Utilisation, out-of-pocket payments and access before and after Covid-19

The goal of Universal Health Coverage (UHC) is that everyone needing healthcare can access quality services without financial hardship. Recent research covering countries with UHC systems documents the emergence, and acceleration following the COVID-19 pandemic of unapproved informal payment systems by providers that collect under-the-table payments from patients. In 2001, Thailand extended its ‘30 Baht’ government-financed coverage to all uninsured people with little or no cost sharing. In this paper, we update the literature on the performance of Thailand’s Universal Health Coverage Scheme (UCS) with data covering 2019 (pre-COVID-19) through 2021. We find that access to care for Thailand’s UCS-covered population (53 million) is similar to access provided to populations covered by the other major public health insurance schemes covering government and private sector workers, and that, unlike reports from other UHC countries, no evidence that informal side payments have emerged, even in the face of COVID-19 related pressures. However, we do find that nearly one out of eight Thailand’s UCS-covered patients seek care outside the UCS delivery system where they will incur out-of-pocket payments. This finding predates the COVID-19 pandemic and suggests the need for further research into the performance of the UHC-sponsored delivery system

Business · Disease · Economic growth · Economics · Environmental health · Health care · Pandemic · Payment · Population · Universal design · Global Health Care Issues · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Finance

• Reducing private health expenditure in Greece

  Open Access•Stefanos Karakolias, Miltiadis Nektarios et al.•Frontiers in Public Health•2026

  Incluir item

• Who Will Take Care of Us When We Get Older Than This?”

  Open Access•Suchon Tepjan, P A Newman et al.•Sexuality Research and Social…•2026

  Incluir item

• The role of telehealth during Covid-19 outbreak

  Open Access•Elham Monaghesh, Alireza Hajizadeh•BMC Public Health•2020

  Incluir item

• Informal Payments And The Financing Of Health Care In Developing And Transition Countries

  Maureen Lewis•Health Affairs•2007

  Incluir item

• Covid-19 and resilience of healthcare systems in ten countries

  Open Access•Catherine Arsenault, Anna D Gage et al.•Nature Medicine•2022

  Incluir item

• Health systems development in Thailand

  Open Access•Viroj Tangcharoensathien, Woranan Witthayapipopsakul et al.•The Lancet•2018

  Incluir item

• Impact of Covid-19 pandemic on utilisation of healthcare services

  Open Access•Ray Moynihan, Sharon Sanders et al.•BMJ Open•2021

  Incluir item

• How Jaminan Kesehatan Nasional (JKN) coverage influences out-of-pocket (OOP) payments by vulnerable populations in Indonesia

  Open Access•Nirwan Maulana, Prastuti Soewondo et al.•PLOS Global Public Health•2022

  Incluir item

• The Impact of Health Insurance Programs on Out-of-Pocket Expenditures in Indonesia

  Open Access•Budi Aji, Manuela De Allegri et al.•International Journal of…•2013

  Incluir item

• Health Services Utilization in China during the Covid-19 Pandemic

  Open Access•Wei Xia, Haowen Yuan et al.•International Journal of…•2022

  Incluir item

• Formalizing under-the-table payments to control out-of-pocket hospital expenditures in Cambodia

  Open Access•S Barber, Sarah Louise Barber•Health Policy and Planning•2004

  Incluir item

• Unofficial Fees in Bangladesh

  Open Access•James R Killingsworth, Naomi Hossain et al.•Health Policy and Planning•1999

  Incluir item

• Trends in out-of-pocket payments for health care in Kyrgyzstan, 2001-2007

  Open Access•Jane Falkingham, Baktygul Akkazieva et al.•Health Policy and Planning•2010

  Incluir item