ArticlePloS one2018
Strategic purchasing and health system efficiency: A comparison of two financing schemes in Thailand.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 2 of them syntheses that pooled it.
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Who cites it
38 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Health Insurance Schemes and Their Influences on Healthcare Variation in Asian Countries: A Realist Review and Theory's Testing in Thailand.International journal of health policy and management · 2024Pooled it
- The Experiences of Strategic Purchasing of Healthcare in Nine Middle-Income Countries: A Systematic Qualitative Review.International journal of health policy and management · 2023Pooled it
- Implications of Kenya's Enhanced Public Officers Medical Scheme on Equity in Strategic Purchasing and Progress Towards Universal Health Coverage.Public health challenges · 2026Article
- Community caregivers and innovative financing: a qualitative analysis of Thailand's Ubolratana Hospital model using the consolidated framework for implementation research.Health policy and planning · 2026Article
- Prospective payment system transformation (2000-2024): temporal trends, payment architecture, and cross-national variation.Health economics review · 2026Review
- Health financing strategies for achieving Universal Health Coverage in low- and middle-income countries: a narrative review.Frontiers in public health · 2026Review
- Factors influencing financial protection of the elderly within the framework of universal health coverage: A scoping review.Journal of education and health promotion · 2026Review
- Financing and purchasing mechanisms of primary health care in Southeast Asia region: Findings from a scoping review.SSM - health systems · 2025Review
- Article
- Towards a Sustainable Healthcare System: A Concept Paper for a National Hybrid Financing Model for Malaysia.International journal of health policy and management · 2025Article
- Systematic Review of Financing Functions for Universal Health Coverage in Low- and Middle-Income Countries: Reforms, Challenges, and Lessons Learned.Public health reviews · 2025Review
- A comprehensive review on strategic purchasing of diagnostic imaging services.Journal of education and health promotion · 2025Review
- Assessing diagnosis-related groups based direct medical expenditures of chronic disease patients in general hospital of lower southern Thailand.Cost effectiveness and resource allocation : C/E · 2024Article
- Health care cost accounting in the Indian hospital sector.Health policy and planning · 2024Article
- How does Public Financial Management (PFM) influence health system efficiency: A scoping review.Wellcome open research · 2024Article
- Refining the provider payment system of India's government-funded health insurance programme: an econometric analysis.BMJ open · 2023Article
- Budget monitoring, accountability practices and their influence on the efficiency of county health systems in Kenya.PLOS global public health · 2023Article
- Role of healthcare cost accounting in pricing and reimbursement in low-income and middle-income countries: a scoping review.BMJ open · 2022Article
- The trust and insurance models of healthcare purchasing in the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in India: early findings from case studies of two states.BMC health services research · 2022Article
- Disclosure, transparency, and accountability: a qualitative survey of public sector pharmaceutical committee conflict of interest policies in the World Health Organization South-East Asia Region.Globalization and health · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
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Abstract
Strategic purchasing is an essential health financing function. This paper compares the strategic purchasing practices of Thailand's two tax-financed health insurance schemes, the Universal Coverage Scheme (UCS) and the Civil Servant Medical Benefit Scheme (CSMBS), and identifies factors contributing to successful universal health coverage outcomes by analysing the relationships between the purchaser and government, providers and members. The study uses a cross-sectional mixed-methods design, including document review and interviews with 56 key informants. The Comptroller General Department (CGD) of Ministry of Finance manages CSMBS as one among civil servant welfare programmes. Their purchasing is passive. Fee for service payment for outpatient care has resulted in rapid cost escalation and overspending of their annual budget. In contrast, National Health Security Office (NHSO) manages purchasing for UCS, which undertakes a range of strategic purchasing actions, including applying closed ended provider payment, promoting primary healthcare's gate keeping functions, exercising collective purchasing power and engaging views of members in decision making process. This difference in purchasing arrangements resulted in expenditure per CSMBS member being 4 times higher than UCS in 2014. The governance of the purchaser organization, the design of the purchasing arrangements including incentives and use of information, and the institutional capacities to implement purchasing functions are essential for effective strategic purchasing which can improve health system efficiency as a whole.
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