Development of an Operational Framework for Implementing the 'Universal Health Coverage 30-Baht Co-Payment Policy via Single Identity Card in Ubon Ratchathani Provincial Health Network.

Abstract

     This research is classified as Research and Development (R&D). The objectives were to study the current state, identify problems and needs, create and develop, trial, evaluate, refine, and disseminate an implementation model for the "30-Baht Treatment Everywhere with a Single ID Card" policy within the health network of Ubon Ratchathani Province. The study was conducted from November 2024 to June 2025. The target group consisted of 600 individuals, including community leaders, Village Health Volunteers (VHVs), doctors, professional nurses, public health academics, and private organization representatives.Additionally,13purposively selected participants were included, comprising 5 service recipients, 5 service providers, and 3 administrators, along with 9 experts.  Data were collected using questionnaires, recording forms, and focus group discussion guides. The data were analyzed using descriptive statistics.

     Results: The findings revealed that: 1) The highest service need was for chronic disease care, followed by traditional Thai medicine and physical therapy. A significant implementation barrier was the lack of real-time data integration in the IT systems. 2) The finalized implementation model comprised 8 steps: (1) Translating policy into action plans, (2) Resource allocation, (3) Communication and dissemination, (4) Plan execution, (5) Monitoring, inspection, and reporting, (6) Evaluation, (7) Improvement and scaling up, and (8) Creative questioning using Appreciative Inquiry (AI). The model's overall appropriateness and consistency were rated at the highest level. 3) Implementation progress was significant: 100% of the 26 hospitals and 366 network service units completed registration. Electronic Health Record (EHR) connectivity was achieved at 100%. Digital service utilization was high, with 862,023 citizen verifications using a Health ID and 95,802 Telemedicine consultations. Cybersecurity risks persisted at 100% despite achieving full integration (100%) of mHealth registration and Electronic Health Records (EHR). System adoption included 862,023 Health ID verifications and 95,802 telemedicine sessions. While digital transformation moderately improved operational efficiency, it significantly exacerbated staff workloads and hospital congestion, particularly in tertiary centers. Conversely, the transition successfully streamlined patient flow, reducing average outpatient (OPD) wait times by 50.97 minutes.