Academic journal article Applied Health Economics and Health Policy

Healthcare Use and Voluntary Health Insurance after Retirement in Thailand

Academic journal article Applied Health Economics and Health Policy

Healthcare Use and Voluntary Health Insurance after Retirement in Thailand

Article excerpt

Published online: 6 February 2014

© Springer International Publishing Switzerland 2014


Background The dramatic changes occurring in the age structure of the Thai population make providing healthcare services for the elderly a major challenge for decision makers. Because the number of the elderly will be increasing, together with the number of retired workers, under the Social Health Insurance (SHI) scheme, there will be the unmet needs for healthcare use after retirement. The SHI scheme does not cover workers after retirement unless they could use free healthcare for the elderly. In addition, the government budget is tight regarding the support of universal healthcare and long-term care services for all of the elderly. Therefore, the government could support retired workers who have the ability to pay by facilitating voluntary health insurance.

Objective The main objectives of the present study are to analyze the characteristics of workers that need health insurance after retirement and to identify the factors explaining healthcare use to offer healthcare services to meet the workers' needs and expectations.

Methods Four hundred insured workers under the Social Health Insurance (SHI) Scheme in Thailand were interviewed using a structured questionnaire. The Anderson-Newman model of healthcare use is the conceptual framework used in this study to understand the factors that explain healthcare use patterns of workers. Multiple regressions are employed extensively to evaluate the variables that predict healthcare use.

Results According to the survey, a person that purchases voluntary health insurance is likely to be female, have a higher personal income, and healthy. The characteristics related to healthcare use were poor health status, a high personal income, and peeople afflicted by chronic illness.

Conclusions There is a gap between healthcare service use and the demand for voluntary health insurance. People that have a high income are more likely to purchase voluntary health insurance, while people in worse health and afflicted by chronic illness may have greater difficulty purchasing voluntary health insurance because they face higher premiums or are denied coverage by insurers.

1 Introduction

The rapid aging of the population, especially among the elderly population, has challenged governments to address ways to serve the growing demand of the elderly in terms of the use of institutional healthcare services. Healthcare services for the elderly will increase markedly as the number of elderly people and the number of elderly people with disabilities and chronic illness increase. In addition, as the baby boomers enter retirement, the need for healthcare will greatly increase, turning current problems into a crisis if the governments are not well prepared [1]. Because the higher rate of chronic illness among the elderly will influence the healthcare use pattern, the understanding of healthcare use patterns relative to chronic illness such as diabetes mellitus, hypertension, high cholesterol, and cardiovascular diseases is useful for those planning and developing health service programs for older persons.

Thailand has now reached a new demographic turning point with the advent of an aging society [2]. The older population or population aged 60 years and above increased from 1.5 million in 1960 to approximately 7.4 million in 2008, and it is expected to be 17.7 million in 2030 [3]. Furthermore, not only is the overall share of the aging population increasing, but also the increases are large and rapid in the extreme age group of 80 years and older [4]. From the year 2000 to 2050, the growth rate of the older adult population is projected to increase by 227 % while the elderly population (age 80 years and over) will increase by 686 % [2]. As the numbers of the older population that need healthcare and long-term care services increase, public health insurance should be adjusted and reformed to meet the demands of people after retirement. …

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