Impact of Demographic Change on Thailand’s Healthcare System

Abstract

This study employed situational analysis combined with predictive research, aimed to project the future size and structure of the Thai population and assess the subsequent impacts on healthcare service demand and expenditure. Population projections up to the year B.E. 2630 under three scenarios were conducted using the Demographic Analysis and Population Projection System (DAPPS). Future outpatient visits and inpatient admissions were estimated using the constant age-specific rate method, whereas future healthcare expenditures were projected based on the National Transfer Accounts framework. The findings reveal that Thailand is currently experiencing a severe population contraction. Under the medium-variant scenario, the total population is projected to decline by more than half, from 65.0 million in the year B.E. 2567 to approximately 26.2 million by the year B.E. 2630. The proportions of the child population (0-14 years) and working-age populations (15-59 years) will contract rapidly to 5.7% and 41.5%, respectively, whereas the elderly population (60 years and older) will surge to constitute 52.8% of the nation’s total population. Consequently, healthcare service utilization and spending will predominantly shift toward the elderly, who are projected to account for 82.0% of outpatient visits, 77.5% of inpatient admissions, and 72.8% of health expenditures. In contrast, the demand for maternal, pediatric, and obstetric services will decrease drastically. These profound structural shifts highlight an urgent need for comprehensive healthcare policy reform, focusing on strategic health workforce planning and the reallocation of public health resources toward elderly care to mitigate these impending impacts.