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"display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_evidence_object_id": "display-claim:ad1f1284c67c7ccd451e244b" }, { "node_id": "tha:dhs-moph", "label": "MoPH public system", "family": "national", "display_claim_ids": [ "display-claim:fba54177446781edf11ec98a" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_evidence_object_id": "display-claim:fba54177446781edf11ec98a" } ], "graph_edges": [ { "source_node_id": "tha:dhs-moph", "target_node_id": "tha:dhs-phc", "relationship": "organizes public primary-care infrastructure", "relationship_family": "operations", "display_claim_ids": [ "display-claim:ddfaac6c0d0d44998c5ceed6" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_evidence_object_id": "display-claim:ddfaac6c0d0d44998c5ceed6" }, { "source_node_id": "tha:dhs-moph", "target_node_id": "tha:dhs-hospital", "relationship": "organizes public district hospital infrastructure", "relationship_family": "operations", "display_claim_ids": [ "display-claim:d4e89658757802713692e4ba" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_evidence_object_id": "display-claim:d4e89658757802713692e4ba" }, { "source_node_id": "tha:dhs-phc", "target_node_id": "tha:dhs-hospital", "relationship": "links primary care and hospital care in district configurations", "relationship_family": "network", "display_claim_ids": [ "display-claim:345cbbb091a8b4061ab97ec3" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_evidence_object_id": "display-claim:345cbbb091a8b4061ab97ec3" } ] }, "title": "District health systems connect primary care and hospitals", "statement": "The public district configuration links hospitals and primary-care centres. The diabetes study offers an observed UCS district dataset, while the HiT supplies national organization context; neither source measures every referral or integration outcome.", "citation": "WHO Thailand HiT 2024, section 5.3, PDF page 128; Sriratanaban et al. 2018, Introduction and Methods.", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6208489/", "locator": "HiT section 5.3, including PDF page 128; district study Introduction and Methods.", "period": "HiT context through 2024; UCS district claims, fiscal years 2014 to 2015", "territory": "Thailand; district study covers 838 districts and excludes Bangkok and Pattaya", "evidence_mode_candidate": "observed", "verification_source_layer": "research_literature", "coverage_domains": [ "primary_care", "hospital_organization", "networks", "facility_data", "utilization", "patient_flows", "governance", "authoritative_review" ], "source_references": [ { "title": "Thailand Health System in Transition Review, second edition", "citation": "Tangcharoensathien V, editor. Thailand health system review. Manila: World Health Organization Regional Office for the Western Pacific; 2024. https://apo.who.int/publications/9789290620457", "url": "https://apo.who.int/publications/9789290620457", "locator": { "locator_type": "report_sections", "sections": [ "2 Organization and governance", "3 Health financing", "5.3 Primary/ambulatory care", "6 Principal health reforms" ], "physical_pdf_pages": [ 40, 128 ], "source_word_anchor": "devolution of subdistrict health centres from the MoPH", "source_word_count": 8 }, "source_version": { "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c", "detected_media_type": "text/html", "page_count": 326, "hash_verified": true, "retrieved_at": "2026-08-21" }, "source_projection_id": "country-improvement-source:THA:who-hit-2024", "display_source_id": "display-source:THA:9802ff3da7c75076de0ae47e", "source_version_id": "display-source-version:00ea86538bc5d7ebf1c679d8" }, { "title": "Associations between structures and resources of primary care at the district level and health outcomes", "citation": "Sriratanaban J, et al. Associations between structures and resources of primary care at the district level and health outcomes: a case study of diabetes mellitus care in Thailand. Risk Management and Healthcare Policy. 2018;11:199-208. https://pmc.ncbi.nlm.nih.gov/articles/PMC6208489/", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6208489/", "locator": { "locator_type": "article_sections", "sections": [ "Methods", "Study design and population", "Introduction" ], "source_word_anchor": "hospitals and primary care centers", "source_word_count": 5 }, "source_version": { "response_sha256": "d5c78b793ef44de31b80e4bef4652a12675c653e6b66d2cc81cd0867abfaf8a9", "detected_media_type": "text/html", "hash_verified": true, "retrieved_at": "2026-08-21" }, "source_projection_id": "country-improvement-source:THA:district-primary-care-2018", "display_source_id": "display-source:THA:f91f2d0718b489ea8621fb1b", "source_version_id": "display-source-version:1c3f0d2c599e3ab534c5db09" } ], "source_version": { "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c", "detected_media_type": "text/html", "page_count": 326, "hash_verified": true, "retrieved_at": "2026-08-21" }, "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:f91f2d0718b489ea8621fb1b" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:1c3f0d2c599e3ab534c5db09" ], "display_claim_ids": [ "display-claim:5e9df0e1705d570a8cae693d", "display-claim:a6e13758671bd100cb9cc74f", "display-claim:ebed14227cd3276d99c55bcd", "display-claim:ad1f1284c67c7ccd451e244b", "display-claim:fba54177446781edf11ec98a", "display-claim:ddfaac6c0d0d44998c5ceed6", "display-claim:d4e89658757802713692e4ba", "display-claim:345cbbb091a8b4061ab97ec3" ], "display_evidence_object_id": "display-claim:5e9df0e1705d570a8cae693d", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:THA:delivery-referrals:scheme-specific-formal-referral-and-choice", "country_id": "THA", "mapping_group": "delivery_and_referrals", "target_view": "referrals", "target_slot": "registered-network-referral-and-choice-rules", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "source-linked legal, NHSO operational-design and strategic-purchasing scheme comparison", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:who-uhc-law-2019", "country-improvement-source:THA:strategic-purchasing-2015", "country-improvement-source:THA:participatory-governance-2021", "country-improvement-source:THA:nhso-uhc-overview-2019" ], "typed_fields": { "ucs": "The NHSO overview describes general UCS care as starting at a registered contracting unit, with referral to a participating UCS hospital when the unit lacks capacity.", "shi": "SHI access is reported through a registered contractor hospital and its network.", "csmbs": "CSMBS is described as allowing a different public-facility choice arrangement and no referral requirement in the scheme comparison.", "counter_referral": "No source in this pack establishes a nationwide, measured counter-referral completion rate.", "boundary": "Formal scheme design does not show adherence, bypassing, waiting time or successful information return in practice." }, "analytical_objects": { "graph_nodes": [ { "node_id": "tha:ref-member", "label": "Scheme member", "family": "community", "display_claim_ids": [ "display-claim:953e926ccc2c62abd3d5bfb4" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:953e926ccc2c62abd3d5bfb4" }, { "node_id": "tha:ref-registered", "label": "Registered primary or contractor unit", "family": "provider", "display_claim_ids": [ "display-claim:49d004b264eb0ef4d3427f60" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:49d004b264eb0ef4d3427f60" }, { "node_id": "tha:ref-network", "label": "Contracted referral network", "family": "provider", "display_claim_ids": [ "display-claim:2b9f7778f2c4852b59e790f0" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:2b9f7778f2c4852b59e790f0" }, { "node_id": "tha:ref-ucs", "label": "UCS purchaser", "family": "purchaser", "display_claim_ids": [ "display-claim:d0473e2c359e9da9bc682929" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:d0473e2c359e9da9bc682929" }, { "node_id": "tha:ref-other", "label": "SHI and CSMBS arrangements", "family": "purchaser", "display_claim_ids": [ "display-claim:910ec19a3233922643ae24f9" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:910ec19a3233922643ae24f9" } ], "graph_edges": [ { "source_node_id": "tha:ref-ucs", "target_node_id": "tha:ref-registered", "relationship": "organizes access through registered UCS units", "relationship_family": "purchasing", "display_claim_ids": [ "display-claim:896525e58fc1eb76a3ce3bcd" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:896525e58fc1eb76a3ce3bcd" }, { "source_node_id": "tha:ref-registered", "target_node_id": "tha:ref-network", "relationship": "uses referral for care beyond unit capability", "relationship_family": "referral", "display_claim_ids": [ "display-claim:e7d6cb89f1dfd5546316ad65" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:e7d6cb89f1dfd5546316ad65" }, { "source_node_id": "tha:ref-other", "target_node_id": "tha:ref-network", "relationship": "uses different scheme-specific network and choice rules", "relationship_family": "purchasing", "display_claim_ids": [ "display-claim:44d8be1624bf1d060842bef9" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:44d8be1624bf1d060842bef9" }, { "source_node_id": "tha:ref-member", "target_node_id": "tha:ref-registered", "relationship": "accesses registered provider arrangements where applicable", "relationship_family": "referral", "display_claim_ids": [ "display-claim:722f3efd228d5c6390776a5c" ], "display_source_ids": [ "display-source:THA:9802ff3da7c75076de0ae47e", "display-source:THA:9222ddf590558dc2f6695666", "display-source:THA:4583b01ee59420e2dcf1b7e7", "display-source:THA:8734b6d25533b3663ffad6ba", "display-source:THA:7314adacbffcec44578e8459" ], "source_version_ids": [ "display-source-version:00ea86538bc5d7ebf1c679d8", "display-source-version:5bea5b203654d8204150cf9c", "display-source-version:979bedebe72df1c9d74175ad", "display-source-version:fc4e21b175fc9346785ead74", "display-source-version:30332a19c24c1892278e94c2" ], "display_evidence_object_id": "display-claim:722f3efd228d5c6390776a5c" } ] }, "title": "Referral and patient choice are scheme-specific", "statement": "UCS and SHI use registered provider arrangements and referral pathways, whereas CSMBS has different facility-choice provisions. The available sources do not justify a single national gatekeeping or counter-referral performance measure.", "citation": "WHO Thailand HiT 2024, Table 2.1, PDF page 40; WHO UHC law profile 2019; NHSO UHC overview 2019, PDF page 30; Patcharanarumol et al. 2015, Table 1; Tangcharoensathien et al. 2021, Results and Table 2.", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4597041/", "locator": "HiT Table 2.1, PDF page 40; WHO legal-profile access section; NHSO overview, Policy design for benefits package, PDF page 30; strategic-purchasing Table 1; governance article Results and Table 2.", "period": "Published legal and scheme descriptions from 2015 to 2024; NHSO overview issued 2019", "territory": "Thailand statutory public schemes", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "coverage_domains": [ "actors", "decision_rights", "primary_care", "hospital_organization", "referral_design", "observed_referral", "networks", "patient_flows", "governance", "market_structure", "authoritative_review" ], "source_references": [ { "title": "Thailand Health System in Transition Review, second edition", "citation": "Tangcharoensathien V, editor. Thailand health system review. Manila: World Health Organization Regional Office for the Western Pacific; 2024. https://apo.who.int/publications/9789290620457", "url": "https://apo.who.int/publications/9789290620457", "locator": { "locator_type": "report_sections", "sections": [ "2 Organization and governance", "3 Health financing", "5.3 Primary/ambulatory care", "6 Principal health reforms" ], "physical_pdf_pages": [ 40, 128 ], "source_word_anchor": "devolution of subdistrict health centres from the MoPH", "source_word_count": 8 }, "source_version": { "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c", "detected_media_type": "text/html", "page_count": 326, "hash_verified": true, "retrieved_at": "2026-08-21" }, "source_projection_id": "country-improvement-source:THA:who-hit-2024", "display_source_id": "display-source:THA:9802ff3da7c75076de0ae47e", "source_version_id": "display-source-version:00ea86538bc5d7ebf1c679d8" }, { "title": "UHC law in practice: legal access rights to health care, Thailand country profile", "citation": "World Health Organization. UHC law in practice: legal access rights to health care: country profile: Thailand. Geneva: WHO; 2019. https://www.who.int/publications/i/item/9789240000179", "url": "https://www.who.int/publications/i/item/9789240000179", "locator": { "locator_type": "report_sections", "sections": [ "Overview", "Statutory insurance schemes", "Access to health care" ], "physical_pdf_pages": [ 1, 4, 8 ], "source_word_anchor": "legal access rights to health care", "source_word_count": 6 }, "source_version": { "response_sha256": "a7b5ebb390b3c00da589ff9dc2baa1aaed8c6c4775ebbff027ebed402240fda5", "detected_media_type": "text/html", "page_count": 11, "hash_verified": true, "retrieved_at": "2026-08-21" }, "source_projection_id": "country-improvement-source:THA:who-uhc-law-2019", "display_source_id": "display-source:THA:9222ddf590558dc2f6695666", "source_version_id": "display-source-version:5bea5b203654d8204150cf9c" }, { "title": "Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing", "citation": "Patcharanarumol W, et al. Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing. 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Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand. 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The diabetes study offers an observed UCS district dataset, while the HiT supplies national organization context; neither source measures every referral or integration outcome.", "tags": [], "territory": "Thailand; district study covers 838 districts and excludes Bangkok and Pattaya", "title": "District health systems connect primary care and hospitals", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6208489/" }, { "kind": "source_reference", "source": "Thailand Health System in Transition Review, second edition", "url": "https://apo.who.int/publications/9789290620457" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked legal analysis, system review and observed referral studies", "mapping_group": "time_and_reform", "mapping_id": "candidate-mapping:THA:time-reform:formal-design-and-implementation-boundaries", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:who-uhc-law-2019", "country-improvement-source:THA:participatory-governance-2021", "country-improvement-source:THA:referral-information-sharing-2022", "country-improvement-source:THA:university-self-referral-2021" ], "support_state": "candidate_supported", "target_slot": "formal-scheme-design-versus-observed-implementation", "target_view": "reforms", "typed_fields": { "causal_boundary": "No source here proves that a legal rule or organizational reform caused national changes in referral completion, integration or patient choice.", "formal_layer": "Legal and scheme sources establish differentiated access, participation and registration arrangements.", "observed_layer": "Referral information sharing and self-referral studies identify implementation concerns in their defined samples.", "organizational_layer": "The HiT reports an ongoing local-government transfer of subdistrict centres." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "WHO Thailand HiT 2024; WHO UHC law profile 2019; Tangcharoensathien et al. 2021; Lertpong et al. 2022; Chotipanich et al. 2021.", "country_ids": [ "THA" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "observed_referral", "ownership", "patient_flows", "primary_care", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": null, "institution": null, "locator": { "description": "HiT Overview and sections 5.3 and 6; WHO legal-profile access sections; governance article Results; referral-information Results and Discussion; self-referral Introduction, Methods and Results." }, "material_id": "material:1b431b7c1c505f2db80ebaf7", "notes": [], "origin": "candidate-analytical-mappings", "period": "Formal and reported evidence from 2019 to 2024; one-hospital observation published 2021", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "page_count": 326, "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c" }, "statement": "Thai sources establish scheme rules and report a current primary-care governance transition, while referral studies show bounded implementation concerns. These evidence layers should not be conflated into a national causal claim about integration or patient behaviour.", "tags": [], "territory": "Thailand, with the self-referral result limited to one hospital", "title": "Formal rules, organizational change and observed use remain separate", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9635045/" }, { "kind": "source_reference", "source": "Thailand Health System in Transition Review, second edition", "url": "https://apo.who.int/publications/9789290620457" }, { "kind": "source_reference", "source": "UHC law in practice: legal access rights to health care, Thailand country profile", "url": "https://www.who.int/publications/i/item/9789240000179" }, { "kind": "source_reference", "source": "Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7896578/" }, { "kind": "source_reference", "source": "Self-Referral to the University Hospital Resulting in Unnecessary Patient Expenses", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8281879/" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://iris.who.int/server/api/core/bitstreams/0a110dbd-c49a-4bbb-b4b4-91bca3bc8b86/content" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked professional-perception survey and one-hospital prospective study", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:THA:relationships-networks:observed-referral-information-and-self-referral", "source_projection_ids": [ "country-improvement-source:THA:referral-information-sharing-2022", "country-improvement-source:THA:university-self-referral-2021" ], "support_state": "candidate_supported", "target_slot": "reported-information-exchange-and-local-self-referral", "target_view": "referrals", "typed_fields": { "counter_referral": "Neither study reports a national counter-referral-completion rate.", "generalizability": "The first is a respondent-perception study and the second is one hospital; neither estimates nationwide referral completion or bypass prevalence.", "information_exchange": "The professional survey describes perceptions of healthcare information sharing in referrals across within-hospital, Bangkok and cross-province experiences.", "self_referral": "The prospective study observes self-referral at one super-tertiary university hospital." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Lertpong et al. 2022, healthcare-professional results and Discussion; Chotipanich et al. 2021, Introduction, Methods and Results.", "country_ids": [ "THA" ], "coverage_domains": [ "authoritative_review", "governance", "hospital_organization", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "observed", "excerpt": null, "institution": null, "locator": { "description": "Referral-information article, healthcare-professional Results and Discussion; self-referral article, Introduction, Methods and Results." }, "material_id": "material:8c24db7eead78da856b00644", "notes": [], "origin": "candidate-analytical-mappings", "period": "Studies published 2021 and 2022", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "77da4d6054ee2cee96c1022a58d10e708e7d2430e1ff49bef3e185797ca3d1f6" }, "statement": "A national professional-perception study identifies information-sharing constraints in referrals, while a one-hospital prospective study observes self-referral. They demonstrate implementation questions but do not quantify national referral completion, counter-referral or bypassing.", "tags": [], "territory": "Thailand; self-referral observation limited to one super-tertiary university hospital", "title": "Observed referral evidence is local and implementation-focused", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC9635045/" }, { "kind": "source_reference", "source": "Self-Referral to the University Hospital Resulting in Unnecessary Patient Expenses", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8281879/" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked system review, purchasing comparison and private-contracting study", "mapping_group": "relationships_and_networks", "mapping_id": "candidate-mapping:THA:relationships-networks:public-private-and-scheme-branches", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:strategic-purchasing-2015", "country-improvement-source:THA:participatory-governance-2021", "country-improvement-source:THA:private-sector-contracting-2023" ], "support_state": "candidate_supported", "target_slot": "public-delivery-and-contracted-provider-branches", "target_view": "public-private", "typed_fields": { "boundary": "The sources do not provide a current national public-private market share, universal contract list or comparative performance result; the 2023 contracting study is focused on Greater Bangkok.", "choice": "UCS and SHI access is tied to registered contractor networks, while CSMBS has a different public-facility choice design.", "private_branch": "Private providers participate through scheme-specific contracted arrangements and a broader private market.", "public_branch": "Primary care is reported as publicly dominated, with MoPH facilities central to the public delivery network.", "urban_contracting": "A 2023 qualitative study reports that NHSO and SSO contract private providers to address gaps in public provision, particularly in urban settings." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "WHO Thailand HiT 2024, section 5.3 and Table 2.1; Patcharanarumol et al. 2015, Table 1; Tangcharoensathien et al. 2021, Results and Table 2; Marshall et al. 2023, Abstract and Results.", "country_ids": [ "THA" ], "coverage_domains": [ "actors", "authoritative_review", "facility_data", "governance", "hospital_organization", "market_structure", "networks", "ownership", "primary_care", "referral_design", "utilization" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": null, "institution": null, "locator": { "description": "HiT primary-care section and Table 2.1; strategic-purchasing Table 1; governance article Results and Table 2; private-contracting Abstract, Methods and Results." }, "material_id": "material:bf5d0b6f316ce532f66d9c6a", "notes": [], "origin": "candidate-analytical-mappings", "period": "Published sources from 2015 to 2024; private-contracting study published 2023", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "research_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "page_count": 326, "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c" }, "statement": "Thailand's primary-care system is publicly dominated, but private providers can participate through particular scheme contracts and private payment. Patient choice and provider access depend on the coverage scheme and registered network.", "tags": [], "territory": "Thailand; qualitative private-contracting findings focus on Greater Bangkok", "title": "Public delivery is central, with scheme-specific private participation", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4597041/" }, { "kind": "source_reference", "source": "Thailand Health System in Transition Review, second edition", "url": "https://apo.who.int/publications/9789290620457" }, { "kind": "source_reference", "source": "Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7896578/" }, { "kind": "source_reference", "source": "Contracting the private health sector in Thailand's Universal Health Coverage", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10146570/" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked national review and district study with explicit non-inference limits", "mapping_group": "decision_rights_and_autonomy", "mapping_id": "candidate-mapping:THA:decision-autonomy:public-provider-autonomy-and-accountability-boundary", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:district-primary-care-2018", "country-improvement-source:THA:strategic-purchasing-2015" ], "support_state": "candidate_supported", "target_slot": "public-provider-management-boundary", "target_view": "autonomy", "typed_fields": { "boundary": "No source in this pack establishes a national answer for hospital hiring, capital, procurement or retained-revenue authority.", "devolution": "The 2022 transfer of subdistrict health centres is an institutional change whose service and autonomy effects require further evidence.", "payment": "Purchasing and payment methods constrain the use of funds but do not disclose every provider's budget discretion.", "public_management": "The MoPH-centered public system and district hospital-primary-care configuration support an accountability relationship, not evidence of a uniform autonomous-provider model." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "WHO Thailand HiT 2024, primary-care and reform sections; Sriratanaban et al. 2018, Methods; Patcharanarumol et al. 2015, Table 1.", "country_ids": [ "THA" ], "coverage_domains": [ "authoritative_review", "autonomy", "decision_rights", "governance", "hospital_organization", "networks", "ownership", "primary_care", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": null, "institution": null, "locator": { "description": "HiT section 5.3, PDF page 128, and principal-reforms section; district study Methods; purchasing article Table 1." }, "material_id": "material:5bea17f5c9436abef0b5c641", "notes": [], "origin": "candidate-analytical-mappings", "period": "District data 2014 to 2015 and institutional review through 2024", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "page_count": 326, "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c" }, "statement": "The evidence supports a MoPH-centred public delivery context, district configurations and purchaser accountability. It does not support a uniform national claim about hospital or primary-care autonomy across staffing, procurement, capital and operations.", "tags": [], "territory": "Thailand; district study excludes Bangkok and Pattaya", "title": "Public-provider autonomy is not uniform or fully specified", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://apo.who.int/publications/9789290620457" }, { "kind": "source_reference", "source": "Associations between structures and resources of primary care at the district level and health outcomes", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6208489/" }, { "kind": "source_reference", "source": "Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4597041/" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked legal, NHSO operational-design and strategic-purchasing scheme comparison", "mapping_group": "delivery_and_referrals", "mapping_id": "candidate-mapping:THA:delivery-referrals:scheme-specific-formal-referral-and-choice", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:who-uhc-law-2019", "country-improvement-source:THA:strategic-purchasing-2015", "country-improvement-source:THA:participatory-governance-2021", "country-improvement-source:THA:nhso-uhc-overview-2019" ], "support_state": "candidate_supported", "target_slot": "registered-network-referral-and-choice-rules", "target_view": "referrals", "typed_fields": { "boundary": "Formal scheme design does not show adherence, bypassing, waiting time or successful information return in practice.", "counter_referral": "No source in this pack establishes a nationwide, measured counter-referral completion rate.", "csmbs": "CSMBS is described as allowing a different public-facility choice arrangement and no referral requirement in the scheme comparison.", "shi": "SHI access is reported through a registered contractor hospital and its network.", "ucs": "The NHSO overview describes general UCS care as starting at a registered contracting unit, with referral to a participating UCS hospital when the unit lacks capacity." } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "WHO Thailand HiT 2024, Table 2.1, PDF page 40; WHO UHC law profile 2019; NHSO UHC overview 2019, PDF page 30; Patcharanarumol et al. 2015, Table 1; Tangcharoensathien et al. 2021, Results and Table 2.", "country_ids": [ "THA" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "hospital_organization", "market_structure", "networks", "observed_referral", "patient_flows", "primary_care", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": null, "institution": null, "locator": { "description": "HiT Table 2.1, PDF page 40; WHO legal-profile access section; NHSO overview, Policy design for benefits package, PDF page 30; strategic-purchasing Table 1; governance article Results and Table 2." }, "material_id": "material:f09320dffbabf99eb0a12f49", "notes": [], "origin": "candidate-analytical-mappings", "period": "Published legal and scheme descriptions from 2015 to 2024; NHSO overview issued 2019", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "page_count": 326, "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c" }, "statement": "UCS and SHI use registered provider arrangements and referral pathways, whereas CSMBS has different facility-choice provisions. The available sources do not justify a single national gatekeeping or counter-referral performance measure.", "tags": [], "territory": "Thailand statutory public schemes", "title": "Referral and patient choice are scheme-specific", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4597041/" }, { "kind": "source_reference", "source": "Thailand Health System in Transition Review, second edition", "url": "https://apo.who.int/publications/9789290620457" }, { "kind": "source_reference", "source": "UHC law in practice: legal access rights to health care, Thailand country profile", "url": "https://www.who.int/publications/i/item/9789240000179" }, { "kind": "source_reference", "source": "Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC7896578/" }, { "kind": "source_reference", "source": "Thailand UHC & overview of the Universal Coverage Scheme of the National Health Security Office", "url": "https://media.nhso.go.th/assets/portals/1/files/Lesson_Learn_on_UHC/62-1_OVERVIEW_Book(Eng).pdf" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://iris.who.int/server/api/core/bitstreams/0a110dbd-c49a-4bbb-b4b4-91bca3bc8b86/content" } ] }, { "analytical_mapping": { "mapping_basis": "source-linked WHO system reviews, WHO legal profile and scheme purchasing study", "mapping_group": "actors_and_functions", "mapping_id": "candidate-mapping:THA:actors-functions:scheme-and-delivery-architecture", "source_projection_ids": [ "country-improvement-source:THA:who-hit-2024", "country-improvement-source:THA:who-hit-2024-organizational-interlinkages", "country-improvement-source:THA:who-uhc-law-2019", "country-improvement-source:THA:strategic-purchasing-2015", "country-improvement-source:THA:participatory-governance-2021" ], "support_state": "candidate_supported", "target_slot": "national-stewardship-purchasing-and-delivery", "target_view": "functions", "typed_fields": { "boundary": "These roles do not establish a single purchaser, uniform provider ownership, identical access conditions, or complete provider autonomy across schemes.", "delivery": "public primary care and hospitals are central to UCS delivery, alongside contracted private providers in specified arrangements", "other_public_schemes": "SHI and CSMBS have distinct administering authorities and access arrangements", "provincial_administration": "The HiT identifies Provincial Health Offices as provincial administrators that report to governors, receive MoPH technical support, and oversee or support named public facilities and district health offices", "stewardship": "MoPH has national stewardship and operates much of the public delivery system", "ucs_purchasing": "NHSO administers and purchases for UCS" } }, "annotation_status": "open", "authors": [], "availability": {}, "citation": "WHO Thailand HiT 2024, Figure 2.3 and physical PDF page 26, sections 2 to 5 and Table 2.1; WHO UHC law profile 2019; Patcharanarumol et al. 2015; Tangcharoensathien et al. 2021.", "country_ids": [ "THA" ], "coverage_domains": [ "actors", "authoritative_review", "decision_rights", "governance", "government_responsibilities", "hospital_organization", "market_structure", "networks", "ownership", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": null, "institution": null, "locator": { "description": "HiT Figure 2.3 and accompanying organizational text, physical PDF page 26; HiT Table 2.1, PDF page 40; WHO legal-profile statutory-schemes section; purchasing article Table 1." }, "material_id": "material:8bcab68e612962e3c5f42a86", "notes": [], "origin": "candidate-analytical-mappings", "period": "National architecture described in sources published 2015 to 2024", "publication_date": null, "publication_year": null, "record_kind": "candidate_analytical_mapping", "record_kind_label": "Candidate Analytical Mapping", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "page_count": 326, "response_sha256": "2faa2400933d852768edc70596bc541935f0f5996209b98ffeac4bd2ab233d5c" }, "statement": "Thailand combines MoPH stewardship and extensive public delivery with scheme-specific purchasing. 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