HealthCare System Development Project 1

2 1.Growth & Competitiveness 2.Inclusive Growth 3.Green Growth 4.Internal Process Development

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1. / (Gap Analysis) 6. (Indicators to fill gap)

Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2010 Revision Japan Korea China Thailand World 5 Proportion of elderly (>65 years old)

DiseaseYear 2011Year 2012 Infectious disease Non communicable diseases Circulatory diseases Accident Cancer Rate per 100,000 populationsMorbidity 6 Source: Bureau of Policy and Strategy, Ministry of public health

Disease Infectious disease Non communicable diseases Circulatory diseases Accident Cancer Rate per 100,000 populationsMortality 7 Source: Bureau of Policy and Strategy, Ministry of public health

Source: Thailand Health Profile Major Causes of Death in Thailand,

DiphtheriaPertussis Neonatal Tetanus Measles Source: Disease Control Department, Ministry of Public Health 9 Mark reduction of vaccine preventable diseases Thailand

10 Health service delivery system in Thailand Health centers 9,768 Municipality Medical Centers 365 District hospitals 776 Provincial hospitals 68 Pharmacy 11,154 Private clinics 17,671 Other public hospitals 120 Private hospitals 323 Regional hospitals 28 University hospitals 17 Other MoPH hospitals 55 MOPH facilities Sub-district District Province Source: 1. Thailand Health Profile Bureau of Policy and Strategy, MoPH,

Private Hospital Clinics (2013) Private Hospitals Bangkok 98, Other provinces 224 Total 322 Medical clinics Bangkok 3,970, Other provinces 14,533 Total 18,503 Drugstores Bangkok 4,912, Other provinces 11,780 Total 16,692 Traditional medicine Drugstores Bangkok 443, Other provinces 1,615 Total 2,058 Private Hospital Clinics (2013) 11 Source: Bureau of Policy and Strategy, Bureau of Sanatorium and Art of Healing, Food And Drug Administration; Ministry of public health

Health Facilities in the Public Sector (2010) Source : Bureau of Health Administration; Ministry of public health Administrative LevelHealth facility Bangkok 5 medical school hospitals 26 general hospitals 13 specialized hospitals/institutions 68 community health care centers Regional level 6 medical school hospitals 33 regional hospitals 48 specialized hospitals Provincial level 83 general hospitals District level 774 community hospitals 284 municipal health centers Sub-district level 9,768 health promoting hospitals Village level 198 community health posts 48,049 rural community primary health care centers 3,108 urban community primary health care centers 1,055,000 Village Health Volunteers Health Facilities in the Public Sector (2010) 12

Excellent Center General,Regional Hos.(96) Community Hos.(743) THPH(9,750) CPHC. Center (9,750) Family health leader Province(200,000-2M.) District(10, ,000) Subdistrict (1- 10,000) Village Family SELF CARE PHC 1 o MC 2 o MC 3 o MC Health Service Infra-structure 13 Source : Bureau of Health Administration; Ministry of public health

Service plan Regional hospital High level Advance = 33 Standard = 48 M2 = 91 F1-3 (F1=73,F2=518,F3=92) P 1-2 (P1=226 P2=9,750. ) Primary health care Primary care Secondary care Large community hospital Small general hospital General hospital Excellent center M1 = 35 Mid level First level 14 Source : Bureau of Health Administration; Ministry of public health

Health service delivery system in Bangkok is not well organized and fragmented. MoPH has limited role in service provision in Bangkok Private sector and other ministries play greater role in Bangkok. 15 Source: Thailand Health Profile Proportion of hospital beds by region and agency, 2008

Declining of the population to bed ratios over time was observed, especially those of the North and Northeast; however, disparities between regions remain. 16 Source: Thailand Health Profile Population to bed ratios by region,

17 Source: Thailand Health Profile Population to provider ratios,

There was mark reduction in the disparities of population to health care provider ratios for Bangkok and the Northeast during Population to doctor ratio of the Northeast remained 5 time of Bangkok while the ratios of other professions were 1.5 – 2 times of Bangkok 18 Source: Thailand Health Profile Disparities of population/healthcare provider ratios for Bangkok and the Northeast,

19 Source: Kanchanachitr et al (2011) Thailand has relatively low numbers of doctor and nurse to 1,000 populations compared with countries at the same level of economy Doctor and nurse to 1,000 population among ASEAN countries among ASEAN countries

Aim to ensure security of drug supply and to maintain price level of necessary pharmaceutical supplies to ensure accessibility for all Thais Production Stocking distribution Trade of between national security and promoting local pharmaceutical industry (push and pull) Competing with local pharmaceutical firms in producing generic drugs Production of vaccines Role of Government Pharmaceutical organization (GPO) 20

Policies response to increase demand for healthcare of Non-Thais Medical hub (academic training and conference, medical care, dental care, spa and Thai traditional medicine) Promoting Thailand as center of medical education, academic training, and conferences) Loosening professional barrier in importing foreign professions Reduce income gap between public and private sector in order to prevent brain drain 21

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