Situation of Medical Service Utilization, Illness Patterns, and Treatment Modalities of Eligible Migrant Health Insurance in Healthcare Utilization in Public Hospitals under the Supervision of the Office of the Permanent Secretary, Ministry of Public Health, Thailand

Abstract

This study examined migrant health insurance coverage and healthcare utilization in hospitals under the supervision of the Ministry of Public Health, Thailand; using secondary data from the Office of Information Technology, Ministry of Public Health, from 2018 to 2022. Qualitative data were collected from in-depth interviews and group discussions with key stakeholders. It was found that during 2018–2022, the average outpatient charge per visit increased across all hospital types, with regional hospitals having the highest costs, rising from approximately THB 965 to THB 1,505, while community hospitals increased from about THB 405 to THB 746. The average number of outpatient visits per case was similar across hospital types (approximately 1.2–1.6 visits per person per year), with community hospitals showing the highest visit frequency. For inpatient services, both the average charge per length of stay and charge per visit increased in all hospital types. Regional hospitals incurred the highest costs, with the charge per length of stay increasing from approximately THB 3,590 to THB 4,921 and the charge per visit rising from THB 7,901 to THB 12,380, while community hospitals, although lower, showed notable increases from THB 2,309 to THB 2,894 per length of stay and from THB 6,192 to THB 10,496 per visit. Qualitative findings underscored the need to expand insurance coverage to all migrant worker groups, review insurance rates for affordability, streamlining health examination procedures, and incorporating preliminary mental health screenings. Additionally, recommendations included engaging local nonprofit organizations to improve services for uninsured migrants and involving private insurers to support migrant workers awaiting social security eligibility. This study provides evidence on healthcare utilization and service delivery among insured migrants; offering policy-relevant insights to support the strengthening of the migrant health insurance system under the Ministry of Public Health in Thailand.