Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.
J Prev Med Public Health. 2021 Mar;54(2):129-136. doi: 10.3961/jpmph.20.318. Epub 2021 Mar 4.
This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand.
The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis.
Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were-in descending order of frequency-insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors.
Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.
本研究探讨了阻碍人们在医院获得医疗服务的人口因素,并提出了改善泰国医疗管理的政策方法。
本研究的数据来自泰国国家统计局于 2017 年进行的一项健康和福利调查。这项基于人口的健康和福利调查由熟练的访谈员系统地进行,共调查了 21519384 人。人口统计学数据(年龄、性别、宗教、婚姻状况、教育、职业和居住地区)、慢性病和医疗保险覆盖范围等相关的自变量。因变量是获得医疗服务的程度。随后对单因素分析中发现的有统计学意义的变量进行多因素逻辑回归分析。
仅有 2.5%的人在需要门诊治疗、住院或口腔保健时不去医院。人们生病时不去政府医院就诊的主要原因按频率降序排列依次为:没有时间去就诊、医院排队时间长、交通不便、医院床位不足、没有牙医、没有人陪伴以及无法支付交通费用。多因素逻辑回归分析表明,无法获得医院提供的卫生服务与人口统计学、教育、职业、健康福利和地理位置因素有关。
可及性不仅取决于健康和福利保障的覆盖范围,还取决于与就医便利性相关的社会经济因素。