Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector
This discussion paper is one of five discussion papers for the Thailand public financial management report. It focuses on efficiency and equity in the financing of health services, and the evolving role of central and local government in the health...
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| Format: | Report |
| Language: | English en_US |
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World Bank, Washington, DC
2017
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| Online Access: | http://documents.worldbank.org/curated/en/136461468117866298/Thailand-Public-finance-management-report http://hdl.handle.net/10986/27401 |
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okr-10986-27401 |
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oai_dc |
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Digital Repository |
| institution_category |
Foreign Institution |
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Digital Repositories |
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World Bank Open Knowledge Repository |
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World Bank |
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English en_US |
| topic |
ACCESS TO HEALTH CARE ACCESS TO HEALTH SERVICES AGE GROUPS AGE STRUCTURE AGED AGING AMBULATORY CARE ANTENATAL CARE BRAIN DRAIN BREAST CANCER BUDGET ALLOCATION BULLETIN CAPITA HEALTH EXPENDITURE CAPITATION CAPITATION PAYMENT CARDIOVASCULAR RISK FACTORS CARE PERFORMANCE CENTRAL BUDGET CERVICAL CANCER CHRONIC CONDITIONS CHRONIC DISEASE CITIZEN CLINICAL OUTCOMES CLINICAL PRACTICE COMMUNICABLE DISEASES COMMUNITY HOSPITALS COST OF CARE DECISION MAKING DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DEMAND FOR LONG-TERM CARE DEMOCRACY DEMOGRAPHIC TRANSITION DEPENDENCY RATIO DETERMINANTS OF HEALTH DIABETES DISPARITIES IN HEALTH DISSEMINATION DOCTORS DRUGS ECONOMIC GROWTH ECONOMIC OUTCOMES ELDERLY ELDERLY PEOPLE ELDERLY POPULATION EMPLOYMENT EPIDEMIOLOGICAL CHANGES EPIDEMIOLOGICAL TRANSITION EPILEPSY EQUITY IN ACCESS EXPENDITURE CONTROL EXPENDITURES FAMILY PLANNING FEE-FOR-SERVICE FERTILITY RATE FINANCE MANAGEMENT FINANCIAL BARRIERS FINANCIAL INCENTIVE FINANCIAL MANAGEMENT FINANCIAL PROTECTION GENERAL PRACTITIONERS GLUCOSE GOVERNMENT AGENCIES HEALTH CARE HEALTH CARE COSTS HEALTH CARE EXPENDITURE HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CARE WORKERS HEALTH CENTERS HEALTH COSTS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURE GROWTH HEALTH EXPERTS HEALTH FINANCING HEALTH FINANCING REFORM HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INSURERS HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROMOTION HEALTH RESEARCH HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE UTILIZATION HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HEALTH WORKFORCE HEALTHCARE INSTITUTIONS HOSPITAL ADMISSION HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SYSTEMS HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HYPERTENSION ILLNESS IMMUNIZATION INCENTIVES FOR PROVIDERS INCOME INCOME COUNTRIES INFANT INFANT MORTALITY INFANT MORTALITY RATES INFERTILITY INFORMAL SECTOR INJURIES INTERNATIONAL COMPARISONS INTERNATIONAL TRADE INTERVENTION LABOR FORCE LABOR MARKET LIFE EXPECTANCY LIFE EXPECTANCY AT BIRTH LIVE BIRTHS LOCAL AUTHORITIES LOCAL GOVERNMENTS LOW INCOME MATERNAL MORTALITY MATERNAL MORTALITY RATIO MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL EQUIPMENT MEDICAL STAFF MEDICAL TECHNOLOGY MINISTRY OF EDUCATION MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SPENDING NATIONAL HEALTH SYSTEMS NURSE OBESITY OUTPATIENT SERVICES PARTICIPATION IN DECISION PATIENT PATIENT PARTICIPATION PATIENTS PAYMENTS FOR HEALTH CARE PHARMACISTS POCKET PAYMENTS POCKET PAYMENTS BY PATIENTS POLICY RESPONSE POPULATION PROJECTIONS POPULATION SIZE PREVENTIVE HEALTH SERVICES PRIMARY CARE PRIMARY HEALTH CARE PRIVATE HEALTH INSURANCE PRIVATE HOSPITAL SECTOR PRIVATE HOSPITALS PRIVATE INSURANCE PRIVATE SECTOR PRIVATE SPENDING PROGNOSIS PROGRESS PROVIDER PAYMENT PROVINCIAL HOSPITALS PROVISION OF SERVICES PUBLIC DEMAND PUBLIC EXPENDITURE PUBLIC EXPENDITURE ON HEALTH PUBLIC HEALTH PUBLIC HEALTH SYSTEM PUBLIC HOSPITAL PUBLIC HOSPITAL SYSTEMS PUBLIC PROVIDERS PUBLIC SECTOR QUALITY OF HEALTH RESOURCE ALLOCATION RISK FACTORS RURAL AREAS RURAL POPULATION SERVICE DELIVERY SHARE OF HEALTH SPENDING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SOCIAL SERVICES SURGERY UNFPA URBAN AREAS URBANIZATION VACCINES WORKERS WORLD HEALTH ORGANIZATION WORLD POPULATION |
| spellingShingle |
ACCESS TO HEALTH CARE ACCESS TO HEALTH SERVICES AGE GROUPS AGE STRUCTURE AGED AGING AMBULATORY CARE ANTENATAL CARE BRAIN DRAIN BREAST CANCER BUDGET ALLOCATION BULLETIN CAPITA HEALTH EXPENDITURE CAPITATION CAPITATION PAYMENT CARDIOVASCULAR RISK FACTORS CARE PERFORMANCE CENTRAL BUDGET CERVICAL CANCER CHRONIC CONDITIONS CHRONIC DISEASE CITIZEN CLINICAL OUTCOMES CLINICAL PRACTICE COMMUNICABLE DISEASES COMMUNITY HOSPITALS COST OF CARE DECISION MAKING DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DEMAND FOR LONG-TERM CARE DEMOCRACY DEMOGRAPHIC TRANSITION DEPENDENCY RATIO DETERMINANTS OF HEALTH DIABETES DISPARITIES IN HEALTH DISSEMINATION DOCTORS DRUGS ECONOMIC GROWTH ECONOMIC OUTCOMES ELDERLY ELDERLY PEOPLE ELDERLY POPULATION EMPLOYMENT EPIDEMIOLOGICAL CHANGES EPIDEMIOLOGICAL TRANSITION EPILEPSY EQUITY IN ACCESS EXPENDITURE CONTROL EXPENDITURES FAMILY PLANNING FEE-FOR-SERVICE FERTILITY RATE FINANCE MANAGEMENT FINANCIAL BARRIERS FINANCIAL INCENTIVE FINANCIAL MANAGEMENT FINANCIAL PROTECTION GENERAL PRACTITIONERS GLUCOSE GOVERNMENT AGENCIES HEALTH CARE HEALTH CARE COSTS HEALTH CARE EXPENDITURE HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CARE WORKERS HEALTH CENTERS HEALTH COSTS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURE GROWTH HEALTH EXPERTS HEALTH FINANCING HEALTH FINANCING REFORM HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INSURERS HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROMOTION HEALTH RESEARCH HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE UTILIZATION HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HEALTH WORKFORCE HEALTHCARE INSTITUTIONS HOSPITAL ADMISSION HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SYSTEMS HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HYPERTENSION ILLNESS IMMUNIZATION INCENTIVES FOR PROVIDERS INCOME INCOME COUNTRIES INFANT INFANT MORTALITY INFANT MORTALITY RATES INFERTILITY INFORMAL SECTOR INJURIES INTERNATIONAL COMPARISONS INTERNATIONAL TRADE INTERVENTION LABOR FORCE LABOR MARKET LIFE EXPECTANCY LIFE EXPECTANCY AT BIRTH LIVE BIRTHS LOCAL AUTHORITIES LOCAL GOVERNMENTS LOW INCOME MATERNAL MORTALITY MATERNAL MORTALITY RATIO MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL EQUIPMENT MEDICAL STAFF MEDICAL TECHNOLOGY MINISTRY OF EDUCATION MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SPENDING NATIONAL HEALTH SYSTEMS NURSE OBESITY OUTPATIENT SERVICES PARTICIPATION IN DECISION PATIENT PATIENT PARTICIPATION PATIENTS PAYMENTS FOR HEALTH CARE PHARMACISTS POCKET PAYMENTS POCKET PAYMENTS BY PATIENTS POLICY RESPONSE POPULATION PROJECTIONS POPULATION SIZE PREVENTIVE HEALTH SERVICES PRIMARY CARE PRIMARY HEALTH CARE PRIVATE HEALTH INSURANCE PRIVATE HOSPITAL SECTOR PRIVATE HOSPITALS PRIVATE INSURANCE PRIVATE SECTOR PRIVATE SPENDING PROGNOSIS PROGRESS PROVIDER PAYMENT PROVINCIAL HOSPITALS PROVISION OF SERVICES PUBLIC DEMAND PUBLIC EXPENDITURE PUBLIC EXPENDITURE ON HEALTH PUBLIC HEALTH PUBLIC HEALTH SYSTEM PUBLIC HOSPITAL PUBLIC HOSPITAL SYSTEMS PUBLIC PROVIDERS PUBLIC SECTOR QUALITY OF HEALTH RESOURCE ALLOCATION RISK FACTORS RURAL AREAS RURAL POPULATION SERVICE DELIVERY SHARE OF HEALTH SPENDING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SOCIAL SERVICES SURGERY UNFPA URBAN AREAS URBANIZATION VACCINES WORKERS WORLD HEALTH ORGANIZATION WORLD POPULATION Lindelow, Magnus Hawkins, Loraine Osornprasop, Sutayut Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| geographic_facet |
East Asia and Pacific Thailand |
| description |
This discussion paper is one of five
discussion papers for the Thailand public financial
management report. It focuses on efficiency and equity in
the financing of health services, and the evolving role of
central and local government in the health sector. Over the
last few decades, Thailand has seen significant improvements
in health outcomes, reflecting sustained public investment
in both infrastructure and human resources. Thailand has
also succeeded in expanding the coverage of health
protection schemes, culminating in the introduction of the
Universal Coverage (UC) scheme in 2001. These efforts have
broadened access to health services, contributed to greater
and more equitable utilization, and helped reduce the
financial burden and the risk of impoverishment associated
with health care expenses. However, there are fewer data on
broader measures of health system performance, including
dimensions of quality. Overall, available evidence suggests
a mixed picture. For instance, while there has been
improvement in the management of chronic conditions, a
significant number of cases remain undiagnosed or untreated.
Similarly, Thailand has seen recent improvement in 2-year
survival rates from cancer and heart attacks, but still lags
far behind Organization for Economic Co-operation and
Development (OECD) countries. While the achievements of
Thailand's health system are undeniable, this paper
highlights three key challenges: (i) inequalities in
utilization and spending; (ii) mounting cost pressures; and
(iii) fragmentation of financing and unresolved issues
concerning the respective roles of central and local
government. This paper provides evidence of regional
differences in diagnosis and management of chronic disease,
and of survival rates from cancer and heart attacks. These
data do not suggest a strong relationship between the health
system and spending on the one hand, and on quality or
health outcomes on the other. Indeed, efficiency may be a
greater concern, with over-provision now a growing problem
in some parts of the health system. However, more evidence
is needed on these issues. For example, while high levels of
spending and utilization in the Civil Servant Medical
Benefit Scheme (CSMBS) are often noted, it is less clear
whether this is associated with better outcomes (e.g. higher
cancer survival rates or improved health outcomes for the
elderly). The implications of geographic disparities in
spending in the Social Security Scheme (SSS) and the CSMBS
also warrant further attention. |
| format |
Report |
| author |
Lindelow, Magnus Hawkins, Loraine Osornprasop, Sutayut |
| author_facet |
Lindelow, Magnus Hawkins, Loraine Osornprasop, Sutayut |
| author_sort |
Lindelow, Magnus |
| title |
Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| title_short |
Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| title_full |
Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| title_fullStr |
Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| title_full_unstemmed |
Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector |
| title_sort |
thailand public finance management report : government spending and central-local relations in thailand’s health sector |
| publisher |
World Bank, Washington, DC |
| publishDate |
2017 |
| url |
http://documents.worldbank.org/curated/en/136461468117866298/Thailand-Public-finance-management-report http://hdl.handle.net/10986/27401 |
| _version_ |
1764464271381495808 |
| spelling |
okr-10986-274012021-04-23T14:04:42Z Thailand Public Finance Management Report : Government Spending and Central-Local Relations in Thailand’s Health Sector Lindelow, Magnus Hawkins, Loraine Osornprasop, Sutayut ACCESS TO HEALTH CARE ACCESS TO HEALTH SERVICES AGE GROUPS AGE STRUCTURE AGED AGING AMBULATORY CARE ANTENATAL CARE BRAIN DRAIN BREAST CANCER BUDGET ALLOCATION BULLETIN CAPITA HEALTH EXPENDITURE CAPITATION CAPITATION PAYMENT CARDIOVASCULAR RISK FACTORS CARE PERFORMANCE CENTRAL BUDGET CERVICAL CANCER CHRONIC CONDITIONS CHRONIC DISEASE CITIZEN CLINICAL OUTCOMES CLINICAL PRACTICE COMMUNICABLE DISEASES COMMUNITY HOSPITALS COST OF CARE DECISION MAKING DEMAND FOR HEALTH DEMAND FOR HEALTH CARE DEMAND FOR LONG-TERM CARE DEMOCRACY DEMOGRAPHIC TRANSITION DEPENDENCY RATIO DETERMINANTS OF HEALTH DIABETES DISPARITIES IN HEALTH DISSEMINATION DOCTORS DRUGS ECONOMIC GROWTH ECONOMIC OUTCOMES ELDERLY ELDERLY PEOPLE ELDERLY POPULATION EMPLOYMENT EPIDEMIOLOGICAL CHANGES EPIDEMIOLOGICAL TRANSITION EPILEPSY EQUITY IN ACCESS EXPENDITURE CONTROL EXPENDITURES FAMILY PLANNING FEE-FOR-SERVICE FERTILITY RATE FINANCE MANAGEMENT FINANCIAL BARRIERS FINANCIAL INCENTIVE FINANCIAL MANAGEMENT FINANCIAL PROTECTION GENERAL PRACTITIONERS GLUCOSE GOVERNMENT AGENCIES HEALTH CARE HEALTH CARE COSTS HEALTH CARE EXPENDITURE HEALTH CARE RESOURCES HEALTH CARE SPENDING HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CARE WORKERS HEALTH CENTERS HEALTH COSTS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURE GROWTH HEALTH EXPERTS HEALTH FINANCING HEALTH FINANCING REFORM HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE SCHEMES HEALTH INSURANCE SYSTEM HEALTH INSURERS HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICY HEALTH PROFESSIONALS HEALTH PROMOTION HEALTH RESEARCH HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE UTILIZATION HEALTH SERVICES RESEARCH HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HEALTH WORKFORCE HEALTHCARE INSTITUTIONS HOSPITAL ADMISSION HOSPITAL BEDS HOSPITAL REVENUES HOSPITAL SYSTEMS HOSPITALIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES HYPERTENSION ILLNESS IMMUNIZATION INCENTIVES FOR PROVIDERS INCOME INCOME COUNTRIES INFANT INFANT MORTALITY INFANT MORTALITY RATES INFERTILITY INFORMAL SECTOR INJURIES INTERNATIONAL COMPARISONS INTERNATIONAL TRADE INTERVENTION LABOR FORCE LABOR MARKET LIFE EXPECTANCY LIFE EXPECTANCY AT BIRTH LIVE BIRTHS LOCAL AUTHORITIES LOCAL GOVERNMENTS LOW INCOME MATERNAL MORTALITY MATERNAL MORTALITY RATIO MEDICAL BENEFIT MEDICAL DOCTORS MEDICAL EDUCATION MEDICAL EQUIPMENT MEDICAL STAFF MEDICAL TECHNOLOGY MINISTRY OF EDUCATION MORBIDITY MORTALITY NATIONAL HEALTH NATIONAL HEALTH SPENDING NATIONAL HEALTH SYSTEMS NURSE OBESITY OUTPATIENT SERVICES PARTICIPATION IN DECISION PATIENT PATIENT PARTICIPATION PATIENTS PAYMENTS FOR HEALTH CARE PHARMACISTS POCKET PAYMENTS POCKET PAYMENTS BY PATIENTS POLICY RESPONSE POPULATION PROJECTIONS POPULATION SIZE PREVENTIVE HEALTH SERVICES PRIMARY CARE PRIMARY HEALTH CARE PRIVATE HEALTH INSURANCE PRIVATE HOSPITAL SECTOR PRIVATE HOSPITALS PRIVATE INSURANCE PRIVATE SECTOR PRIVATE SPENDING PROGNOSIS PROGRESS PROVIDER PAYMENT PROVINCIAL HOSPITALS PROVISION OF SERVICES PUBLIC DEMAND PUBLIC EXPENDITURE PUBLIC EXPENDITURE ON HEALTH PUBLIC HEALTH PUBLIC HEALTH SYSTEM PUBLIC HOSPITAL PUBLIC HOSPITAL SYSTEMS PUBLIC PROVIDERS PUBLIC SECTOR QUALITY OF HEALTH RESOURCE ALLOCATION RISK FACTORS RURAL AREAS RURAL POPULATION SERVICE DELIVERY SHARE OF HEALTH SPENDING SOCIAL HEALTH INSURANCE SOCIAL SECURITY SOCIAL SERVICES SURGERY UNFPA URBAN AREAS URBANIZATION VACCINES WORKERS WORLD HEALTH ORGANIZATION WORLD POPULATION This discussion paper is one of five discussion papers for the Thailand public financial management report. It focuses on efficiency and equity in the financing of health services, and the evolving role of central and local government in the health sector. Over the last few decades, Thailand has seen significant improvements in health outcomes, reflecting sustained public investment in both infrastructure and human resources. Thailand has also succeeded in expanding the coverage of health protection schemes, culminating in the introduction of the Universal Coverage (UC) scheme in 2001. These efforts have broadened access to health services, contributed to greater and more equitable utilization, and helped reduce the financial burden and the risk of impoverishment associated with health care expenses. However, there are fewer data on broader measures of health system performance, including dimensions of quality. Overall, available evidence suggests a mixed picture. For instance, while there has been improvement in the management of chronic conditions, a significant number of cases remain undiagnosed or untreated. Similarly, Thailand has seen recent improvement in 2-year survival rates from cancer and heart attacks, but still lags far behind Organization for Economic Co-operation and Development (OECD) countries. While the achievements of Thailand's health system are undeniable, this paper highlights three key challenges: (i) inequalities in utilization and spending; (ii) mounting cost pressures; and (iii) fragmentation of financing and unresolved issues concerning the respective roles of central and local government. This paper provides evidence of regional differences in diagnosis and management of chronic disease, and of survival rates from cancer and heart attacks. These data do not suggest a strong relationship between the health system and spending on the one hand, and on quality or health outcomes on the other. Indeed, efficiency may be a greater concern, with over-provision now a growing problem in some parts of the health system. However, more evidence is needed on these issues. For example, while high levels of spending and utilization in the Civil Servant Medical Benefit Scheme (CSMBS) are often noted, it is less clear whether this is associated with better outcomes (e.g. higher cancer survival rates or improved health outcomes for the elderly). The implications of geographic disparities in spending in the Social Security Scheme (SSS) and the CSMBS also warrant further attention. 2017-06-27T20:48:01Z 2017-06-27T20:48:01Z 2011-04 Report http://documents.worldbank.org/curated/en/136461468117866298/Thailand-Public-finance-management-report http://hdl.handle.net/10986/27401 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Economic & Sector Work :: Other Health Study Economic & Sector Work East Asia and Pacific Thailand |