บทคัดย่อ
Final Integrated Report(Health Management and Financing Study Project ADB no. 2997 – THA)Despite the continuing improvement of the Thai people’s health for the past years, the reform of the Thai health care system should be undertaken mainly because of dramatic changes of Thailand’s demographic, social, political and economic factors especially led by the economic crisis in 1997. After the crisis, the ADB(Asian Development Bank) provided $500 million loans supporting the Thai social sectors including the health sector in addition to contract technical assistance teams to provide policy recommendations for Thailand’s health sector development. The health technical assistance team was composed of representatives from Management Sciences for Health and the Health System Research Institute. They suggested that : better remuneration be given to health professionals particularly doctors working in rural areas to prevent the shortage of health personnel in such areas as well as encouraging the existing referral system, a pilot project of transforming a number of public hospitals into more autonomised hospitals which would legitimately be supported by the Public Organisation Act be carried out, health public budgets be controlled for example the use of capitation basis for the CSMBS and fund merging between the SSS and WCS program, the new poverty line be applied on the LIC scheme to reduce its leakage to the non-eligible, the reform be taken place gradually and separated into 2 phases, 1st phase (3 yrs) for implementing pilot projects and 2nd phase (5-10 yrs) for distributing the developed models, block granting system be introduced for allocating recurrent budgets to encourage higher degree of decentralised management, more integrated district health systems and provincial health board responsible for health services planning and purchasing health care be established.
