A Comparison on Budget Allocations from the National Health Security Fund between Contracting Unit for Primary care and Tambon Health Promoting Hospitals with and without Transferred to the Local Administrative Organizations
Keywords:
National Health Security Fund, Budget Allocation, Transfer Missions, Local Administration Organization, Tambon Health Promoting HospitalAbstract
This mixed-methods research aimed to: 1) study the situation of health insurance fund management and expenditure allocation for public health services from the health insurance fund of the contracting unit for primary care (CUP)by conducting in-depth interviews among the 4 contracting parties and 16 directors of tambon health promoting hospitals, and 2) compare the proportion of expenditure allocation using data from contracting unit for primary care (CUP), National Health Security office (NHSO), and Tambon health promoting hospital (THPH), and 3) develop policy recommendations on health insurance fund management and expenditure allocations by analyzing, synthesizing research, concepts, theories and context related to current and future budget management. The results showed as follows.
1. The allocation model depends on the agreement with the District Coordinating Committee for the allocation of money, medical supplies, and durable items, and this, at fixed cost.
2. The CUP allocated 73.05 percent of money and 26.95 percent of appliances to non-transferred SHPH. Transferred SHPH is allocated for 54.78% of the money, 45.22% of appliance.
3. To ensure fairness in the provision of services, we proposed three options for different conditions: 1) in the case of the original CUP (the host hospital does not charge service fees) within the context of amending the regulations on the Ministry of Public Health’s maintenance allowance, 2) in the case of the original CUP (the host hospital does not charge service fees), the direct transfers to the SHPH in the context of not amending the maintenance allowance regulations, and 3) in the case of the new CUP (the host hospital does not charge service fees), the direct transfers to the THPH.
4. In terms of policy recommendation, the National Health Security Fund should review and adjust the allocation model to be appropriate, fair, and without inequality in the allocation of medical service costs to THPH, transfers, and non-transfers.
Ministry of Public Health, Department of Local Administration, and the National Health Security Office can use the proposed options to consider the arrangement, mechanism, and proportion of budget allocation for public health services to the transferred THPHs.
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