Socioeconomic inequalities in health outcomes among the older population in the era of Thailand’s Universal Health Coverage

Seminar No. 1182
17 สิงหาคม 2565 เวลา 12.30 – 13.30 น.

Speaker: Sirinya Kaikeaw


In Thailand, achieving the Universal Health Coverage (UHC) has been evidenced since 2002. All Thai citizens enjoy access to a comprehensive benefit package of essential healthcare services with full financial protection. Challenges remain, however, in the form of inequality in health outcomes among older Thais. This study examines patterns and trends of socioeconomic inequality among Thai older adults (aged 50+) during the UHC era (2003-2019) and identifies the potential effect of UHC and other health determinants contributing to health inequality among older adults. Data sets from a four-year series of the National Health and Welfare Survey (HWS) between 2003 and 2019 were used in this study. The health outcomes of interest derived from the Thai EQ-5D index, which is an indicator of better health. The Erreygers’ concentration index (CI) was employed to assess the socioeconomic inequality in health outcomes. Further, this study applied Tobit regression and decomposition analysis to determine the underlying drivers of health inequality. The finding suggests that Thai older adults (aged 50 and older) appear to have better health during the UHC era, but socioeconomic inequality in health outcomes still persists which is better health outcomes were more prevalent among the rich older adults (pro-rich inequality). It is interesting to highlight that the degree of health inequality decreased throughout the UHC period (CI=0.061 in 2003 to CI=0.024 in 2019). Moreover, Thailand’s health security schemes —the Universal coverage schemes (UCS), urban-rural residence, and household wealth quintiles are the major positive contributors to decreasing the health inequality among Thai adults in 2003 and 2019.