Abstract
Core Package for Oral Health Care on Universal Coverage Policy, Thailand The purposes of this study were to review knowledge, concepts and experiences of the core package for oral health care, and to recommend the proper core package for oral health care in Thai context which was applicable and fit with needs of the oral health care. The study was conducted by reviewing literature, evaluating sample province and stakeholders’ opinion discussing.Results of the study, Pathumthani, sample province, had more dental patients since the Universal Coverage policy had started. For example, tooth filling, scaling, and extraction had increased 25.3%, 25.1%, and 16.2% respectively. However, waiting list or queue was also increased for instant, there were 164 dental substitution cases and 136 root canal treatment cases in February 2002. The focus group discussion of providers found that there were some problems of policy implementation such as unclear definition of package, increase in the number of patients, and management. The focus group discussion of consumers, another side, demanded for kinds of services which could alleviate pains and restore ability of chewing. Delphi stakeholders meeting prioritized all of services into three groups: 1) The first priority (4.8-5.0 score): Topical Fluoride, Systemic Fluoride, Periodontitis treatment, Celt lip & palate, Oral cancer, Oral infection, and Amalgam filling.2) The second priority (4.0-4.7 score): Scaling, Sealant, Oral patho, Full denture, Root canal treatment, Impacted tooth, Oral health examination, Consulting, Extraction, Pulp treatment in primary teeth, and Tooth-colored filling. 3) The third priority (less than score 4.0): Partial denture, Crowding teeth, and Fixed denture.There were three alternative concepts of the package establishment: 1) Full Treatment Need, 2) Treatment Need with some conditions, 3) Treatment Need by age groups (for example 0-13 age group: Fluoride, Sealant, Oral Exam, Amalgam filling, Root canal treatment, Extraction, Pulp treatment, Oral patho, etc / 14-59 age group: Fluoride, Oral exam, Scaling, Periodontitis, Amalgam filling, Root canal treatment, Impacted tooth, Extraction, Oral patho, Tooth-colored filling, Acrylic partial denture / 60+ age group: Fluoride, Oral exam, Scaling, Periodontitis, Amalgam filling, Extraction, Oral patho, Tooth-colored filling, Full denture, Acrylic partial denture). These options were subject to budget, manpower and capacity of services. For policy establishment, there were some suggestions from the research: 1) the third concept was suitable for resource scarcity, 2) co-payment mechanism was a method to control over demand side, 3) condition of treatment care could increase awareness of self care, 4) some treatments with high cost and chair time might not suitable to be in package such as fixed and metal denture, 5) well-organized system of queue, referral system and finance were required. This research may contribute to improve oral health care service. However, it’s needed to have further studies such as, cost of services, public-private mixed service, consumers’ behavior, etc.
