Medical Expenditure of Traffic Accident Patients and Subsequent Financial Burden from Different Payment Methods of Traffic Accident Protection Fund and Universal Health Security Fund in Chon Buri: A Policy Recommendation - ค่าใช้จ่ายการรักษาพยาบาลผู้ประสบอุบัติเหตุจราจรและภาระทางการเงินที่เป็นผลจากระบบและกลไกการเบิกจ่ายเงินกองทุนประกันผู้ประสบภัยจากรถ และกองทุนหลักประกันสุขภาพถ้วนหน้าในจังหวัดชลบุรี: ข้อเสนอเชิงนโยบาย

Abstract

                 This descriptive research was a study of traffic accident situation, incidence of traffic accident in-patient, different payment methods among health insurance schemes, subsequence financial burden on the hospitals participated in universal health care coverage scheme in Chon Buri province from October 2006 to September 2007.  Reviews of in-patient database, injury surveillance database, traffic accident and NHSO in-patient payment database of the hospitals, were made.  A deterministic simulation model was developed to analyze and project the financial burden on the hospitals and universal health security fund.

                 The results demonstrated the impacts of traffic accident to the health status of the population both individual and society at large.  Unfair different payment methods of traffic accident protection fund caused financial burden on the hospitals and universal health security fund at the sum of 16.92 million baht in the fiscal year 2006.  As a consequence, the hospital budget for general in-patient was deducted by 4.01 percent.  There is an urgent need to reform the payment method and financial management of traffic accident protection fund.  Applying DRG-RW as payment method, increasing the contribution of traffic accident protection fund for the medical expenditure, improving management efficiency of the fund should be considered as short- to medium-term interventions.  A systematic national level research should be further conducted to develop a reform proposal of traffic accident protection insurance scheme in the future.

Key words:      traffic accident, financial mechanism, health insurance