Abstract
Objectives of this study are to (1) estimate fiscal space for universal health coverage (UHC) in Thailand, and (2) investigate the demand-supply gaps in health workers and develop microsimulation models to examine how to improve the allocation of health workers in the same areas. The study on health fiscal space found that the public budget for the Universal Coverage Scheme (UCS), when compared with the national goals of Sustainability, Adequacy, Fairness, and Efficiency (SAFE), tends to be neither sustainable nor adequate in the next ten years. This study also conducted quantitative analysis on three options to integrate the three schemes of UHC, which could reduce public budgets and improving fiscal efficiency. In addition, the political economy analysis indicates that there are possibilities to expand sources of funds such as earmarked VAT and tax reform for universal social welfare. The political movement is necessary to actualize the revenue and budget expansion. The study of area-based network allocation focuses on the hospitals under the Office of Permanent Secretary of the Ministry of Public Health and extends to the public-private partnership analysis. The basic results show that healthcare networking combined the primary hospitals and the first--secondary and middle-secondary hospitals within each district could alleviate workforce shortage. Furthermore, the provincial networking of the secondary and tertiary hospitals with the private hospitals which provide inpatient service could not significantly reduce workload per worker at the national average. However, when considered by province, the public-private partnership could reduce workload per worker by 10% or more in major provinces.
