Last updated Siriraj Hospital, Bangkok, the oldest and largest hospital in Thailand, also the teaching hospital of the first medical college
Healthcare in Thailand is overseen by the Ministry of Public Health (MOPH), along with several other non-ministerial government agencies. Thailand's network of public hospitals provide universal healthcare to all Thai nationals through three government schemes. Private hospitals help complement the system, especially in Bangkok and large urban areas, and Thailand is among the world's leading medical tourism destinations. However, access to medical care in rural areas still lags far behind that in the cities.
As of 2019[update], Thailand's population of 68 million is served by 927 government hospitals and 363 private hospitals with 9,768 primary care health units (SHPH clinics), responsible for Thai citizens’ health at the sub-district level.[1] SHPH has played a significant role in the Thai public health. Additionally, there are 25,615 private clinics.[2]
Universal health care is provided through three programs: the civil service welfare system for civil servants and their families, Social Security for private employees, and the universal coverage scheme, introduced in 2002, which is available to all other Thai nationals.[3] Some private hospitals are participants in the programs, but most are financed by patient self-payment and private insurance. According to the World Bank, under Thailand’s health schemes, 99.5 percent of the population have health protection coverage.[4]
The MOPH oversees national health policy and also operates most government health facilities. The National Health Security Office (NHSO) allocates funding through the universal coverage program. Other health-related government agencies include the Health System Research Institute (HSRI), Thai Health Promotion Foundation ("Thai Health"), National Health Commission Office (NHCO), and the Emergency Medical Institute of Thailand (EMIT). Although there have been national policies for decentralization, there has been resistance in implementing such changes and the MOPH still directly controls most aspects of health care.
Thailand introduced universal coverage reforms in 2001, one of only a handful of lower-middle income countries to do so. Means-tested health care for low-income households was replaced by a new and more comprehensive insurance scheme, originally known as the 30 baht project, in line with the small co-payment charged for treatment. People joining the scheme receive a gold card, which allows them to access services in their health district and, if necessary, to be referred for specialist treatment elsewhere.[4]
The bulk of health financing comes from public revenues, with funding allocated to contracting units for primary care annually on a population basis. According to the WHO, 65 percent of Thailand's health care expenditure in 2004 came from the government, while 35 percent was from private sources. Thailand achieved universal coverage with relatively low levels of spending on health, but it faces significant challenges: rising costs, inequalities, and duplication of resources.[4][5]
Although the reforms have received a good deal of criticism, they have proved popular with poorer Thais, especially in rural areas, and they survived the change of government after the 2006 military coup. Then, Public Health Minister, Mongkol Na Songkhla, abolished the 30 baht co-payment and made the scheme free. It is not yet clear whether the scheme will be modified further under the military government that came to power in May 2014.[6][7][8]
In 2009, annual spending on health care amounted to 345 international dollars per person in purchasing power parity (PPP). Total expenditures represented about 4.3 percent of gross domestic product (GDP). Of this amount, 75.8 percent came from public sources and 24.2 percent from private sources. Physician density was 2.98 per 10,000 population in 2004, with 22 hospital beds per 100,000 population in 2002.[9]
Data for utilization of health services in 2008 includes: 81 percent contraceptive prevalence, 80 percent ante-natal care coverage with at least four visits, 99 percent of births attended by skilled health personnel, 98 percent measles immunization coverage among one-year-olds, and 82 percent success in treatment of smear-positive tuberculosis. Improved drinking-water sources were available to 98 percent of the population, and 96 percent were using improved sanitation facilities.[10]
Most hospitals in Thailand are operated by the Ministry of Public Health. Private hospitals are regulated by the Medical Registration Division. Other government units and public organizations also operate hospitals, including the military, universities, local governments and the Red Cross.
Health Districts
Different provinces in Thailand are arranged into different health districts by region. Each health district is responsible for about 3-6 million people living in those provinces. It aims to provide better quality medical services for citizens within that region and increased efficiency in terms of transferring patients to other hospitals if there is a lack in capability of care within that district. Health districts in Thailand are organized into the following categories, as of August 2017:[11][12]
Thailand has an unconventional approach to providing first responders in an emergency: it sends volunteers. Some 65 percent of emergency cases in Bangkok are handled by volunteers. Fully equipped ambulances with professional staff are sent only if required.[13]
There are three levels of medical emergency help in Thailand, from first responder (FR) level to basic life support (BLS) level, and advanced life support (ALS) level. Most volunteers have attained the FR level. They are affiliated with foundations and local administrative bodies.[14] Thailand's Medical Emergency Hotline center responds to about 1.5 million medical emergencies each year. About a million involved FR teams transporting patients to medical facilities. BLS and ALS teams handled about 200,000 cases each.[14]
Two organizations, the Poh Teck Tung Foundation and the Ruamkatanyu Foundation[th] are the two largest free first responders in Bangkok. They rely on private donations, but sometimes volunteers must use their own money to buy vehicles, gas, uniforms, and medical equipment. Volunteers are not allowed to accept money from hospitals or from victims. The volunteers say they do this to help people or as a way to earn karma for the next life.[13] The training level of volunteers is not high, just 24 hours. The National Institute of Emergency Medicine (NIEMS) is seeking to increase minimum training to 40 hours, a move initially opposed by the Rescue Network of Thailand, an association of voluntary first responders.[14]
Not all first responder organizations are altruistic. Significant money must be at stake[citation needed] as, sometimes, competition for patients between organizations leads to turf wars and even gun play.[15]
For much of its history, rural areas in Thailand were under-served medically. Rural health centers failed to attract health workers as they could not compete with urban areas offering higher salaries and more social amenities. The government, in 1975, launched a medical welfare scheme for poor and vulnerable citizens, both rural and urban. They trained health workers specifically to work in rural areas. Government policy-makers later required all doctors trained in Thailand to start their careers by working in rural hospitals before moving to urban hospitals. The Medical Council of Thailand runs the three-year national internship program that almost all medical school graduates must participate in, which is a criterion for further residency training. In 1992, the Collaborative Project to Increase Rural Doctor (CPIRD) Program was introduced by the Ministry of Public Health and Ministry of Education in order to increase the number of doctors in rural areas.
To control brain drain, a frequent occurrence in the 1980s, they stopped training medical personnel in English and created good working environments in rural areas. These measures have only been partially successful: in 2009, a study found that there was one physician per 565 persons in Bangkok, but only one physician per 2,870 persons in Isan.[16]As of 2019[update], Thailand produces 3,000 doctors yearly at 40 medical education centers.[2]
A certified first responder is a person who has completed a course and received certification in providing pre-hospital care for medical emergencies. Certified individuals should have received much more instruction than someone who is trained in basic first aid and cardiopulmonary resuscitation (CPR) but they are not necessarily a substitute for more advanced emergency medical care rendered by emergency medical technicians and paramedics. First responders typically provide advanced first aid level care, CPR, and automated external defibrillator (AED) usage. The term "certified first responder" is not to be confused with "first responder", which is a generic term referring to the first medically trained responder to arrive on scene and medically trained telecommunication operators who provide pre-arrival medical instructions as trained Emergency Medical Dispatchers (EMD). Many police officers and firefighters are required to receive training as certified first responders. Advanced medical care is typically provided by EMS, although some police officers and firefighters also train to become emergency medical technicians or paramedics.
A public hospital, or government hospital, is a hospital which is government owned and is fully funded by the government and operates solely off the money that is collected from taxpayers to fund healthcare initiatives. In almost all the developed countries but the United States of America, and in most of the developing countries, this type of hospital provides medical care free of charge to patients, covering expenses and wages by government reimbursement.
Tourism is an economic contributor to the Kingdom of Thailand. Estimates of tourism revenue directly contributing to the GDP of 12 trillion baht range from one trillion baht (2013) 2.53 trillion baht (2016), the equivalent of 9% to 17.7% of GDP. When including indirect travel and tourism receipts, the 2014 total is estimated to be the equivalent of 19.3% of Thailand's GDP. The actual contribution of tourism to GDP is lower than these percentages because GDP is measured in value added not revenue. The valued added of the Thailand's tourism industry is not known. According to the secretary-general of the Office of the National Economic and Social Development Council in 2019, the government projects that the tourism sector will account for 30% of GDP by 2030, up from 20% in 2019,Thailand expects to receive 80 million visitors in 2027.
Healthcare in Malaysia is mainly under the Ministry of Health. Malaysia generally has an efficient and widespread system of health care, operating a two-tier health care system consisting of both a government base universal healthcare system and a co-existing private healthcare system. While there is a universal healthcare system, specialist services require queuing despite being free. Hence the private health care plays a major role in providing specialist services which complements the universal health care.
Healthcare in Singapore is under the purview of the Ministry of Health of the Government of Singapore. It mainly consists of a government-run publicly funded universal healthcare system as well as a significant private healthcare sector. Financing of healthcare costs is done through a mixture of direct government subsidies, compulsory comprehensive savings, national healthcare insurance, and cost-sharing.
As literacy and socioeconomic status improves in Ethiopia, the demand for quality service is also increasing. Besides, changes in the demographic trends, epidemiology and mushrooming urbanization require more comprehensive services covering a wide range and quality of curative, promotive and preventive services.
Healthcare in Laos is provided by both the private and public sector. It is limited in comparison with other countries. Western medical care is available in some locations, but remote areas and ethnic groups are underserved. Public spending on healthcare is low compared with neighbouring countries. Still, progress has been made since Laos joined the World Health Organization in 1950: life expectancy at birth rose to 66 years by 2015; malaria deaths and tuberculosis prevalence have plunged; and the maternal mortality ratio (MMR) has declined by 75 percent.
The Ministry of Interior of the Kingdom of Thailand is a cabinet-level department in the Government of Thailand. The ministry has wide ranging responsibilities. It is responsible for local administration, internal security, citizenship, disaster management, road safety, land management, issuance of national identity cards, and public works. The ministry is responsible for appointing the 76 governors of the Provinces of Thailand. The Minister of Interior is the head of the ministry. He is appointed by the King of Thailand on the recommendation of the prime minister. Since 1 September 2023, the head of the ministry has been Anutin Charnvirakul. He is aided by two deputy ministers. The FY2019 budget of the ministry is 371,802 million baht.
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
Tanzania has a hierarchical health system which is in tandem with the political-administrative hierarchy. At the bottom, there are the dispensaries found in every village where the village leaders have a direct influence on its running. The health centers are found at ward level and the health center in charge is answerable to the ward leaders. At the district, there is a district hospital and at the regional level a regional referral hospital. The tertiary level is usually the zone hospitals and at a national level, there is the national hospital. There are also some specialized hospitals that do not fit directly into this hierarchy and therefore are directly linked to the ministry of health.
The Ministry of Public Health is a Thai governmental body responsible for the oversight of public health in Thailand. It is commonly referred to in Thailand by its abbreviation so tho (สธ.).
Healthcare in Portugal is provided through three coexisting systems: the National Health Service, special social health insurance schemes for certain professions and voluntary private health insurance. The SNS provides universal coverage, although in 2012 measures were implemented to ensure the sustainability of the service by the introduction of user fees to be paid for at the end of treatments. In addition, about 25% of the population is covered by the health subsystems, 10% by private insurance schemes and another 7% by mutual funds. The Ministry of Health is responsible for developing health policy as well as managing the SNS. The Health Regulatory Entity (ERS) is the public independent entity responsible for the regulation of the activity of all the public, private and social healthcare providers. In 2019 the government proposes to scrap all fees, which constitute about 2 percent of the NHS's budget, apart from some hospital emergencies.
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Hospitals in Thailand are operated by both the public and private sector, to provide medical services for prevention, cure and rehabilitation of patients with medical and health-related conditions. The majority are operated by the Ministry of Public Health (MOPH). Private hospitals are regulated by the Medical Registration Division under the MOPH's Department of Health Service Support following the Sanatorium Act, B.E. 2541. Other government units and public organisations also operate hospitals, including the military, universities, local governments and the Red Cross. The full listing of hospitals can be accessed at List of hospitals in Thailand.
Examples of health care systems of the world, sorted by continent, are as follows.
The public healthcare system in India evolved due to a number of influences since 1947, including British influence from the colonial period. The need for an efficient and effective public health system in India is large.
India has a multi-payer universal health care model that is paid for by a combination of public and government regulated private health insurances along with the element of almost entirely tax-funded public hospitals. The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services.
The COVID-19 pandemic in Thailand began with the identification of the first case in the country on 13 January 2020, and has been ongoing since then.
↑ G20 Health Care: "Health Care Systems and Health Market Reform in the G20 Countries." Prepared for the World Economic Forum by Ernst & Young. January 3, 2006.
↑ Hughes D, Leethongdee S (2007). "Universal coverage in the land of smiles: lessons from Thailand's 30 baht health reforms". Health Affairs. 26 (4): 999–1008. doi:10.1377/hlthaff.26.4.999. PMID17630443.
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