Health-seeking behaviors of southern Thai middle-aged women by type of health insurance.

摘要

In 2001, the Thai Ministry of Public Health launched new universal health insurance a 30 baht scheme—a flatfee 30 baht (US{dollar} 0.65) Universal Health Card (UC) subsidized by the government to extend health insurance to the poor.; The purpose of this study was to describe the perceived health status, self-care activity and patterns of access to care of the UC insured compared to the older national program the Social Security Card (SSC) insured. Design of the study involved triangulation of data from a survey large sample (n = 326) with data from semi-structured interviews in a small sample (n = 10) of participants from Yala, a southern Thai province.; Data from the survey was found to show significant differences among the women by type of health insurance. Compared to the SSC women, the UC women had less education, less income, lower health status, and were more likely to be Muslim, and to live in rural area. The UC women reported undertaking a wide range of self-care activities for minor health problems, and rarely needing or seeking medical care for themselves. Health disparities between the UC and the SSC were found.; A random sample of 10 women was recruited for a semi-structured interview consisting of eight open-ended questions. The questions sought the women's definitions of health, self-evaluation of their health status, identifications of self-care strategies they used to maintain or promote their health, their views of the healthcare services they utilized, and how they thought that being a middle-aged women affected their health. Data from these interviews were interpreted by content analysis (Wilson, 1989). The analysis yielded thirteen themes that were validated with the informants.; Themes generated from the interviews exhibited common values of both the UC and the SSC women about “being healthy” and “self-care strategies”. Other themes emerged under “use of health service”.; The survey data and interview data helped the researcher to describe the women's health seeking behaviors and to reveal problems regarding the health insurance implementation. Factors to be reconsidered to enhance the efficiency of the health policy include personal barriers, structural barriers, and proper health communication.