A difficult balancing act: Policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand

Teerawattananon, Yot and Russell, Steve (2008) A difficult balancing act: Policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand. Value in Health, 11 (SUPPL. 1). S52-S60. ISSN 1098-3015

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Abstract

Objectives: In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Methods: Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Results and Conclusions: Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

Item Type:	Article
Uncontrolled Keywords:	decision-making,economic evaluation,health-care benefit package,thailand
Faculty \ School:	Faculty of Social Sciences > School of Global Development (formerly School of International Development)
UEA Research Groups:	Faculty of Social Sciences > Research Groups > Health and Disease
Depositing User:	Pure Connector
Date Deposited:	28 Oct 2013 16:46
Last Modified:	12 Jan 2023 15:31
URI:	https://ueaeprints.uea.ac.uk/id/eprint/44024
DOI:	10.1111/j.1524-4733.2008.00367.x

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