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Purchasing Community-Based Long-Term Care Services Under Thailand's Universal Coverage Scheme: A Provider's
Aungsumalee Pholpark1, Samrit Srithamrongsawat2
1Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.
Summary
Community-based long-term care (CBLTC) in Thailand faces challenges like budget limits and caregiver payment issues. Improving purchasing arrangements is crucial for supporting older adults and family caregivers under the Universal Coverage Scheme (UCS).
Area of Science:
- Health Services Research
- Public Health Policy
- Gerontology
Background:
- Thailand's Universal Coverage Scheme (UCS) includes community-based long-term care (CBLTC) to support aging populations.
- CBLTC aims to improve quality of life for dependent older adults and aid family caregivers.
Purpose of the Study:
- To examine community-based long-term care (CBLTC) purchasing arrangements at the subdistrict level in Thailand.
- To identify challenges within these purchasing arrangements under the Universal Coverage Scheme (UCS).
Main Methods:
- Qualitative case study utilizing a health financing framework.
- Semi-structured interviews with 40 key informants across subdistricts and regional/central levels.
- Thematic analysis using inductive and deductive approaches.
Main Results:
- Significant challenges identified in CBLTC purchasing: budget constraints and inadequate volunteer caregiver compensation.
- Misalignment exists between outlined service benefits and actual service provision.
- A lack of a robust monitoring system hinders effective CBLTC implementation.
Conclusions:
- Improvements are needed in CBLTC purchasing arrangements within Thailand's UCS.
- Enhancing provider payment mechanisms is essential for efficiency.
- Addressing identified challenges will better support dependent older adults and family caregivers.
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