文章推荐：泰国多支付方全民医疗体系：社会医疗保险、医疗服务利用与商业医疗保险购买｜保险学术前沿

Core Insights - The article discusses the differences in healthcare service utilization and private health insurance procurement among adults aged 45 and above in Thailand's multi-payer universal health system, focusing on three main public health insurance plans: Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), and Social Security Scheme (SSS) [5][9]. Group 1: Healthcare Service Utilization - CSMBS and SSS participants reported significantly higher outpatient service utilization compared to UCS participants, indicating lower barriers to accessing outpatient care for CSMBS and SSS enrollees [16][18]. - Among the 3,158 respondents, 66.31% had at least one outpatient visit in the past two years, with CSMBS participants having the highest outpatient service usage rate at 73.42%, compared to UCS (65.11%) and SSS (62.90%) [16][17]. - No significant differences were observed in hospitalization rates or frequency among the three insurance plans, likely due to the uniform payment system based on Diagnosis-Related Groups (DRG) for inpatient services [20][21]. Group 2: Private Health Insurance Procurement - Only 5.45% of respondents purchased private health insurance, with SSS participants being twice as likely to hold private insurance compared to UCS participants, while CSMBS participants showed lower likelihood [6][17]. - After adjusting for other variables, the difference in private insurance ownership between SSS and UCS participants diminished, indicating that socioeconomic status and health behaviors are significant factors influencing private insurance procurement [21][22]. Group 3: Policy Implications - The findings highlight the need for policymakers to address disparities in healthcare service utilization among different insurance plan participants, which could inform reforms aimed at achieving equitable healthcare access [26]. - The study suggests that standardizing benefits and payment methods across different insurance plans may help reduce disparities in service utilization [20][21].