Abstract
Currently, the government has implemented the “One ID Card, Universal Healthcare”
project in collaboration with the private sector to expand access to health service. This initiative
aims to enhance convenience, improve service efficiency, and increase accessibility to dental
care. In addition, the project is intended to reduce overcrowding in basic dental services and to
strengthen the capacity of public facilities to deliver advanced levels of care. This study aimed
to evaluate changes in access to dental services before and after the implementation of the
project and to assess the satisfaction among stakeholders. It also sought to identify factors
influencing participation, examine changes in service delivery, and assess reductions in indirect
costs among the public utilizing the project. This study was retro-prospective design, guided by
Andersen’s Behavioral Model of Health Service Use and the framework of Penchansky and
Thomas. Data were collected through an online questionnaire, and secondary data on dental
service utilization were obtained from the National Health Security Office (NHSO) database. The
sample comprised Thai citizens covered by the Universal Coverage Scheme and individuals
utilizing the program between 2022 and May 2025. Descriptive statistics, correlation analysis,
and structural equation modeling were employed in the analysis. The findings indicated an
increase in access to dental services, with 87.5% of new patients having not utilized public
hospital services in the previous three years. However, this figure may not represent the exact
proportion, as the researchers lacked access to nationwide dental service data. Regarding
satisfaction, 96.6% of service recipients and 74.8% of service providers reported being satisfied
with the program. In contrast, only 29.6% of respondents from public hospitals expressed
satisfaction, despite acknowledging that the program facilitated greater access to dental services.
Their dissatisfaction might stem from perceptions that the program did not contribute to an
increase in new patients, did not ease workload, and did not reduce the demand for basic
services in public hospitals. Most clinics chose to participate in the program to enhance their
reputation, attract and retain new patients, increase income, facilitate public access to dental
services, and help reduce overcrowding in public hospitals. In addition, 96.3% of service
recipients reported that the program reduced their expenses, and 86.6% indicated that it
allowed them to avoid taking leave from work. Structural equation modeling revealed
associations among personal factors, health behaviors, clinic accessibility, convenience and
facilities, clinic satisfaction, and acceptance of service quality. [CMIN/DF = 5.270, CFI = 0.921,
RMSEA (90% CIs) = 0.065 (0.062-0.068), SRMR = 0.0413]
