purchasing framework needs some degree of decentralization to the local
level in order to link with the local authorities and to allow increasing
community engagement in decision making.
• Explore whether more local commissioning of health services would be
more efficient than provincial purchasing, especially for primary health
care.
Epidemiological transition and the ageing of the population
• Identify innovative ways to minimize the reliance on high-cost tertiary care
through greater investments in disease prevention and health promotion
and by addressing the social determinants of health outside of clinical
settings. In addition, appropriate long-term care models need to be
developed, which will require adapting the character and range of health
facilities and services.
Quality monitoring, quality assurance and health technology assessment
• Develop methods to use routinely collected data to monitor, assess and
improve quality of care, including clinical outcome assessment. At present
this is an unexploited opportunity in Thailand.
• Continue building institutional capacity for health technology assessment
to inform the purchase of cost-effective interventions and thereby improve
value for money.