Health Care System in
Thailand
Jay Wajana Leelapattana
Jung Manasvanich
Academic fellows
Outline
• Welcome to Thailand
• Health statistics
• Hospital distribution
• Health beliefs and practices
• Health insurance system
• Medical training system
Welcome!!!
Kingdom of Thailand
• 51st largest country
• Approx. 67 million people
• 10 Million people in Bangkok
KRUNGTHEP
Q1
A: Ayutthaya
B: Chiangmai
C: Krungthep
D: Pattaya
KRUNGTHEPMAHANAKHON AMONRATTANAKOSIN
MAHINTHRAYUTTHAYA MAHADILOK PHOP
NOPPHARATRATCHATHANIBURIROM
UDOMRATCHANIWETMAHASATHAN
AMONPHIMAN AWA-TANSATHIT
SAKKATHATIYA WITSANUKAMPRASIT
TUK TUK
Health Statistics 2008
• Life expectancy
– Male 70 years, Female 78 years
• Crude birth rate 12.4/ 1000 population
• Crude death rate 6.3/ 1000 population
• Infant Death rate 7.3/ 1000 live births
• Maternal mortality rate 11.3/100,000 live births
1960 1980
2000 2020
Department of Public Prosecution;Department of Health
Leading causes of death in 2008 (from 397,327 death)
No of Death
Malignant neoplasm, all forms 55403
Accidents and poisonings 34851
Diseases of heart 18820
Hypertension and cerebrovascular diseases 15596
Pneumonia and other diseases of lung 14542
Nephritis, nephrotic syndrome and nephrosis 14235
Diseases of liver and pancreas 8738
Suicide, homicide and other injury 6935
Tuberculosis, all forms 4821
Human immunodeficieney virus (HIV) disease 4683
Dengue haemorrhagic fever 155
Office of the Permanent Secretary for Public Health, Ministry of Public Health
Thai Language ภาษาไทย
• กขฃคฅฆงจฉชซฌญฎฏฐฑฒณดตถทธนบป ผฝ
พฟภมยรลวศษสหฬอฮ
• อะ อา อิ อี อึ อื อุ อู เอะ เอ แอะ แอ เออะ เออ โอะ โอ เอาะ ออ
อัวะ อัว เอียะ เอีย เอือะ เอือ อา ไอ ใอ เอา ฤ ฤๅ ฦ ฦๅ
Q2
A: ขอบคุณ Kobkun
B: อร่ อย Aroy
C: ผมรักคุณ Pom rak kun
Hospital distribution
6 regions
• at least 1 university or
1 tertiary care hospital
76 provinces
• 1 provincial hospital
• community hospitals
• health care centers
Community hospital
Traditional health belief and healing
practice
• Health is seen as a state of balance
between the state of physical, social and
super-natural environment.
• Combination of traditional Chinese
medicine, Thai herbal medicine/massage
and others which are practiced differently
in different part of Thailand
Some examples
• Antibiotics
• Prefer drug injection to oral pills
• Serious illness as a divine punishment for
sins or bad Karma.
• Mothers may believe that they directly
contributed to their children’s disabilities
by violating certain taboos during
pregnancy.
Wat Rong Khun
Role of Buddhist temples in Thailand
• As a place for those who has no family to
take care of them (elderly, children) or
who are unable to live in society for any
reason (disability)
• A healing place for drug addiction
• A healing and a last place for HIV/AIDs
Role of Buddhist temple in the
treatment of HIV/AIDs
• Wat Pra Baht Nam Pu (since 1992)
National Health Scheme
1. Universal coverage Scheme
• 30 Baht / Golden card scheme
2. Civil servant medical benefit scheme
3. Social security scheme
4. Others
• Private health insurance
• Other forms of welfare
Currency
“Thai Baht”
1 CAD
=
30 Baht
Universal Coverage Scheme (UCS)
Nature Entitlement, tax-based system
Financing model Public contracted model, capitation 2200 THB in 2009
Beneficiaries Thai citizens uncovered by SSS and CSMBS (47 million)
Benefit package Comprehensive package including prevention and promotion
services (PP) and accredited alternative medicines with an
exclusion list of some services
Service providers Contracted public and private hospitals and requiring all
hospital to establish one primary care unit (PCU) for every
10,000-15,000 registered population
Payment method OP,PP - Capitation
IP - DRG weighted global budget
A/E and HC OP – point system,
AE/HC IP –DRG weighted global budget 28
Muay Thai
Loy Kra Thong
“Wai”
Medical training system
High school Practice
1 year as an intern
Medical in provincial hospital Specialty Fellowship
school training training
6 years 2 years of practicing 3-5 years 1-2 years
in community hospital
Family medicine
Anesthesiology
Hematology
Psychiatry
Forensic medicine
Facts
• No compulsory postgraduate training program
• Most of the doctors in Thailand are specialists
• Some of the specialist do primary care works in
their own clinics
• Most Thai doctors working in at least 2 different
hospitals
Ratio: People per physician (2007)
NE Southern Northern Central Bangkok
Average = 1: 2,778 ( 36 physicians per 100000 population)
Canada = 214 physicians per 100000 population
“I don't want you
to be only a doctor,
but I also want you
to be a man.”
Mahidol Adulyadej, Prince of Songkla
the father of modern medicine and public health of Thailand
Thank you
ขอบคุณ