Equity in the delivery of health care in Thailand

Abstract

Equity in the delivery of health care in ThailandThe Thai national health objective have never been pronounced in equity objective as observed in the new 1997 constitution. These statements are philosophical rather than operational objectives because the targets to achieve have never been set out. Therefore, there is a need to measure inequity to help set the national health objective and monitor the situation as mention in the constitution. The index to measure equity must portray these characteristics. First, the index has to stratify population by income to reflect socio-economic dimension in health inequity. Secondly, the index must reflect experiences of the entire population. Thirdly, the index must be sensitive to changes in the distrivution of population across socio-economic groups. These requirements lead to the need to use concentration index to measure inequity patterns. Furthermore, concentration index satisfiex three basic requirements : it relates to relative index of inequality, it has more visual appeal, and it is calculated from a concentration curve. Concentration index has been used to measure inequity in health eare financing in Thailand using the socioeconomic surveys (SES) of 1986 and 1992 Kakwani index was calculated by subtracting concentration index of taxation with concentration index of income distribution to reflect progressivity or regressivity of health care finance. The results of Kakwani index call for the second phase of research which focus on developing indices for health care delivery. The objective of this study is to investigate to what extent health care is distributed according to need, rather than according to ability to pay. Detailed objectives can be elaborated as follows: 1)To measure equality of health care utilisation for equal need. 2)To measure equality of health utilisation with respect to geographical ares and socioeconomic variables.