where the size of population was 12-13% was dispropor-
tionately lower (7-11%).
When OP visits and admissions were concentrated
among the poorest UCS beneficiaries more than their
richest counterparts, this pro-poor utilization drove the
pro-poor outcome of government health subsidies.
Health payment across rich-poor quintiles
During the UC period, certain UCS beneficiaries reported
having to pay out-of-pocket for their medical services. As
a result of the high frequency OP utilization, more UCS
members, 4% to 9%, though small, paid for OP services
than those for admission s
ervices, 1% to 4% when they
chose to bypass services to higher level of care without
properly referral; or paid for self-prescribed medicines in
private pharmacies or used private providers not covered
by the Scheme, Table 2. In public health facilities, 4-5%
of the UCS members paid for their OP visits during
2003-2006, in contrast to the 1-2% who did so during
2007-2009 period when the 30 Baht flat rate copayment
was abolished after the change of government.
The payment for IP admission in public hospitals
occurred for 3% of UC patients admitted during 2003
2006 and reduced to less than 2% in 2007 and 2009
when copay was abolished. Health payment to private
facilities by the UCS members occurred mostly for OP
visits to private clinics but rarely for private hospital vis-
its and admissions, as they are more costly and unaf-
fordable in particular private sector IP services.
The difference in likelihood and average amount of
payment to public facilities across wealth quintiles of the
UCS beneficiaries for OP and IP services is illustrated in
Figures 6 and 7, respectively. The size of the balloon
reflects the size of the population in the five wealth quin-
tiles. A common pattern emer
ged for all years; Figure 6
and 7 illustrated 2004.
Figure 6 shows out of pocket payment for OP services,
where 33% of the poorest quintiles paid for OP services
but the amount was small, slightly more than 50 Baht
average per visit (less than US$ 2) while around 50% of
the richest quintiles paid f
or their OP services with a
much larger average amount, almost 400 Baht per visit
(approximately US$ 13).
Similarly, Figure 7 illustrates that a lower proportion
of the poorest compared to the richest quintiles were