泰国全民健康覆盖行动:泰国和非泰国人口普遍获得新冠肺炎综合服务

Tangcharoensathien V, Viriyathorn S, Sachdev S, Sriprasert K, Kongkam L, Srichomphu K, Patcharanarumol W
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引用次数: 0

摘要

2002年,泰国通过三个主要的公共健康保险计划实现了全民健康覆盖;由税收资助的公务员医疗福利计划(CSMBS)覆盖公共部门雇员及其家属(占总人口的7.1%),由工资税资助的社会健康保险计划(SHI)覆盖私营部门雇员(17.2%),由税收资助的全民保险计划(UCS)覆盖其余大多数人(75.7%)[1,2]。登记的移徙工人受社会保险覆盖,而由公共卫生部管理的自愿缴费移徙者健康保险涵盖无证件移徙者及其家属。因此,许多未登记的移徙工人及其家庭成员不受任何金融风险保护制度的保护;服务费用是自掏腰包的。地区卫生系统的广泛地理覆盖有助于充分和公平地获得卫生服务,而未满足的需求水平较低。综合福利方案和就地免费服务导致灾难性卫生支出的流行率(1994年为6.7%,2017年为2.2%)和贫困率(1996年为1.4%,2015年为0.4%(使用人均每天3.1美元的国际贫困线))较低且持续下降。这一视角分析了泰国如何通过全民健康覆盖的视角应对COVID-19大流行,覆盖所有泰国和非泰国人口,包括移民工人,并为每个人提供一整套与COVID-19相关的服务,这是遏制大流行的关键因素。
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Thailand UHC in Action: Universal Access to Comprehensive COVID-19 Services by Thai and Non-Thai Population
Thailand achieved Universal Health Coverage (UHC) in 2002 through three main public health insurance schemes; the tax-financed Civil Servant Medical Benefit Scheme (CSMBS) covers public sector employees and dependants (7.1% of total population), payroll-tax financed Social Health Insurance (SHI) Scheme covers private sector employees (17.2%), and the tax-financed Universal Coverage Scheme (UCS) covers the remaining majority (75.7%) [1,2]. Registered migrant workers are covered by the SHI while voluntary premium-contribution migrant health insurance, managed by Ministry of Public Health (MOPH), covers undocumented migrants and their dependants. Hence, many unregistered migrant workers and their family members are not covered by any financial risk protection systems; services are paid for out-of-pocket [3]. Extensive geographical coverage of district health systems facilitates adequate and equitable access [4] with low levels of unmet needs [5]. The comprehensive benefit package [2] and free-at-point of services result in low and continually decreasing prevalence of catastrophic health spending [6] (6.7% in 1994 to 2.2% in 2017 [7]) and incidence of impoverishment (1.4% in 1996 to 0.4% in 2015 (using international poverty line of US$ 3.1 per capita per day)) [8]. This perspective analyses how Thailand has responded to the COVID-19 pandemic through the UHC lens, covering all Thai and non-Thai populations, including migrant workers, with a comprehensive set of COVID-19-related services for everyone--a key contributing factor to pandemic containment.
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