PROTECTION FOR SERVICE-FEE COLLECTION BY HEALTH CARE PROVIDERS IN HEALTH SERVICE UNITS ACCORDING TO THE NATIONAL HEALTH SECURITY ACT OF B.E.2545

Abstract

This is a qualitative research that aimed to study guidelines and processes in fee collecting staff in health service units in accordance with the National Health Security act of B.E. 2545 via semi-structured interview. The sample consisted of 10 staff members of the health care unit with the highest number of complaints in the year 2015 and 2 administrators of the National Health Security Office.

The results revealed that health care units have guidelines and processes in collecting fees for non-essential drugs or medical tools that fall outside the pick-list from the patients instead of collecting themselves, without negatively affecting its financial situation. The health care unit will inform patients before using it. If a patient is unable to pay, the doctor will change to use essential drug or medical devices in order not to affect health service units. In case of referral patient, the management will apply the same concept but make additional agreement with their personal health care unit before using non-essential drugs or medical devices. On the other hand all providers will collect drug or medical device expenses that patients request. When there are complaints, some health service units will refund all complainers to minimize the effect. However, some health service units will refund in case there is no conflict with their policy. When health service units receive orders according to section 59(2), they will refund to complainers and adjust guidelines and processes to prevent complaints from occurring again, and send a circular to all health service units. The National health security organization have to approve that the control measures are appropriate and inform all other health service units accordingly.

 The study recommends that there should be particular supporting funds for medication costs and medical tools that are not included in the “pick list” for the medical research purposes. It also recommends that the service-fee collections in hospitals and the up-to-date and more attractive disbursement system should be controlled by all stakeholders. Notification on the outcome of any decision of the Standard and Quality Control Board concerning the patient complaints should be made by the health care units.