Which Households Are At Risk Of Catastrophic Health Spending:

Experience In Thailand After Universal Coverage

Exploring the reasons why some households still incur high levels of spending--even under universal coverage--
can help policymakers devise solutions.

Tewarit Somkotra, a lecturer on the faculty of dentistry at Chulalongkorn University in Bangkok, Thailand.
Leizel Lagrada is in the Department of Health Policy Sciences at Tokyo Medical and Dental University in Tokyo, Japan.
HEALTH AFFAIRS - Web Exclusive – March 31, 2009
Project HOPE–The People-to-People Health Foundation, Inc

Available online at: http://content.healthaffairs.org/cgi/content/full/hlthaff.28.3.w467/DC1

“………………The impact of the universal coverage policy implementation in Thailand is demonstrated by the declining incidence of catastrophic health spending among Thai households--particularly among the poor.

The households that remain at risk of catastrophe, as defined here, are better-off households, because of their preference for using private facilities. Others with increased likelihood of incurring catastrophic health expenditures are households with a greater proportion of elderly members, those having a member with a chronic illness or disability, and those having a member who experienced hospitalization. These determinants should prompt policy concerns to protect such households from financial catastrophe. [Health Affairs 28, no. 3 (2009): w467-w478 (published online 31 March 2009; 10.1377/hlthaff.28.3.w467)]