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Universal health insurance and decentralization : a feasibility for universal coverage achievement

วินัย ลีสมิทธิ์; Vinai Leesmidt; ศุภสิทธิ์ พรรณารุโณทัย; Supasit Pannarunothai;
Date: 2544
Abstract
Universal Coverage Initiation and Health Care Decentralization in Different Countries This literature review concerns about the theory and experience on universal coverage initiation that is related to health care decentralization in different countries. The review consists of two important parts. Part one involves the concept of health care decentralization, local government administration, experiences in local government arrangements in some countries, and decentralization situation in Thailand. Part two describes universal coverage initiation in various countries to understand the concept and difficulties in universal health care provision, health care financing, and roles of local government within universal coverage. It is hoped that the obtained knowledge from the review will be the fundamental foundation for policy setting and implementation of universal coverage in Thailand. From literature review, it can be concluded that universal coverage is very essential for health service welfare. Decentralization has no direct relation to universal coverage initiation. Universal coverage can occurs without decentralization. However decentralization has been viewed as an important strategy to achieve the effective and efficient universal coverage. The obtained knowledge can be synthesized to be some recommendations for universal coverage initiation in Thailand that there should be universal coverage policy at the national level. It should be compulsory system rather than voluntary one to prevent the coming problems such as selection bias. The roles of local governments need to be clearly defined both in health care provision and financing roles. Health sector should be accepted as important as other sectors. The universal coverage should be developed step by step to avoid the opposition from both public and private sectors. Finally, it needs to have more information from additional research studies to fulfill the gap of knowledge particularly in administrative and management aspects. At least, there should be information about the roles of local governments within universal coverage in Thailand.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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HSRI Knowledge BankDashboardCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjectsSubjectsการบริการสุขภาพ (Health Service Delivery) [619]กำลังคนด้านสุขภาพ (Health Workforce) [99]ระบบสารสนเทศด้านสุขภาพ (Health Information Systems) [286]ผลิตภัณฑ์ วัคซีน และเทคโนโลยีทางการแพทย์ (Medical Products, Vaccines and Technologies) [125]ระบบการเงินการคลังด้านสุขภาพ (Health Systems Financing) [158]ภาวะผู้นำและการอภิบาล (Leadership and Governance) [1281]ปัจจัยสังคมกำหนดสุขภาพ (Social Determinants of Health: SDH) [228]วิจัยระบบสุขภาพ (Health System Research) [28]ระบบวิจัยสุขภาพ (Health Research System) [20]

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