The Rapid Expansion of Residential Long-term Care Services in Bangkok: A Challenge for Regulation.

Abstract

As in other middle-income countries, Thailand is experiencing accelerating populationageing, with particularly rapid increases in the numbers of people at very old ages.This creates specific challenges related to meeting health and social care needsassociated with later life. This paper analyses the nature of residential long-term care(LTC) services in Bangkok and identifies different forms of provision. It also assessesthe suitability of current regulatory practices and provides some evidence of servicequality. The study applies a multi-method qualitative approach, using the key informantinterviews, focus groups and documentary evidence to piece together a “map” ofavailable services. It provides important insights including a very limited supply ofresidential LTC in Bangkok relative to the rapidly growing demand, scarce financialsupport to service providers, largely absent or in the early stage of state regulation, and a continued stigmatisation of residential LTC. While the research findings should beinterpreted with caution in part due to the limitations of available research or data onthese issues in Bangkok or elsewhere in Thailand, the limitation itself is a cause for concern, both reflecting and contributing to denial among policy-makers and society ingeneral.