon Nayok Province is a teaching hospital of Bangkok-based Faculty of Medicine, Srinakharinwirot University.
For much of its history, rural areas in Thailand were under-served medically. Rural health centres failed to attract health workers as they could not compete with urban areas offering higher salaries and more social amenities. The government, in 1975, launched a medical welfare scheme for poor and vulnerable citizens, both rural and urban. They trained health workers specifically to work in rural areas. Government policy-makers later required all doctors trained in Thailand to start their careers by working in rural hospitals before moving to urban hospitals. To control brain drain, a frequent occurrence in the 1980s, they stopped training medical personnel in English and created good working environments in rural areas. These measures have only been partially successful: in 2009, a study found that there was one physician per 565 persons in Bangkok, but only one physician per 2,870 persons in Isan
Northeast Thailand or Isan (Isan/ th, อีสาน, ; lo, ອີສານ; also written as Isaan, Isarn, Issarn, Issan, Esan, or Esarn; from Pali ''īsānna'' or Sanskrit ईशान्य ''īśānya'' "northeast") consists of 20 provin ...
. , Thailand produces 3,000 doctors yearly at 40 medical education centres.
See also
* Medical tourism
Medical tourism refers to people traveling abroad to obtain medical treatment. In the past, this usually referred to those who traveled from less-developed countries to major medical centers in highly developed countries for treatment unavailable a ...
* Health in Thailand
Thailand has had "a long and successful history of health development," according to the World Health Organization. Life expectancy is averaged at seventy years. Non-communicable diseases form the major burden of morbidity and mortality, while inf ...
References
External links
Thailand Medical News
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