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Benchmarks of Fairness for Health Care Reform in Thailand Combining evidence with opinion of the civic group. Supasit Pannarunothai Center for Health Equity Monitoring Faculty of Medicine, Naresuan University. Scope. Equity trends in Thailand Benchmarks Phase I

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Benchmarks of Fairness for Health Care Reform in Thailand Combining evidence with opinion of the civic group

Supasit Pannarunothai

Center for Health Equity Monitoring

Faculty of Medicine, Naresuan University

scope
Scope
  • Equity trends in Thailand
  • Benchmarks Phase I
  • Objectives and methods for Phase II
  • Quantitative data on equity in Thailand
  • Qualitative data from focus group discussion
  • Experiences learnt
equity trends in thailand
Equity trends in Thailand

The Constitution 1997

Universal health coverage

The Decentralization Act 2001

Equity

Efficiency

Social accountability

Quality

benchmarks of fairness phase i scoring of provincial health reforms
Benchmarks of Fairness Phase I Scoring of Provincial Health Reforms

Score from -5 to +5 with zero representing status quo

The overall score was made by implicit weighting

Pannarunothai and Srithamrongsawat (2000)

lessons learnt from phase i
Lessons learnt from Phase I
  • The benchmarks provided a comprehensive framework for evaluation of health system.
  • It could be used as a tool for provincial health system development.
  • If combining with more objective data, the benchmarks should provide more accurate directions for developments.
objectives for phase ii
Objectives for Phase II
  • The possibility of involving larger groups of civil society in using the benchmarks.
  • Combining quantitative data of the provincial health system with qualitative data (the interpretation of civil society) to rank performance of the provincial health system
methods for phase ii

Focus group discussion

Secondary data analysis

Quantitative tool

Qualitative tool

Qualitative data

Quantitative data

Distribution, national level

Quality data

Strength, weakness at local

Equity score

Methods for Phase II

10 provinces, 8 groups each

81 indicators, 30 groups

46 item-questionnaire

Objective & Across provinces

Subjective & Over time

qualitative data
Qualitative data

8 focus group discussions in each province

1 health managers at provincial level

1 health providers at provincial level

1 health providers at district and subdistrict level

1 non-health officers at local governments

1 health civic group in urban area

1 non-health civic group in urban area

1 health civic group in rural area

1 non-health civic group in rural area

each member of focus group discussion gave scores for 46 questions before and after discussion
Each member of focus group discussiongave scores for 46 questions before and after discussion

Score from

+5 the greatest improvement

to -5 the very worst condition

.

.

1 focus group discussion took about 1:30 hour

strengths and weaknesses of a province by quantitative data

Workload by doctor

Use at primary care

Admission rate

Demographic factor

Overall health status

Use of public services

Strengths and weaknesses of a province by quantitative data

Chiang Mai

lessons learnt from phase ii
Lessons learnt from Phase II
  • The quantitative data were interesting to all groups and facilitating discussions.
  • Judgement of each participant was the mix of quantitative data and own experiences.
  • Non-health civic groups gave lower scores than other groups.
  • The scores could be used for improving the provincial health system.
recommendations
Recommendations
  • The benchmarks should be used for evaluation of health system within the decentralization context.
  • Both objective data and qualitative judgement of the participants in the province are useful information for health system development.
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