Publication:
Government Spending and Central-Local Relations in Thailand's Health Sector

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dc.contributor.authorHawkins, Loraine
dc.contributor.authorLindelow, Magnus
dc.contributor.authorOsornprasop, Sutayut
dc.date.accessioned2013-05-28T19:23:25Z
dc.date.available2013-05-28T19:23:25Z
dc.date.issued2012-08
dc.description.abstractThis paper focuses on efficiency and equity in the financing of health services, and the evolving role of central and local government in the health sector. Thailand has seen significant improvements in health outcomes and succeeded in expanding the coverage of health protection schemes over the last decades. While the achievements of Thailand's health system are undeniable, this paper highlights three key challenges: (i) inequalities in utilization and spending under different health financing schemes and across geographic areas; (ii) mounting cost pressures; and (iii) fragmentation of financing and unresolved issues concerning the respective roles of central and local governments. This paper shows that although some of the differences in utilization and spending across schemes can be explained by the age profile of members, significant variations remain even after controlling for differences. It documents large variation in resources and spending across regions, both for the system as a whole and within the respective health financing schemes. In addition, the paper highlights pressures to increase government health spending that are primarily the result of rising spending in the Universal Coverage (UC) and Civil Servant Medical Benefit Scheme (CSMBS) schemes. Cost pressures are likely to persist due to rising incidence of chronic disease, population aging, continuing pressure from health workers for greater compensation, demands for expanded benefits under the respective schemes, and the rising expectations of patients. Finally, the paper argues for a more systematic and decisive approach to decentralization of prevention and promotion functions, based on more detailed specification of the roles and responsibilities of central and local government. It also suggests that the current approach to primary care decentralization through voluntary transfer of health centers has limited potential, and that there is a need to consider local management of networks of providers that combine both general hospital and primary care services.en
dc.identifierhttp://documents.worldbank.org/curated/en/2012/08/17398753/government-spending-central-local-relations-thailands-health-sector
dc.identifier.doi10.1596/13574
dc.identifier.urihttps://hdl.handle.net/10986/13574
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectACCESS TO HEALTH CARE
dc.subjectACCESS TO HEALTH SERVICES
dc.subjectAGE GROUPS
dc.subjectAGE STRUCTURE
dc.subjectAGED
dc.subjectAGING
dc.subjectAMBULATORY CARE
dc.subjectANTENATAL CARE
dc.subjectBRAIN
dc.subjectBRAIN DRAIN
dc.subjectBREAST CANCER
dc.subjectBUDGET ALLOCATION
dc.subjectBULLETIN
dc.subjectCAPITA HEALTH EXPENDITURE
dc.subjectCAPITATION
dc.subjectCAPITATION PAYMENT
dc.subjectCARDIOVASCULAR RISK FACTORS
dc.subjectCARE PERFORMANCE
dc.subjectCENTRAL BUDGET
dc.subjectCERVICAL CANCER
dc.subjectCHRONIC CONDITIONS
dc.subjectCHRONIC DISEASE
dc.subjectCHRONIC DISEASES
dc.subjectCITIZEN
dc.subjectCITIZENS
dc.subjectCLINICAL OUTCOMES
dc.subjectCLINICAL PRACTICE
dc.subjectCOMMUNICABLE DISEASES
dc.subjectCOMMUNITY HOSPITALS
dc.subjectCOST OF CARE
dc.subjectCURRENT POPULATION
dc.subjectDECISION MAKING
dc.subjectDEMOCRACY
dc.subjectDEMOGRAPHIC TRANSITION
dc.subjectDEPENDENCY RATIO
dc.subjectDETERMINANTS OF HEALTH
dc.subjectDIABETES
dc.subjectDIAGNOSIS
dc.subjectDISEASE MANAGEMENT
dc.subjectDISEASE PREVENTION
dc.subjectDISPARITIES IN HEALTH
dc.subjectDISSEMINATION
dc.subjectDOCTORS
dc.subjectDRUGS
dc.subjectECONOMIC GROWTH
dc.subjectECONOMIC OUTCOMES
dc.subjectECONOMIES OF SCALE
dc.subjectELDERLY
dc.subjectELDERLY POPULATION
dc.subjectEMERGENCY CARE
dc.subjectEMPLOYMENT
dc.subjectEPIDEMIOLOGICAL CHANGES
dc.subjectEPIDEMIOLOGICAL TRANSITION
dc.subjectEPILEPSY
dc.subjectEQUITY IN ACCESS
dc.subjectESSENTIAL HEALTH SERVICES
dc.subjectEXPENDITURE CONTROL
dc.subjectEXPENDITURES
dc.subjectFAMILY PLANNING
dc.subjectFAMILY PLANNING PROGRAMS
dc.subjectFEE-FOR-SERVICE
dc.subjectFERTILITY RATE
dc.subjectFINANCIAL BARRIERS
dc.subjectFINANCIAL INCENTIVE
dc.subjectFINANCIAL INCENTIVES
dc.subjectFINANCIAL MANAGEMENT
dc.subjectFINANCIAL PROTECTION
dc.subjectGENERAL PRACTITIONERS
dc.subjectGLUCOSE
dc.subjectGOVERNMENT AGENCIES
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE COSTS
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH CARE WORKERS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH FINANCING REFORM
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE SCHEMES
dc.subjectHEALTH INSURANCE SYSTEM
dc.subjectHEALTH INSURERS
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROFESSIONALS
dc.subjectHEALTH PROMOTION
dc.subjectHEALTH RESEARCH
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE UTILIZATION
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SERVICES RESEARCH
dc.subjectHEALTH SPENDING
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEM PERFORMANCE
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHEALTH WORKFORCE
dc.subjectHEALTHCARE INSTITUTIONS
dc.subjectHEALTHCARE SYSTEM
dc.subjectHEART ATTACKS
dc.subjectHOSPITAL ADMISSION
dc.subjectHOSPITAL ADMISSIONS
dc.subjectHOSPITAL BEDS
dc.subjectHOSPITAL SYSTEMS
dc.subjectHOSPITALIZATION
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectHYPERTENSION
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectIMMUNIZATIONS
dc.subjectIMPLICATIONS FOR HEALTH
dc.subjectINCOME
dc.subjectINCOME COUNTRIES
dc.subjectINFANT
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATES
dc.subjectINFERTILITY
dc.subjectINFORMAL SECTOR
dc.subjectINJURIES
dc.subjectINTERNATIONAL COMPARISONS
dc.subjectINTERNATIONAL TRADE
dc.subjectLABOR FORCE
dc.subjectLABOR MARKET
dc.subjectLEVELS OF FERTILITY
dc.subjectLIFE EXPECTANCY
dc.subjectLIFE EXPECTANCY AT BIRTH
dc.subjectLIVE BIRTHS
dc.subjectLOCAL AUTHORITIES
dc.subjectLOCAL GOVERNMENTS
dc.subjectLOW INCOME
dc.subjectMATERNAL MORTALITY
dc.subjectMATERNAL MORTALITY RATIO
dc.subjectMEDICAL BENEFIT
dc.subjectMEDICAL DOCTORS
dc.subjectMEDICAL EDUCATION
dc.subjectMEDICAL STAFF
dc.subjectMINISTRY OF EDUCATION
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMYOCARDIAL INFARCTION
dc.subjectNATIONAL HEALTH
dc.subjectNATIONAL HEALTH SYSTEMS
dc.subjectNATIONAL LEVEL
dc.subjectNUMBER OF CHILDREN
dc.subjectNUMBER OF CHILDREN PER WOMAN
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectOUTPATIENT SERVICES
dc.subjectPARTICIPATION IN DECISION
dc.subjectPATIENT
dc.subjectPATIENT PARTICIPATION
dc.subjectPATIENTS
dc.subjectPAYMENTS FOR HEALTH CARE
dc.subjectPHARMACISTS
dc.subjectPHO
dc.subjectPOCKET PAYMENTS
dc.subjectPOLICY RESPONSE
dc.subjectPOPULATION DISTRIBUTION
dc.subjectPOPULATION PROJECTIONS
dc.subjectPREVENTIVE HEALTH SERVICES
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIVATE HEALTH INSURANCE
dc.subjectPRIVATE HOSPITAL SECTOR
dc.subjectPRIVATE HOSPITALS
dc.subjectPRIVATE INSURANCE
dc.subjectPRIVATE SECTOR
dc.subjectPRIVATE SPENDING
dc.subjectPROGNOSIS
dc.subjectPROGRESS
dc.subjectPROVIDER PAYMENT
dc.subjectPROVINCIAL HOSPITALS
dc.subjectPUBLIC DEMAND
dc.subjectPUBLIC EXPENDITURE
dc.subjectPUBLIC EXPENDITURE ON HEALTH
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH EXPENDITURE
dc.subjectPUBLIC HEALTH SYSTEM
dc.subjectPUBLIC HOSPITAL
dc.subjectPUBLIC HOSPITAL SYSTEMS
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC PROVIDERS
dc.subjectPUBLIC SECTOR
dc.subjectQUALITY OF HEALTH
dc.subjectQUALITY SERVICES
dc.subjectRESEARCH INSTITUTIONS
dc.subjectRESOURCE ALLOCATION
dc.subjectRISK FACTORS
dc.subjectRURAL AREAS
dc.subjectRURAL POPULATION
dc.subjectSEGMENTS OF SOCIETY
dc.subjectSERVICE DELIVERY
dc.subjectSHARE OF HEALTH SPENDING
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSOCIAL SECURITY
dc.subjectSURGERY
dc.subjectSURVIVAL RATE
dc.subjectTREATMENT
dc.subjectUNFPA
dc.subjectURBAN AREAS
dc.subjectURBANIZATION
dc.subjectVACCINES
dc.subjectWORKERS
dc.subjectWORLD HEALTH ORGANIZATION
dc.subjectWORLD POPULATION
dc.subjectdecentralization
dc.titleGovernment Spending and Central-Local Relations in Thailand's Health Sectoren
dspace.entity.typePublication
okr.date.disclosure2013-03-01
okr.date.doiregistration2025-05-05T12:18:43.757140Z
okr.doctypePublications & Research::Working Paper
okr.doctypePublications & Research
okr.docurlhttp://documents.worldbank.org/curated/en/2012/08/17398753/government-spending-central-local-relations-thailands-health-sector
okr.globalpracticeHealth, Nutrition, and Population
okr.guid403181468123903442
okr.identifier.externaldocumentum000333037_20130301110543
okr.identifier.internaldocumentum17398753
okr.identifier.report75680
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2013/03/01/000333037_20130301110543/Rendered/PDF/756800WP0GovtS00Box374342B00PUBLIC0.pdfen
okr.region.administrativeEast Asia and Pacific
okr.region.countryThailand
okr.topicHealth Economics and Finance
okr.topicHealth, Nutrition and Population::Population Policies
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicDisease Control and Prevention
okr.topicHealth
okr.topicNutrition and Population
okr.unitHealth, Nutrition & Popultn Team (HDNHE)
okr.volume1 of 1
relation.isAuthorOfPublicationd6df2a53-bb3c-5376-8494-5d7b3af636f6
relation.isAuthorOfPublication.latestForDiscoveryd6df2a53-bb3c-5376-8494-5d7b3af636f6
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