Evaluation of the local health Insurance Fund Management in Surat Thani

Abstract

This article aims to 1) study the management of successful local health insurance funds in the Surat Thani province, 2) evaluate the overall management of local health insurance funds in Surat Thani, and 3) propose a model for improving the management of these funds in the province. This research primarily employs qualitative methods, focusing on in-depth interviews with key informants, including local administrators or staff from local administrative organizations responsible for managing the local health insurance funds, public health officials, and other stakeholders involved in fund management, from both successful and unsuccessful groups, with a total of 38 participants (19 from each group).

The study findings reveal that 1) successful fund management focuses on analyzing the environment or context to align local needs with government policies, emphasizing community participation and health promotion outcomes; 2) the overall evaluation of fund management (across both successful and unsuccessful groups) highlights adherence to government regulations and policies, while also identifying limitations in budget, personnel, and involvement of other health groups within the community; and 3) recommendations include enhancing the knowledge and understanding of fund committees, increasing flexibility in budget allocation, and strengthening community participation and inter-agency coordination.