Spill-over effects on the health system
The implementation of the UCS impacted on all functions of the Thai health
system; many of the scheme’s impacts on health system financing, governance
and service delivery have already been described in this report. Increased
investment in primary care by the UCS increased technical quality and improved
coordination between providers at the district level. Financing reforms, particularly
the use of strategic purchasing by the UCS, led health-care providers to make
major functional and organizational adjustments in order to contain costs and
increase efficiency.
In addition, the UCS contributed significantly to the development of Thailand’s
health information system through hospital electronic discharge summaries
for DRG reimbursement, accurate beneficiary datasets and data sharing.
But such improvements came at a cost. The creation of the NHSO’s disease
management system increased workloads, and some health-care providers even at
health-centre level hired additional IT staff to work on the data in order to improve
their claims rate. On many occasions the information collected was used only
for payment processing and so opportunities to utilize these valuable data for
better health-care management and evaluation were lost. Moreover,