Disrupting the healthcare delivery system: A qualitative study on implementing value-based healthcare in Thailand.

Abstract

The healthcare industry in Thailand is entering a watershed between the familiarity of traditional care providers and the innovative models that can disrupt the landscape creating more value for stakeholders. Public healthcare providers have been struggling to provide timely access to quality care under Thailand’s Universal Health Coverage policy, and how the country will fund healthcare schemes amid the onset of a super-aged society remains unclear. Private healthcare providers have directed their services to the growing medical tourism market, which left the middle-class to choose between the almost prohibitively expensive fees-for-service at private hospitals and the excruciatingly long waits at public healthcare facilities. To guarantee an equitable access to effective care for all Thai citizens, policymakers must ensure that the market for private players remains open to serve the domestic market in fair and flexible healthcare delivery models. The concept of Value-Based Health Care (VBHC) was proposed to address both low quality outcomes and its rising cost in health systems. However, the evidence of its implementation in low- and middle-income countries such as Thailand has been limited. The present study examined whether VBHC can be implemented in Thailand by identifying the perceived possibilities of adopting VBHC models and current public policies that possibly hinder an implementation of VBHC from the perspective of providers in the private healthcare sector of Thailand. Qualitative study was conducted by using documentary reviews, non-participant observations, and in-depth interviews of domestic private providers who were launching a new hospital chain and claimed that they adopted the VBHC model. Qualitative data was analyzed by thematic content analysis. The lesson learnt from this study can further advance the decision-making process for policymakers and healthcare leaders towards the effective implementation of VBHC in Thailand.