Provision of High-cost Complete Denture Service through Universal Healthcare Coverage: Post Implementation Analysis in Western Thailand

Abstract

This cross-sectional study explored service provision and reimbursement situation of high-cost complete denture service delivery under Universal Healthcare Coverage scheme of 37 district hospitals located in western Thailand in fiscal year 2010. This study analyzed determinants associated with no high-cost dental prostheses provision to identify barriers to efficient service delivery. In fiscal year 2010, up to 827 patients received complete denture services which accounted for 3,145,015 THBs reimbursed expense to the National Health Security Office. Median of reimbursement was 74,800 THBs and the reimbursement ranged from 3,280 THBs to 357,896 THBs, excluding a hospital with no reimbursement. Median of labour productivity ratios was 7 cases per dentist and the highest ratio was 16.7 cases per dentist. Univariate and multivariate logistic regression to estimate crude and adjusted association between interested parameters i.e. hospital sizes, numbers of dentists, and degrees of ruralitycould not be undertaken due to insufficient outcome of no service provision. Graphical analysis using box-and whisker diagrams to explore relationship between labour input and service output depicted only primary relationship. Thus further investigation using more advanced analytical techniques of efficiency analysis and total productivity analysis was suggested to comprehensively identify hindrances of high-cost complete denture service delivery problem.