Distribution disparities among medical specialists in Thailand: an equity analysis of the national health workforce database (2015-2024)
Issued Date
2026-03-19
Resource Type
eISSN
20446055
Scopus ID
2-s2.0-105033872534
Pubmed ID
41856576
Journal Title
BMJ Open
Volume
16
Issue
3
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMJ Open Vol.16 No.3 (2026) , e103021
Suggested Citation
Sitthirat P., Suppawittaya P., Yoadsanit S., Osotthanakorn P., Srithamrongsawat S., Suriyawongpaisal P., Kaewkamjonchai P., Tangcharoensathien V. Distribution disparities among medical specialists in Thailand: an equity analysis of the national health workforce database (2015-2024). BMJ Open Vol.16 No.3 (2026) , e103021. doi:10.1136/bmjopen-2025-103021 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115951
Title
Distribution disparities among medical specialists in Thailand: an equity analysis of the national health workforce database (2015-2024)
Corresponding Author(s)
Other Contributor(s)
Abstract
OBJECTIVES: Ensuring equity in medical specialist distribution is essential for achieving universal health coverage (UHC). This study explored the changes in the availability and distribution of medical specialists in Thailand from 2015 to 2024 and assessed the equity impacts on workforce. DESIGN: A retrospective longitudinal analysis of national administrative workforce data. SETTING: Public and private hospitals across Thailand, covering 1471 facilities in 77 provinces. PRIMARY OUTCOME AND EXPLANATORY VARIABLES: The primary outcomes were specialist-to-population ratios and geographical equity measured using the Gini coefficient (G), where values closer to 0 indicate greater equity. Explanatory variables included specialty type, geographical region and the timing of major workforce policies, including mandatory service and specialty-specific legislative interventions. RESULTS: Between 2015 and 2024, the GPs and specialists in Thailand expanded significantly, with improvements in both density and distribution. The Gini coefficient for GPs showed the largest equity improvement (G=0.42 in 2015 and G=0.22 in 2024), reflecting the impact of mandatory service programme and rural recruitment programmes. Among specialists, emergency and family medicine have shown rapid growth and significant reductions in distribution inequity, reflecting the success of legislative policies. Sustainability of workforce policies was challenged by the 'leaking stock' phenomenon due to attraction of career opportunities and economic drives. CONCLUSION: Workforce targeted interventions have led to improvements in the availability and equitable distribution of GPs and medical specialists over the past decade. Further policy, such as retention incentives and assisted technology, is needed to achieve equitable distribution across all specialties, particularly in low-density fields. Thailand's experience offers the lessons for other low- and middle-income countries as the evidence-based and equity-focused workforce policies for UHC advancement.