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Additional file 1. Questionnaire (Questionnaire of the research project “Migrant children population: Child rearing, access to health services and education in Special Economic Zone (SEZ) Mae Sot, Tak Province”).

This paper assesses impacts and constraints of the implementation of universal coverage (UC) in Thailand's public health system so far in selected provinces of the northeast region. Based on incidence and findings discovered in the survey, we can draw out a depiction to explain linkages and systematic consequences of the situations from the Primary Care Units (PCUs) to secondary and tertiary level hospitals. The depiction simply describes the current situation and the impact of UC on the whole system of care provisions with specific constraints at each facility level, and illustrates the systematically negative cyclic consequences of those constraints. Due to the "primary constraints" at all facility levels - mainly because of a shortage of health workers and inadequate budget financing - the Sarng-Nam-Sorm (health promotion and disease prevention ahead of curative health care) and Klai-Baan-Klai-Jai (Health facility near dwelling) strategies of the UC policy face failures at the PCU level, which, as a result, do not reduce, but rather increase number of the patients at the hospital level. Unbearable workloads and poor equipment with a lack of specific needed professionals at most secondary level hospitals at the district level has tended to push them to more often refer inpatient cases to tertiary level hospitals in the provincial cities because it is better and safer for patients. This is often viewed by the tertiary level hospital as over-referral, and puts a tremendous burden on them in terms of physical workloads and financial cost. In this study, we explained that these impacts from facilities in lower levels to those at higher levels are "linking consequences", which will eventually negatively result backward on the lower level facilities in terms of "secondary constraints". In the long run, if no attempt is made to ease the constraints and improve the situation - mainly regarding the inadequacy of the health workforce and funding- this vicious cycle of negative consequences could collapse the whole public health care system and UC., この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。

This paper assesses a variety of views held by the Thai people residing in an area considered "rural" in the Khonkaen province of northeastern Thailand concerning the adoption in 2001 of Universal Coverage (UC) through the 30 Baht Scheme. According to findings from a questionnaire process that included casual interviews, a number of respondents expressed favorable opinions of the concepts underlying the implementation as well as its performance so far. This was especially the case with respect to lower medical expenses, qualitative improvements in health care provision, and attitudes toward the 30 Baht Scheme. Some of those covered by other health schemes, mainly the elderly who obtain their health benefits through the Civil Servant Medical Benefit Scheme (CSMBS), even mentioned a preference to be switched to the 30 Baht Scheme if it were allowed. The fixed co-payment of 30 baht per episode is seen as affordable and fairly reasonable to people across socioeconomic statuses, and therefore need not be revised. For most factors related to satisfaction with the utilisation of medical care, average scores indicate satisfaction. The "co-payment" scored the most satisfactory and "transportation costs" scored the least satisfactory.Now that they are entitled to the right to access better medical care through UC, a larger proportion of people reported that they prefer to visit public health facilities when care is needed rather than private facilities more often compared to the pre-UC period. The rate of care utilisation is also tentatively higher. In this study, an analysis of medical care expenses shows an inequitable burden of the expenses on people across three strata of income groups, which are classified by annual household income per head., この論文は国立情報学研究所の学術雑誌公開支援事業により電子化されました。

Mit Hilfe der thailändischen Sozial- und Wirtschaftsdaten aus dem Jahre 2002 untersucht der Aufsatz die Nutzenverteilung im thailändischen Gesundheitssektor. Analysiert werden die Verteilungen medizinischer Nutzen von diversen Gruppen innerhalb des thailändischen Gesundheitssystems. Die Studie kommt zu dem Ergebnis, dass der Nutzen auf jeder Ebene des Gesundheitswesens im Vergleich zur Zahlungsfähigkeit der Patienten gleich ausgeprägt ist. Bezieht man jedoch die Qualität der Einrichtungen ein, erkennt man einen ungleichen Zugang von Menschen mit unterschiedlichem sozio-ökonomischen Status. Die reiche Bevölkerung wird in Provinzkrankenhäusern, die eine bessere und spezialisiertere Behandlung ermöglichen, begünstigt. Einrichtungen mit begrenzter Behandlungsmöglichkeit wie Gesundheitszentren und Gemeinschaftskrankenhäuser behandeln hingegen eher die ärmeren Bevölkerungsschichten. Der Artikel diskutiert den ungleichen Zugang zum Gesundheitswesen, die Fehlallokation von Gesundheitsressourcen im Land, die Anwendung von Nebenzahlungen unter dem 30-Baht-Gesundheitssystem und die Überlappungen in den Zuweisungen im Allgemeinen Gesundheitssystem Thailands.