在COVID-19之前和之后的使用,口袋支付和访问:泰国的全民健康覆盖计划
Kannika Damrongplasit1, Glenn Melnick2
1Faculty of Economics and Center of Excellence for Health Economics, Chulalongkorn University, Bangkok, Thailand kannika.d@chula.ac.th.
BMJ global health
|May 13, 2024
概括
泰国的全民医疗保险计划 (UCS) 提供了公平的医疗服务,与其他在COVID-19后出现非正式支付的系统不同. 然而,一些UCS患者仍然因寻求系统之外的护理而承担自付费用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 全民健康覆盖 (UHC) 旨在确保在没有经济困难的情况下获得医疗保健.
- 在一些UHC系统中,患者向提供者进行非正式支付已经出现,由COVID-19大流行加速.
- 泰国于2001年启动的全民医疗保险计划 (UCS) 提供了政府资助的覆盖范围,成本共享最小.
研究的目的:
- 评估泰国2019年至2021年的全民健康覆盖计划 (UCS) 的表现.
- 评估患者在UCS内获得护理的机会,并与其他保险计划进行比较.
- 调查UCS内部非正式支付的出现,特别是在COVID-19的背景下.
主要方法:
- 分析泰国普遍医疗覆盖计划 (UCS) 的数据,涵盖2019-2021年期间.
- 对UCS覆盖人口的获取指标与其他公共医疗保险计划下的数据进行比较.
- 检查患者使用模式和自费支出.
主要成果:
- 泰国5300万受UCS覆盖的个人获得护理的机会与其他主要公共保险计划中的情况相美.
- 在UCS中没有发现提供商非正式支付的证据,即使是在COVID-19压力期间.
- 大约12.5%的UCS患者在UCS交付系统之外寻求护理,因此需要自付费用,这一趋势早于大流行.
结论:
- 泰国的UCS展示了有效的访问,并避免了在其他地方看到的非正式支付问题.
- 需要进一步的研究,以了解为什么相当少数UCS患者在官方系统之外承担自付费用.
- 医疗保健系统的性能需要持续评估,以确保为所有人提供全面和负担得起的护理.
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