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The Third Wave of Health Care Reform in Thailand

พงษ์พิสุทธิ์ จงอุดมสุข;
Date: 2009-12
Abstract
Health care reform movements in Thailand have occurred during three main overlapping periods. The first wave of health care reform focused on increasing the geographical coverage of the health care infrastructure, while the second wave focused on reforming health care financing mechanisms. The third wave shifted its focus to strengthening primary care. This paper is aimed at exploring the third wave of health care reform in Thailand using literature and document review. It was found that, among five areas of reform initiatives to strengthen primary care, there was an imbalance of investment in the primary care infrastructure and capacity building of health staff. An insufficient number of health centre staff, along with their limited capacity, is a major constraint affecting the ability to improve health centre performance. The development of a referral system has been neglected and could reduce confidence of the people in primary care. Although health care financing reform has improved financial status of the health centres, it still needs continuous development in order to promote the responsibility and productivity of health centre staff toward its registered population. Finally, there is a need to develop and adapt the concept and practice of family medicine to fit with the country-specific context and to promote it to be well recognized by the general public as well as by physicians. New challenges for the development of primary care in Thailand include its governance system, in the context of health care devolution, and the provision of health services for chronically ill patients and the elderly.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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URI: http://hdl.handle.net/11228/2916
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