Mee-Udon Farung
Int J Health Care Qual Assur. 2014;27(6):456-67. doi: 10.1108/IJHCQA-11-2012-0111.
The purpose of this paper is to investigate the extent to which the Thai Universal Healthcare Insurance Coverage Scheme (UC) has contributed to villagers' well-being in the northeast of Thailand. Public opinion polls specifically advocate the schemes are used to justify its ongoing political support. However, the question still remains as to whether it has made a difference in the lives of poorer rural people.
DESIGN/METHODOLOGY/APPROACH: A multi-methods approach and a well-being focused evaluation (WFE) approach are used to understand villagers' experiences of having and using the scheme and investigate the villagers' satisfaction with the scheme and how this satisfaction has contributed to their life as a whole.
It is found that the scheme had made a valuable contribution to improving perceived wellbeing amongst villagers. Apart from the direct benefits of having that healthcare when needed, there is also the indirect benefit of increasing villagers' sense of security that healthcare will be accessible if required.
RESEARCH LIMITATIONS/IMPLICATIONS: There are still pertinent issues for policy consideration; for example, almost 31 per cent of the villagers with the card have never used it. Approximately 22 per cent of people using the card reported dissatisfactions. Although healthcare direct-costs were now more affordable, a range of opportunity costs, geographic, social, cultural and other factors still need to be factored into further policy and service development to make the scheme more equitable and effective.
ORIGINALITY/VALUE: The study proposes "WFE", a new evaluation approach. WFE may also be applied to other forms of social policy particularly concerning the impact of its policy on people's well-being.
本文旨在研究泰国全民医疗保险覆盖计划(UC)对泰国东北部村民福祉的贡献程度。民意调查特别主张将该计划用作其持续获得政治支持的理由。然而,该计划是否对较贫困农村人口的生活产生了影响这一问题仍然存在。
设计/方法/途径:采用多方法途径和以福祉为重点的评估(WFE)方法,以了解村民拥有和使用该计划的经历,并调查村民对该计划的满意度以及这种满意度如何对他们的整体生活做出贡献。
研究发现,该计划对提高村民的感知福祉做出了宝贵贡献。除了在需要时获得医疗保健的直接好处外,还有间接好处,即增强了村民在需要时能够获得医疗保健的安全感。
研究局限性/启示:仍有一些相关问题需要政策考虑;例如,近31%持有该卡的村民从未使用过。约22%使用该卡的人表示不满意。尽管医疗保健的直接成本现在更可承受,但一系列机会成本、地理、社会、文化和其他因素仍需纳入进一步的政策和服务发展中,以使该计划更加公平和有效。
原创性/价值:该研究提出了“WFE”,一种新的评估方法。WFE也可应用于其他形式的社会政策,特别是关于其政策对人们福祉的影响。