ผู้วิจัย/Authors: Pongpisut Jongudomsuk, Kanchana Kiatthanaphan, Jadej Thammatuch-aree.

ชื่อเรื่อง/Title: Current practice of co-payment in universal coverage policy.

แหล่งที่มา/Source: Total Abstract Journal of Health Science, Vol 12, Page 155-157.

รายละเอียด / Details:

Thailand has implemented Universal coverage Policy nationwide since April 2002. Beneficiaries of this Universal Coverage scheme UCS have to co-pay 30 baht per visit. Co-payment is exempted for the utilization of preventive and promotive services and for people who used to be covered by the Medical Welfare Scheme. The objective of this study was to explore current practice of co-payment under the universal coverage policy. Self-administered questionnaires had been sent to all hospitals in August 2002 who were the main contractors of the UCS and one health facility in their networks. It was found that co-payment in most of health facilities in cases of acute illness that needed follow up visit, the use of preventive and promotive services and referral within the network, with the guideline set by the Ministry of Public Health MOPH.In cases with unclear guideline, co-payment still had the similar pattern in most of the health facilities. Co-payment was required for every visit of chronic patients, who needed regular follow up. Patients who bypassed the referral system had to pay fee-for-ser-vices instead of co-payment. In case that the physician prescribed non-essential drug for patient, health facilities did not request additional co-payment. Main objectives of co-payment were to increase people participation, to make people realize the value of services and to decrease unnecessary health service utilization respectively. Health personnel disregarded co-payment as a mean to increase revenue even in the case of financially strapped health centers. Misunderstanding of health personnel and clients was the most common problem in the implementation of co-payment. There were 18.94 percent of health facility. Where most of them were located in north-eastern and central region, reporting that people could not afford the co-payment. Most of health facilities proposed that rate of co-payment, 30 baht per visit, was inappropriate. Co-payment rate should be adjusted according to the characteristics of patients and places. However, there were 40.65 percent of health facilities who accepted the present co-payment rate. Inappropriate implementation of co-payment could effect access to care of the poor. Realizing its negative consequences, co-payment in health care system should be designed and implemented properly. Single co-payment rate for everybody and everywhere may not be appropriate and defeat its purpose.

Keywords: co-payment, universal coverage policy, medical welfare, health care

ปีที่เผยแพร่/Year: 2005

Address: National health security office, Bangkruay Hospital, Nonthaburi

Code: 20050000431

ISSN/ISBN: 974-506-393-2

Country of publication: Thailand.

Language: English.

Category: Abstract Journal.

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