The Situation of Oral Health Service System Under Universal Coverage Scheme.

Abstract

The study aimed at exploring the situation of dental health service management since the launch of universal health insurance policy, and to determining the impact of the policy on utilization and provision of the dental benefits, oral health promotion and prevention. The results would be used for further implementation and policy recommendation on dental health service management. Three provinces : Payao, Pathumthani, and Yala were selected for studying 1 regional/general hospital and 1 community hospital in each province. The data on treatment service were secondary data and collected by statistical package program, the data were from the daily clients record at the hospitals in the workdays of odd numbers between April - December 2001 and 2002. The data on health promotion derived from interviewing dental health personnel in each province. The data were then processed, analyzed, concluded and reported. The results on treatment service revealed that the number of hospital visits has increased by 26.6 % relative to year 2001, and the number of clients has risen by 20.2 % increasing rate of utilization were served in people aged over 60 while the 0-4 and 5-9 utilized at decreasing rate. In General Hospital those who were previously insured by health card scheme and now covered by Universal Coverage scheme increasing slightly, while this phenomena also happened in those previously covered by the low income scheme. Regarding repeated dental health service, it was found that the average visit of one client is 1.29 and 1.35 times in 2001 and 2002. the most 3 types of dental service provided were the basic service, i.e. tooth extraction, tooth filling, scaling. Considering the service types received at each visit, the percentage of those receiving only dental check up has increased . If the dental check up was not regarded as a type of service, then almost 80 % had attended only one service type at each visit.

The study result of service types under the benefit package indicated that there has been an increase of all types of basic service more than 90 % of the services. For dental health promotion and prevention service, the dental section of each hospital provides oral check up for pregnant women at ante-natal clinic and well-baby clinic. Each hospital does not altered the implementation process and duration. Regarding pre-school age service in Amphur Mueng, all hospitals have not yet implemented dental health promotion in the child development center and in kindergarten classes of primary schools. After the launch of universal health insurance policy, regional/general hospitals remained their responsibility to those schools under the catchment area of the hospital but covered more numbers of schools. In the areas outside Amphur Mueng, all of hospital have carried out dental health surveillance and prevention program in primary schools covering the same numbers of schools and activities between 2001 and 2002. Regarding home service and visit, the dentists working in the dentistry group and dental health section did not involve in preparing family files. These health facilities did not arrange certain service activities that supported self reliance of the people.