Abstract
Analysis of administrative data between 2008-2010 from the Comptroller’s General
Department, National Health Security Office, Social Security Office and Ministry of Public Health
found that accessibility to health care of Thai Elderly people in 2010 was better than previous
fiscal years. However, coverage of prevention services still low in the elder group. Compare to
other age groups, elderly people had higher utilization rate of annual physical checkup, outpatient
visits (6.3 visit per person per year) and in-patient-visits (0.23 visit per person per year).
There were inequity on access to health care among different age-cohort, geographical regions
and different social health protection schemes. Elderly people had higher utilization rate until
the age around 75 years old. Then their access to health care gradually declined. Analysis for
Preventable Admission of the year 2010 is lower than previous fiscal years. This indicator
showed that performance of primary care was better than previous years. Regarding statistic of
admission for length of stay at least 2 months, nearly 40 percent of this admission type was
occupied by elderly patients. Elder beneficiaries of the Civil Servant Medical Benefit Scheme
(CSMBS) shared 72 percent of all CSMBS’s patients who stayed in hospitals at least 2 months.
This is an indirect evident for need of system of intermediate care and long term care, which do
not exist in current Thai health care system. Total expenditure of social health protection
schemes in 2010 was 0.64 percent of GDP.
Forecast of health care expenditure of social health protection schemes during 2011-
2022 was performed using actuarial model, which include assumption of demographic and
macroeconomic development during that period. Changing of demographic structure from
elderly society plays minor role on the future health care expenditure. Technology change and
inflation are key cost drivers. Health care expenditure of the social health protection schemes at
the year 2022 in status quo will be 1.1 percent of GDP. Sensitivity analysis for expansion of
utilization and unit cost of services showed that total expenditure will increase to 1.4 percent of
GDP. Aggresive cost containment measures may decrease heath care expenditure to 0.8
percent of GDP. Better health status also reduces health care expenditure to 1.0 percent of
GDP. Health care performance indicators for elderly people have been developed using
systematic review, gray literature review and result from administrative data analysis. Three
dimensions of indicators are identified, health care production process, health care function and
burden of diseases. Many indicators were dropped due to lack of accurate or reliable data.
Finally, 9 indicators were identified for the first version. More indicators will be included into the
next version if data is available.
In conclusion, Trend of health care performance for elderly care is better compare to
previous year. However, fragmented and incomplete data is a main problem of this study.
Interpretation of the detail result of the study has to be careful. This study also showed
possibility to establish Information of health care performance at Country level, which needs
systematic and official arrangement with continuous effort to guarantee the comprehensive and
accurate data
