Abstract
Advancement of Universal Health Coverage in Thailand since 2002 increased access to both
outpatient (OP) and inpatient (IP) services. This study aimed to analyze the utilizations of government
health insurance schemes and also the factors affecting access to outpatient and inpatient services in
2015. Based on the 2015 Health and Welfare Survey data, descriptive and logit model was performed
to analyze individual utilization of outpatient and inpatient and the factors determining the heath care
utilization.
Results demonstrated that universal health coverage scheme covered the majority of Thai
population. However, the general characteristic, employment and economic status of beneficiaries
differed across different schemes. The illness rate for ambulatory care was 3.1 episodes per capita per
year. Over-the-counter medicines had the biggest share around 27.2 percent, while the hospitalization
was 0.06 admission per capita per year. Most of them were admitted at community hospital and
general hospital (39.6 percent and 38.7 percent respectively), while the hospitalization in private
hospital was only 11.3 percent. In addition, there are some other factors that affected the utilization
of both outpatient and inpatient services such as household characteristic, chronic diseases and the
variation of benefit package of each scheme.
Many people chose to buy drug (around one-third of total treatments). It is important to
establish safety measures through awareness on rational use of drugs and develop a mechanism to
ensure drug quality. Policy maker should strengthen primary care services such as family care team,
home health care and long-term care to reduce the utilization gap in vulnerable groups especially the
poor and elderly and reduce financial burden from medical treatment of patient with chronic disease.
Moreover, government should expand the coverage to uninsured group to increase access to health
care services without financial burden to reduce the gap among health insurance groups.
