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内容記述 |
Background: To promote affordable healthcare to the entire population, Thailand introduced Universal Health Coverage (UHC) in 2002. The number of the older population has increased as a whole in countries where UHC has been successfully implemented. Thus, the Thai government deemed imperative to establish a long-term care program (LTC) for the dependent elderly covered by a Universal Coverage Scheme (UCS), which is administered by the National Health Security Office (NHSO) in Thailand. In 2016, the budget was approved and allocated to local governments to provide LTC services at homes and in community settings.: Objectives: This project aims to evaluate the impact of the Thailand LTC program implemented between 2016 - 2019 and the extent to which its goals were achieved in 2019.: Methods: Budget data obtained from the NHSO were reviewed. Interviews were conducted with NHSO’s officers and formal caregivers from Sainoi Community Hospital to determine the scheme’s successes, failures, and challenges.: Results: from 2016 – 2019, the cumulative number of certified elderly participating in the program increased from 80,826 to 219,518 (36.82%). The number of local governments registered in the program increased every year. Of 7,776 local governments in Thailand, there were only 7,738 local governments that had local health funds system to support the program. In 2016, there were only 1,752 (22.64%) local health funds that: BUDGET IMPACTS: THAILAND’S LONG-TERM CARE POLICY : participated in the program, and it increased to 6,003 (77.58%) in 2019. The budget approved increases from 600 million baht in 2016 to 1,159.20 million baht in 2018, but then it fell to 916.80 million baht in 2019. The actual budget allocated to local governments was lower than what had been approved.: Conclusion: The LTC program in 2019 could not achieve its goals because the local governments could not spend all the budget allocated; the main reasons being unclear financial rules of the national government, as well as the difficulty in finding LTC providers. The local governments were not certain about the extent the payment was covered by the LTC fund. Because the government was concerned about the unspent budget in 2019, the NHSO decreased budget requests to the local governments. Both parties made a concrete effort to solve the problems in the fiscal year 2020.: Keyword: Budget impacts, Long-term care, dependent elderly in Thailand |
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論文要旨 (301.7 kB)
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