Abstract
The Statue on National Health System B.E 2552 section 7, the health system must promote human
value and dignity and attach importance to fairness and equity in society. This concept leads to an attempt
to capture interaction between providers and users in order to improve and develop the health service
system. Every person should be treated equally even though he/she accesses to care under different health
insurance schemes and hospital types. The purpose of this research was to assess the responsiveness of
Thai health care service system according to different types of national health insurance schemes and
health care facilities in 9 provinces. An exit survey of 6,507 out-patients covered by 3 health care schemes:
Civil Servants Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS) and Universal Coverage
Scheme (UCS), was conducted. The health care settings included 4 hospital types: regional/general hospital,
community hospital, university hospital and private hospital. The field survey period was from April
to June 2011.
The study revealed that there were significant difference between median scores, both overall and
hospital-type based, of responsiveness to users among three schemes in some domains and responsiveness
scores under the CSMBS was higher than those from the SSS and UCS. Nevertheless, results from
logistic regression show that, when 75 percentile of score of each component was adopted as cut point for
high responsiveness, health insurance scheme was not significantly associated with all responsiveness
components, except choice: the scores of the CSMBS was significantly higher than those of the UCS. On
the other hand, type of hospital was significantly associated with responsiveness in all components. Overall,
the score of private hospital was significantly higher than those of the others, whereas that of the
university hospital was significantly lower than the scores of the other hospitals, except choice, which was
significantly higher than in the university hospital than in the regional/general hospital.
