Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

After achieving Universal Coverage (UC) in 2002, Thailand demonstrates an impressive decline in the incidence of catastrophic health expenditures. However, there are households that persistently experience catastrophic health expenditures. This study aims to identify the characteristics of households that incur financial catastrophe due to out-of-pocket payments for health care. This study employs multivariate analysis, specifically the probit model, to identify the determinants of households who incurred catastrophic health expenditures which defined as out-of-pocket payments for health care exceed 10% of total consumption and 40% of non-food consumption. Data are taken from pooled data of nationally representative Socio-Economic Surveys (SES) in 2000 (pre-UC) and 2004 (post-UC) which enable to assess the effect of UC policy on households as well. Results reveal that households who belong to higher quintile have higher probability of incurring catastrophic health expenditures. In addition, a large household size and a greater proportion of elderly members in household are more likely to incur catastrophic health expenditures. Of those household which household head with higher level education and economically active work are less likely to incur catastrophic health expenditures. Notably, whether having payments on inpatient care at public or private facility increases the risk to incur catastrophe. Importantly, the result indicates that the implementation of UC policy reduces the likelihood of incurring catastrophic health expenditures. In conclusion, the implementation of UC policy in Thailand made impressive strides toward the decrease in the likelihood of incurring catastrophe, and the determinants that affect the greater risk of incurring catastrophe prompt policy concern in protecting those households with the high risk to incur catastrophe.