Abstract
An achievement of the Universal Health Coverage since 2002 has increased an access in health care utilization of the Thai population. However, populations in Bangkok tend to have an access problem. Basic structure of health service system in Bangkok is different from other regions. This study aims to analyze healthcare utilization and unmet health need both in outpatient (OP) and inpatient (IP) services of population in Bangkok. This is a descriptive study. The 2015 Health and Welfare Survey provided a sample of 5,893 individual persons living in Bangkok for data analysis. Majority of population in Bangkok were covered by the Universal Coverage Scheme (UC) (47.9%) and Social Security Scheme (33.8%). 64.2% of population under UC were in age group 15-60 years, however, 35.8% of them did not work and 18.8% of them were in the poorest quintile. For the OP illnesses, 35.2% of the UC had self-care, mostly by purchasing medication from drug stores. When seeking care at the public hospitals, the UC poorest quintile paid out of pocket disproportionately higher (24%) than patients of other quintiles, with the median amount 1,500 baht higher than the richer quintiles. For IP services, majority of the UC (71.1%) admitted to public hospitals. 32.5% of the poorest quintile had to pay out of pocket for the service with median amount 2,000 baht. Among UC respondents, unmet health need for services was 7.4% for OP and 1.3% for IP, higher than other schemes. The main reasons of the unmet health need for IP services among the UC were unaffordability, inconvenience in travelling, and time barrier (34.6%, 22.3%, and 13.9%, respectively) In Bangkok Metropolitan Area, public hospitals should facilitate an easy access to health services for the UC beneficiaries who had relatively low socio-economic status. This would help mitigate the unmet health need caused by financial hardship due to health payments.
