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泰国未满足的医疗保健需求的流行情况和特征。

Prevalence and profiles of unmet healthcare need in Thailand.

机构信息

International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand.

出版信息

BMC Public Health. 2012 Oct 30;12:923. doi: 10.1186/1471-2458-12-923.

Abstract

BACKGROUND

In the light of the universal healthcare coverage that was achieved in Thailand in 2002, policy makers have raised concerns about whether there is still unmet need within the population. Our objectives were to assess the annual prevalence, characteristics and reasons for unmet healthcare need in the Thai population in 2010 and to compare our findings with relevant international literature.

METHODS

A standard set of OECD unmet need questionnaires was used in a nationally-representative household survey conducted in 2010 by the National Statistical Office. The prevalence of unmet need among respondents with various socio-economic characteristics was estimated to determine an inequity in the unmet need and the reasons behind it.

RESULTS

The annual prevalence of unmet need for outpatient and inpatient services in 2010 was 1.4% and 0.4%, respectively. Despite this low prevalence, there are inequities with relatively higher proportion of the unmet need among Universal Coverage Scheme members, and the poor and rural populations. There was less unmet need due to cost than there was due to geographical barriers. The prevalence of unmet need due to cost and geographical barriers among the richest and poorest quintiles were comparable to those of selected OECD countries. The geographical extension of healthcare infrastructure and of the distribution of health workers is a major contributing factor to the low prevalence of unmet need.

CONCLUSIONS

The low prevalence of unmet need for both outpatient and inpatient services is a result of the availability of well-functioning health services at the most peripheral level, and of the comprehensive benefit package offered free of charge by all health insurance schemes. This assessment prompts a need for regular monitoring of unmet need in nationally-representative household surveys.

摘要

背景

2002 年,泰国实现了全民医保,政策制定者开始关注民众是否仍存在未满足的医疗需求。本研究旨在评估 2010 年泰国人口的年度未满足医疗需求的患病率、特征和原因,并与相关国际文献进行比较。

方法

2010 年,国家统计局采用经合组织(OECD)设定的一套标准未满足需求问卷,在全国范围内开展了一项家庭调查。本研究估计了具有不同社会经济特征的受访者的未满足需求的患病率,以确定未满足需求及其背后的原因是否存在不公平现象。

结果

2010 年,门诊和住院服务的年度未满足需求患病率分别为 1.4%和 0.4%。尽管患病率较低,但全民医保计划成员和贫困及农村人口的未满足需求比例相对较高,存在不公平现象。由于费用导致的未满足需求比例小于由于地理障碍导致的未满足需求比例。最富有和最贫穷五分之一人口的由于费用和地理障碍导致的未满足需求的患病率与部分经合组织国家的水平相当。医疗基础设施和卫生工作者分布的地理延伸是导致未满足需求低患病率的主要因素。

结论

门诊和住院服务的未满足需求的低患病率是由于最偏远地区的卫生服务运作良好,以及所有医疗保险计划免费提供全面的福利套餐所致。本评估提示需要定期在全国代表性家庭调查中监测未满足需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e33/3534405/08f875f0d6de/1471-2458-12-923-1.jpg

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