Abstract
This future research aims to study the situation and trends of factors that affect the health system, analyze scenarios of the health system in the next 10 years, and formulate policy for the Thailand's healthcare system. The research is divided into three phases: 1) Systematic literature review, in-depth interviews, and future research using EDFR. The target group includes 25 experts involved in health policy. 2) Creation of a future vision of the health system by organizing two brainstorming meetings, consisting of a group of executives from public health service units and health strategists (40 people) and a group of experts from both inside and outside the public and private health sectors (50 people). 3) Preparation of policy proposals on the health system based on the opinion of experts. Qualitative data were analyzed using content analysis, and quantitative data were analyzed using descriptive statistics. The study results indicate that 1) factors affecting the health system consist of two groups: 1.1) factors within the individual, including gender, age, marital status, income, educational level, health experience, health beliefs, health behavior, health awareness, health attitude, stress, and anxiety, and health literacy, and 1.2) factors outside the individual, including the environment, social support, health workforce, health information database, news sources, health technology, health innovation, access to the health system, politics, government, and economics. 2) uncertainty factors and impacts on the health system consist of six dimensions and 33 factors, including political and legal dimension (6 factors), economic dimensions (6 factors), social dimension (6 factors), technological dimension (4 factors), environmental dimension (4 factors), and health service system dimensions (6 factors). The highest uncertainty factors include pandemics and economic fluctuations, which have been used to create a 4-scenarios for Thailand's health system, consisting of Scenario 1: a fast-paced economy with the pull of the epidemic; Scenario 2: economic crisis, health crisis; Scenario 3: economic fluctuation without disease scourge, and Scenario 4: wealthy country, stable health system. The results of preparing health system policy proposals are classified as proposals for managing health determinants, which should focus on creating health literacy, developing a healthcare system for the elderly, and emphasizing healthy cities. Proposals for the management of health service systems include the management of both health and non-health organizations, adjustment of the service model from a hospital base to a community base, development of Three public health insurance schemes with equal standard requirements, reform of the information system, cybersecurity system, development of big data, development of employment models (outsourcing, skill mix, task shifting), and promotion and development of the health economy.
