The Universal Coverage Fund Allocation Model in Nakhon Rachasima Province in 2001-2007 - รูปแบบการจัดสรรงบประมาณโครงการหลักประกันสุขภาพถ้วนหน้า จังหวัดนครราชสีมา พ.ศ. 2544-2550

บทคัดย่อ

                       The retrospective descriptive study of the universal coverage fund allocation model was a documentary research, which assessed the model and its weakness and strength of the universal coverage fund allocation in Nakhon Rachasima province in 2001-2007.  Data was collected from books, articles, laws, news, and other relevant documents.  It was found that the shift of policy, the lack of fund, the large province structure, CUP variations, poverty, and health status, all invariably contributed to the annual financial liquidity problems in any allocation models.  Most of fund was spent for medical treatment which remained passive programs.  There were few yet increasing actions in health promotion.  Therefore, the fund allocation model of Nakhon Rachasima province would be shifted to clearly emphasize health promotion leading to eventual case reduction.

                        The strength and weakness analysis of the model indicated that the large amount of fund allocated to the central office led to the financial liquidity particularly in small CUPs.  On the contrary, once only the larger CUPs were affected by financial cut, smaller CUPs, then lacked any incentive to tighten their belts.  The strength of the existing system was appropriate allocation to the central office and across-the-board cut irrespective of CUP sizes.  It was believed that true fixed cost would accommodate clear and realistic forecast of capital outlay.  Moreover, allocation should place more emphasis on health promotion in order to proactively control expense on medical treatment.

                     The strength of fund appropriately allocated to both central office and clinical office would encourge them to improve in management.  The fund which allocated for fixed cost-expenses renders the expenditures planning more possible and realistic.  The fund which emphasize on health promotion can reduce cases and treatment expense.

Key words:      Universal Health Care Coverage, SWOT analysis, fixed cost