Abstract
Background: This study focuses on an evaluation of the universal health care coverage among low
income groups by using four selected characteristics of good governance: equity, efficiency and effectiveness,
participation and transparency.
Methods: The interviews with policy makers and patient representatives were conducted. The purposive
sampling was used to select interviewees. The data was analyzed by a template analysis style, as
the templates are the four selected characteristics of good governance.
Results: After the introduction of universal health care coverage in Thailand, the Thai health care
system has improved. First, equity in Thai health care system is largely improved, which can be seen by
improvement of the accessibility to health services among low income groups. Second, the efficiency of
health care systems has enhanced. Third, people have better opportunity to participate in decision making
process of the health care systems. Fourth, the transparency of health care systems is improved due to
the shift of power to allocate health fund from the Ministry of Public Health to the National Health Security
Office.
Discussion: Despites the improvements in the health care systems, there are still several challenges
that the Thai health care system is facing. For example, the geographical barriers prevent low income
groups from accessing care for chronic conditions, this result showed insufficient allocation of resources
in health care systems. Another challenge for the Thai health care system is a shortage of medical professionals.
Conclusion: the universal health care coverage has improved the accessibility of health care services
among low income groups, efficiency of health care systems and participation of people in decision
making. However, the challenges are still occurring, for example, insufficient of human resources and
geographical barriers.
