Thailand Activates Primary Health System Act to Rescue State Hospitals From Severe Financial Deficit

Thailand activates the Primary Health System Act to assign family doctors to every household, aiming to solve the 82% deficit in state-owned hospitals.

By: AXL Media

Published: Apr 8, 2026, 8:50 AM EDT

Source: Information for this report was sourced from Bangkok Post

A Legislative Pivot Toward Preventive Medicine

The Ministry of Public Health has announced plans to fully exercise the Primary Health System Act BE 2562 as a strategic response to the deepening financial crisis within state-owned hospitals. By shifting the focus to disease prevention at the household level, Public Health Minister Pattana Promphat intends to reduce the sheer volume of patients requiring hospital-level intervention. This move is designed to transform the healthcare landscape, ensuring that larger medical centers are no longer overwhelmed by manageable conditions that could have been prevented through earlier lifestyle or medical guidance.

Family Physicians as the New Frontline Defense

Central to this initiative is the widespread appointment of family physicians who will provide holistic medical treatment directly to citizens. The government’s ambitious plan aims for every Thai family to be under the care of at least one dedicated doctor, creating a specialized layer of primary care. These physicians will serve as essential gatekeepers, filtering patients and providing early treatment that mitigates the risk of non-communicable diseases. By establishing this close link between families and practitioners, the ministry hopes to foster a healthier population while simultaneously protecting hospital resources for those in critical need.

Addressing the Relative Weight Funding Gap

Despite efforts to improve cash flow, the current reimbursement system remains a primary source of financial distress for state facilities. The ministry had projected a healthcare budget for fiscal year 2027 that would cover approximately 10,000 baht per adjusted relative weight (AdjRW), a significant increase from the current 8,350 baht rate. However, Minister Pattana acknowledged that even this increased figure falls short of the actual costs incurred by hospitals for long-term or complex cases. The AdjRW system, which calculates payments based on the length of stay and the intensity of care required, continues to highlight the disparity between government funding and clinical reality.