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Incentive and Regulation for physician retention in rural area: Thailand experience

Incentive and Regulation for physician retention in rural area: Thailand experience. Thinakorn Noree Human Resources for Health Research and Development office. Ratio doctor density Between Bangkok to Northeastern region. Rural development HFA/PHC. Economic crisis. Economic boom.

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Incentive and Regulation for physician retention in rural area: Thailand experience

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  1. Incentive and Regulationfor physician retention in rural area:Thailand experience Thinakorn Noree Human Resources for Health Research and Development office

  2. Ratio doctor density Between Bangkok to Northeastern region Rural development HFA/PHC Economic crisis Economic boom Economic recovery External brain drain 1965 1970 1975 1980 1985 1990 1995 2000 2005 Financial strategies 1979 Development of rural Health infrastructure 1968 3 years compulsory public work Fine 10,000 USD 1975 Hardship allowance 60-88 USD/mo 1995 Non-private practice allowance 250 USD/mo 1997 Increase Hardship allowance Normal 50 USD/mo Remote 250 USD/mo Very remote 500 USD/mo New medical graduate Normal area = 1,000 USD/mo Very remote = 1,500 USD/mo Southern area = 1,800 USD/mo Private sector = 2,000 USD/mo 2005 Special allowance More than 3 yrs work - 125 USD/mo Southern area – 250 USD/mo

  3. Ratio doctor density Between Bangkok to Northeastern region Rural development HFA/PHC Economic crisis Economic boom Economic recovery External brain drain 1965 1970 1975 1980 1985 1990 1995 2000 2005 Non-financial strategies 1978 Best rural doctor award 1991 PC level 8 (from 11 levels) 2007 PC level 9 (from 11 levels)

  4. Ratio doctor density Between Bangkok to Northeastern region Rural development HFA/PHC Economic crisis Economic boom Economic recovery External brain drain 1965 1970 1975 1980 1985 1990 1995 2000 2005 Educational strategies 1974 Rural doctor program (Rural recruitment and hometown placement) 1979 Medical education reform (PHC base, rural training) 1997 Collaborative Project to increase productionof rural doctor 300-500 /year 2006 ODOD project (one district one doctor)

  5. Lessons learned 1. More equitable socio-economic development is the basis for sustainable distribution of HRH 2.Contiunous and serious implementation of unified, integrated strategies, including integrated rural development, improved rural HS infrastructures, education, social, financial strategies are needed 3. Watch out for rapid economic growth, demand in rich countries, and international trade Data source: Suwit wibulpholprasert

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