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Assoc.Prof.Wilawan Senaratana
Faculty of Nursing,
Chiang Mai University
Health Care System
In Thailand
Outline of presentation
• Health definition and health dimensions
• Health system
• Goal of health care system
• Why healt...
Health is a stage of complete physical
mental, social and spiritual well being not
merely absence of disease and infirmity...
Health
State of human being which is perfect in
physical, mental, spiritual and social aspects
all of which are holistic i...
What is holistic health ?
Health dimension - Physical mental
psychosocial and spiritual
Host dimension - Individual groups...
Health
Individual Environment
Health
System
Genetics
Behaviors
Beliefs
Spirituality
Physical/Biological Factors
Culture/Re...
Health system
• Health care institution
• Health resources
• Health care management
• Health care services
Health care dimension
• Self care 70-80%
• Modern medicine 10-20%
• Alternativecare 10%
Five Level of Health Service System in Thailand
Self Care
PHC
Primary Care
Secondary Care
Excellence Center
Tertiary
Famil...
Goal of Health Care System
1. To maximize the qualityof health care
2. To minimize the nationalexpenditureson
health care
...
Why health system reform is needed?
1. Health is separated system not holistic focusing on
biomedical health system not bi...
Movement in health system reform process
Using Triangle that moves the mountain strategy by
Dr. Prawase Wasee
1. Knowledge...
1992 Health system Research Institute (HSRI)
was established and Act was enacted
1997 Thailand had a new constitution
Jan ...
March 2000 Establishment of National Health System
Reform Commission and HSRO to get
the reform function completed within ...
2000-2002
- More than 100 public forums were held nationwide
- holding 500 public forums were held networks districts
and ...
2002 – 2005 Several forums or session of health assemblieswere
held and follow up and review the major issue of
the major ...
Jan 2007 NHB was deliberated by the National
Legislative Assembly in its second and
passed into law in its third reading
1...
Health Social and Political Reform
Political reform
- Autonomous Organization
- GoodGovernance
- Participation
Delegate
au...
1997 Thailand had a new constitution which in
section 52 specify the accessibility to quality
health care for all Thai peo...
Aim of UC
• Quality health service
• equity in accessibility
• Efficient health services
• Choice for health service
• Goo...
The principles of UC of health care
• Universal Coverage
• All Thai citizens receive health care according to the
standard...
Community Hospital Under UC
CUP - Contracting unit for primary care
Roles : Provide medical care to the registered and
set...
Health Center
Care provider at tambon / village level 1,000 - <10,000
population
Personnel: RN, Public health officer, Mid...
Recent Policy
• Tambon Health Promoting Hospital
• Leverage HC to Tombon Hospital and set up
referral system and networkin...
Thailand Health Profile 2007
2007 The 30 baht scheme health care
policy was replaced by full public
aid policy of the new government
Achievements of Universal Health Care Scheme
• UC has revealed that it is a good project and beneficial for
the people esp...
The national health security office budget
Types of expenses (forfiscal year) 2010 2011
1 Inpatientand Outpatientservices
...
Health system in thailand by wilawan senaratana
Health system in thailand by wilawan senaratana
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Health system in thailand by wilawan senaratana

  1. 1. Assoc.Prof.Wilawan Senaratana Faculty of Nursing, Chiang Mai University Health Care System In Thailand
  2. 2. Outline of presentation • Health definition and health dimensions • Health system • Goal of health care system • Why health system reform is needed • National health security
  3. 3. Health is a stage of complete physical mental, social and spiritual well being not merely absence of disease and infirmity. (WHO)
  4. 4. Health State of human being which is perfect in physical, mental, spiritual and social aspects all of which are holistic in balance.(Section 3, National Health Act)
  5. 5. What is holistic health ? Health dimension - Physical mental psychosocial and spiritual Host dimension - Individual groups families and communities Health care dimension - : - Prevention Promotion - Curative and Rehabilitation
  6. 6. Health Individual Environment Health System Genetics Behaviors Beliefs Spirituality Physical/Biological Factors Culture/Religion Population/Education Security Communication and Transportation Technology Economy/Politics Quality/Efficiency Public/Private Equity/Coverage Type and level of service Dynamics FACTORS RELATED TO HEALTH
  7. 7. Health system • Health care institution • Health resources • Health care management • Health care services
  8. 8. Health care dimension • Self care 70-80% • Modern medicine 10-20% • Alternativecare 10%
  9. 9. Five Level of Health Service System in Thailand Self Care PHC Primary Care Secondary Care Excellence Center Tertiary Family Village Sub -Districts Districts Province Health Center Community hospital Universities hospital General, Regional
  10. 10. Goal of Health Care System 1. To maximize the qualityof health care 2. To minimize the nationalexpenditureson health care 3. To achieve equitable distributionof quality health care and burden of costs
  11. 11. Why health system reform is needed? 1. Health is separated system not holistic focusing on biomedical health system not biosocial health system 2. Changes in health issues and diseases 3. Issue in quality accessibility and equity of health care 4. Emphasis on curative care with high cost 5. Limitation of people participation
  12. 12. Movement in health system reform process Using Triangle that moves the mountain strategy by Dr. Prawase Wasee 1. Knowledge building and management 2. Social mobilization 3. Political Support
  13. 13. 1992 Health system Research Institute (HSRI) was established and Act was enacted 1997 Thailand had a new constitution Jan 2000 Established the National Health System Reform office (HSRO)
  14. 14. March 2000 Establishment of National Health System Reform Commission and HSRO to get the reform function completed within 3 years
  15. 15. 2000-2002 - More than 100 public forums were held nationwide - holding 500 public forums were held networks districts and provinces level - Synthesis and draft National Health Bill Dec 2002 - National Health Bill was accepted for consideration by the cabinet
  16. 16. 2002 – 2005 Several forums or session of health assemblieswere held and follow up and review the major issue of the major issue of the proposed NHB and revised Dec 2005 NHB in its first reading Feb 2006 Dissolution of Parliament the NHB have to wait for the following House of Representatives Sept 2006 There was a coup this resulting in the dropping of NHB
  17. 17. Jan 2007 NHB was deliberated by the National Legislative Assembly in its second and passed into law in its third reading 19 March 2007 The National Health Act was published in The Government Gazette
  18. 18. Health Social and Political Reform Political reform - Autonomous Organization - GoodGovernance - Participation Delegate authority (1999) - Government System reform - Downsizing and good government Social reform - Educational Act 1999 - Learning reform Health system reform -Thinking paradigm -System -Activities Networking Public forum NGO Healthy Community New Constitution 1997 Globalization Economicand social crisis 1997 Economic reform People participation
  19. 19. 1997 Thailand had a new constitution which in section 52 specify the accessibility to quality health care for all Thai people National Health Security Office was establishedin 2003
  20. 20. Aim of UC • Quality health service • equity in accessibility • Efficient health services • Choice for health service • Good Health for All
  21. 21. The principles of UC of health care • Universal Coverage • All Thai citizens receive health care according to the standardized benefit package • There is a master plan and coordinating mechanism for all agencies, financial and institutional sustainability
  22. 22. Community Hospital Under UC CUP - Contracting unit for primary care Roles : Provide medical care to the registered and set up supporting system for PCU in the network , personnel, medicine medical devices / communication system technical support and quality control
  23. 23. Health Center Care provider at tambon / village level 1,000 - <10,000 population Personnel: RN, Public health officer, Midwife and Dental nurseRoles: • Integrated public health services Health promotion, Disease prevention primary medical treatment for common disease and referral system • Support primary health care • Basic dental care • Home visit
  24. 24. Recent Policy • Tambon Health Promoting Hospital • Leverage HC to Tombon Hospital and set up referral system and networking with private sector
  25. 25. Thailand Health Profile 2007
  26. 26. 2007 The 30 baht scheme health care policy was replaced by full public aid policy of the new government
  27. 27. Achievements of Universal Health Care Scheme • UC has revealed that it is a good project and beneficial for the people especially the poor • Community hospital and health center has translated policies in to action in a concrete manner effectively, easily accessible, good quality • It is necessarythat the budgetand human resources be adequate and suitable
  28. 28. The national health security office budget Types of expenses (forfiscal year) 2010 2011 1 Inpatientand Outpatientservices 1.1 Inpatientand outpatientservices (Includingspecial areas) 1.2 Services forspecific diseases 1,940.29 25.56 2,062.29 30.22 2 Disease preventionand healthcare promotion 271.79 242.92 3 Medical rehabilitationservice 5 7.83 4 Maintenance 148.69 148.69 5 Compensationfor medical errors underarticle 41 ofNational Health Security Act Remaining 2.68 6 Payment related to the qualityof services performedbyhealthcare unit 5 5 7 Essential drugsand neglected drugs 5 7.6 8 Dental services Includingthe spendingoninpatient andoutpatient services, disease preventionandhealthcare promotion 39.25 9 Pre-hospital emergencymedical services Set upby National Emergency Medical Service Centre 10 Payment forspecial allowance to medical workers underPublic Health Ministry 60.92 Need to conductstudy and proposeto cabinet Total budget excluding (10) 2,401.33 2,546.48 The total budget 2,462.25 2,546.48 Source : National Health Social Office

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