ผู้วิจัย/Authors: Samrit Srithamrongsawat, Phenkhae Lapying.

ชื่อเรื่อง/Title: Financial management of the universal health care coverage project in the first-year implementation : A case study in four provinces.

แหล่งที่มา/Source: Total Abstract Journal of Health Science, Vol 12, Page 330-332.

รายละเอียด / Details:

This study wasaimed to assess the first-year implementation of financing reform and its implications in the first and second pilot provinces, namely samut sakhon, Phuket, Sukhothai, and Ubon Ratchathani. The study was conducted during November 2001 to January 2002 by employing qualitative methods, in-depth interview and focus group discussion among health administrators, project managers and providers at all levels. Some health administrators and providers perceived the financing reform as an insituation of government officers with political support which was to most troublesome among all the universal coverage policy components. Financial management alone without other supplementary reforms was not able to reallocate health personnel and badly affected the previously over resourced provinces. The inclusinve capitation payment had negative effects on the relationship among hospitals in the provinces, accessibility and quality of care, especially in provinces where previous relationship was poor and getting insufficient budget. The DRGs wdigted global budget payment for inpatient care provided incentives for over admission and resulted in lowering cost recovery for hospitals; this provided disincentives to improve service capabilities such as doing more complicated or difficlut surgery. However, the exclusive capitation had fewer unddesirable effects on accessibility and quality of care compared to the inclusive. Capitation payment to health facilities for promotive and preventive services provided minimal incentive in service provision. Moreover, allowing contracting units for primary care (CUPs) ato create their own reallocation mechanism b rought about confusions, financial problem and difficulty in service provision among health centers, especially in budget deficit CUPs. For further smooth policy implementation, incremental change of budget allocation which taking both demand and supply side factors into account was recommended and supplemented by an explicit policy of equitable health resources distribution. Exclusive capitation excluding salary is preferred due to fewer side effects on bebeficiaries compared to the inclusive method. A standardized payment, combining overhead and performance, was recommended to pay to health facilities within CUPs while performance based payment was preferred for promotive and preventive services.

Keywords: budget, payment, financial management, health facility, CUPs, administration, reform, resource allocation, payment method, equity, management, quality of care

ปีที่เผยแพร่/Year: 2005

Address: Health insurance office, mististry of public Health, Dental Health division, Department of Health Minsistry of Publice Health

Code: 20050000560

ISSN/ISBN: 974-506-393-2

Country of publication: Thailand.

Language: English.

Category: Abstract Journal.

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