Intention of private hospitals to become contractors in the prepaid social security scheme in Thailand: why and why not?

ABSTRACT

The objective of the study was to examine whether private hospitals wanted be main contractors (MCs) under the social security scheme. Data were obtained from a cross-sectional survey of 94 private hospitals in Bangkok and its vicinity area conducted between August 1995 and May 1996 using in-person interview and hospital survey forms. The overall response rate was 88.3%. The results showed that some 46 hospitals (55%) expressed their intention to become MCs. However, nearly 40% of MCs in 1995 indicated that they really did not want to join the scheme while several non-MC hospitals said that they wanted to participate. The most prevalent justifications for the intention of the hospitals to become MCs, or not, were operational and marketing-related in nature. While the scheme was considered a profitable market opportunity by many, it affected hospital positioning. Participation in the scheme might also complicate health services delivery. Whether private hospitals wanted, or did not want, to become MCs was associated with ownership status (p = 0.001) and leading competitive strategies of the hospitals (p = 0.041).