A case study integrating scenario thinking with dialysis policymaking in Thailand

Area of Science:

• Health Policy Analysis
• Futures Studies in Healthcare
• Health Systems Strengthening

Background:

• Healthcare policymaking faces challenges in addressing future uncertainties, especially concerning infrastructure and stakeholder behavior.
• Scenario thinking, a method for exploring plausible futures, is underutilized in healthcare policy development.
• This study applied scenario thinking to Thailand's 2024 dialysis policy to navigate future uncertainties.

Purpose of the Study:

• To apply scenario thinking to guide healthcare policymaking under future uncertainty.
• To evaluate the robustness of policy options across different future scenarios.
• To assess the utility of scenario thinking within the healthcare policy process.

Main Methods:

• Scenario development using the intuitive logics and critical scenario methods.
• Policy analysis to evaluate the robustness of options across developed scenarios.
• Evaluation of the scenario thinking approach using fitness-for-purpose, influence, and efficiency indicators.

Main Results:

• Four scenarios were developed based on kidney transplant accessibility and skilled workforce availability.
• Patient approval prior to dialysis and quality monitoring can enhance dialysis program adaptability.
• Uncertainty remains regarding the performance of service provider payment mechanisms; scenario thinking proved efficient for characterizing uncertainty.

Conclusions:

• Scenario thinking offers a systematic framework for evaluating healthcare policies under future uncertainty, leading to more robust policy outcomes.
• Adaptations were developed to integrate scenario thinking with existing healthcare policy processes and standards.
• Further research is recommended to facilitate the broader adoption of scenario thinking in healthcare policymaking.