The 30-Baht Scheme : utilization of the gold card and the patient satisfaction at the Chulalongkorn Memorial Hospital, Bangkok

Abstract

A cross-sectional descriptive study was carried from 3rd-28th February 2003 at Chulalongkorn Memorial Howpital. The objectives of the study were to examine utilization of the Gold Card among the 30-Baht patients, to describe the attitude towards the 30-Baht Scheme and to determine satisfaction with hospital services under this scheme. The study was hospital based with a sample of 213 subjects were purposively determined as subjects. Two comparative groups (both 30-baht patients) were considered - registered and self-referred groups. Trained interviewers used pre-tested questionnaires to collect data, which included demographic features, attitude, utilization and satisfaction variables. Descriptive statistics as well as Non-arametric test, chi-Square test and correlation were used to explain relationships and significant difference between the variables of interest in the two groups. Women respondents represented 72.7% of the sample. A quarter of respondents is aged above 60 years. Generally, education level is low (51% primary grade) and unemployment is hight (32%). The literacy rate is low in the self-referred group, and 43% do not earn income at all, yet they can afford to pay for the services at Chulalongkorn Hospital. The self-referred group prefers this Hospital because of skilled doctors and trust and confidence in care. Nearly 85% of them are willing to register at this Hospital if given an opportunity. 52% of respondents used the Gold Card only in 2002, while 26% never used so far. Very few (15%) have used more than 6 times. The attitude of the respondents towards the 30-baht scheme was moderate (2.58), while both groups did not seem to agree with continuity of the scheme, though they felt privileged of using the Gold card. There was a significant difference in attitudes between the groups (p<.001). Satisfaction level was found high among the respondents (80.37%). Satisfaction in the care provided by doctors was accorded the highest rating in both the groups (>90%). And there was no significant difference in the satisfaction level between the registered and self-referred groups (p<.05), though there is difference in attitudes. Satisfaction had weak positive relation with attitude. A significant differnce was determied between the gold card utilization and payment methods (p<.001). Services of Chulalongkorn Hospital are regarded as highly satisfied by the 30-baht patients. In general, there seemed to be low utilization of the Gold Card among the registered group. Despite moderate attitudes towards the 30-Baht scheme, no variables seemed to deter the satisfction level of all respondents. However, respondent were not happy with the waiting time. Nonetheless, high satisfaction level among the users reflects the efficiency and high quality care at the Chulalongkorn Memorial Hospital.