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Sanita Hirunrassamee , Ph.D. 1 and Sauwakon Ratanawijitrasin , Ph.D. 2

DOES YOUR HEALTHCARE DEPEND ON HOW YOUR INSURER PAYS PROVIDER? VARIATION IN UTILIZATION AND OUTCOEMS IN THAILAND. Sanita Hirunrassamee , Ph.D. 1 and Sauwakon Ratanawijitrasin , Ph.D. 2 1 Pharmacy Division,Phramongkutklao Hospital, Thailand.

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Sanita Hirunrassamee , Ph.D. 1 and Sauwakon Ratanawijitrasin , Ph.D. 2

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  1. DOES YOUR HEALTHCARE DEPEND ON HOW YOUR INSURER PAYS PROVIDER?VARIATION IN UTILIZATION AND OUTCOEMS IN THAILAND SanitaHirunrassamee, Ph.D.1 and SauwakonRatanawijitrasin, Ph.D.2 1 Pharmacy Division,Phramongkutklao Hospital, Thailand. 2 Associate Professor, Faculty of Social Sciences and Humanities, Mahidol University, Thailand.

  2. Payment mechanisms in Thailand (2003-2005)

  3. Hospitals face different incentives & pressures from financial mechanisms in a multiple health insurance environment.

  4. What happen to access and efficiency in this environment? • Objective: • To examine resource utilization patterns and health outcomes under the multiple payment methods, focusing on assessing • Access to Medicines • Access to Medical technologies • Treatment outcomes (compared to CPGs) • Efficiency in resource use • among beneficiaries of the 3 government health insurance schemes in Thailand

  5. Data Source • 3 government hospitals • 1 tertiary care facility • 2 secondary care facilities • FY 2003-2005 data e-database • Patient demographic data • Health insurance benefits • Items and costs of prescribed drugs and treatment procedures …for assessment of access to care … Paper med. record • Clinical outcome …for assessment of efficiency of health care services…

  6. Analysis • Health insurance payment • Access to care • Efficiency :Cost-effectiveness technique • Costs = hospital costs • Treatment Outcomes • AUGIB • evaluated at end of treatment • Epilepsy • evaluated at end of year • Lung cancer • evaluated at end of year

  7. p= 0.00 Subgroup analysis UC

  8. Price as major condition:limit access to care

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