Hospital-based Online Birth Registration in Thailand

Netnapis Suchonwanich

Assistant secretary general

National Health security office

2

Content Background of health insurance registration in

Thailand

Evolution of seamless operation for UC

enrollment system

Move forward to birth and birth defect registry

MOI’s Main System for issuing the National ID CardMOI’s Main System for issuing the National ID Card

9 RegionalCenters

ID CardCentral

76 Provincial

Offices876

District Offices

KhonthaiCA

CPDCentral

PopulationDatabase

CentralRegistration

Bureau

CentralRegistration

Bureau

Initial Participation

AgenciesPDS

Population DataSubset

201Major Local

Offices

Internet

Khonthai.com

980 Minor Local

Offices

6,744Sub-districtAuthorities

ParticipationAgencies

Population Data

Subset at agency

72,000 Villages

OverseaRegistration

Offices

ICR - IC Reader

PC ICR

Public Officer

•Data Reading

•Data Updating

People

House Owner

•Data Read/Update

Database atRegionalcenter

Data Communication

Network

CardControl

•2,002 Health care•274 Social Security •1,282 Hospital

100,000

Multi-Purpose

machine

Kiosks

47 MOUAgencies

257Personnel Divisions

•Data Read/Update•Data Read/Update

•Data Read/Update

•Applying for card•Data Read/Update

•Applying for card•Data Read/Update

Universal coverageScheme

(UC)

Civil Servant Medical Benefits Scheme

(CSMBS)

Dynamic of health insurance status

in Thailand

Social security Scheme

(SSS)

DeadDead

Dead

Work in Formal sector

QuitFired retired

QuitFiredretired

Become gov.officer

ม้�งStateless people

Beneficiary enrollment System

Social Security Office

Civil Servant

Immigration Department

Ministry of Interior

RegistrationData fromprovincialOffices( Batch online)

RegistrationData from Other registrationunits (online)

Internet

Centralized database

CSMBS member

(every 2 weeks)

SSS member (every 2 weeks

)

Health in

surance

data (every

day)

Birth – death data

(every month)

Death data

(every month)

Peop

le l

ive i

n

fore

ign

coun

tries

Birth –

death data

(every day)

Enrollment dataVerified data

Enrollme

nt data

NHSO

Verified data (

real time)

EAI

State enterprise,local administration

Mem

bers

d

ata

Card ID , Purchase province

Eligibility primary care unit,

Referral hospital , start

date,

Expiry date

transdate

How to identify the beneficiaries

People withoutNational ID card

People with National ID card

Key 13 digits

Card reader

Household registration booklet or certificate of birth

Key 13 digits

How to identify the beneficiaries at the provider’s site

Website

Kiosk

9

Interactive voice recognition

(24 hrs. service)

1330

(สปสช.)

Information of UC Scheme from NHSO head office :

eligibilty data

Information from Ministry of Interior : first name, last name, birth date, live status,hometown address

Concurrent retrieves data from 2 remote sites database : MOI , NHSO

0

2

4

6

8

10

12

14

registration error

Decrease in beneficiary enrollment errors from 2002-2005

System analysis for unregistered persons by age group (June 2011)

00-0

4 y

5-9

y

10-1

4y

15-1

9 y

20-2

4 y

25-2

9 y

30-3

4 y

35-3

9 y

40-4

4 y

45-4

9 y

50-5

4 y

55-5

9 y

60-6

4 y

65-6

9 y

70-7

4 y

75-7

9 y

80-8

4 y

85-8

9 y

90-9

4 y

95- 9

9y

100-

124

y0

20000

40000

60000

80000

100000

120000

Total uninsured = 481,332

child 0-5 yr.

Working age

õ ä þ Ă ø ä ā ä á þ āĕä Ĝā Ă þ ä āĔĂ

SSS -> ćĤĒç 95,531 115,318 93,353 100,018 91,131 95,409 85,827 89,700 86,204

SSS -> UC 33,864 37,023 33,608 39,997 30,752 33,920 32,609 31,837 33,205

-

20,000

40,000

60,000

80,000

100,000

120,000

140,000

èĩĒù

ćù

Ĝôėčù SSS -> ćĤĒç SSS -> UC

The gap from out-SSS to become UC member

OCT 2010

NOV2010

FEB2011

DEC2010

JAN2011

MAR2011

APR2011

MAY2011

JUN2011

NULL

SSSNULL

MONTH

AM

OU

NT

-

5,000

10,000

15,000

20,000

25,000

เดื�อน

จำ�นว

น

OFC -> ว่�าง OFC -> UC

OFC -> ว่�าง 21,752 12,975 7,970 8,875 7,491 7,407 8,089 7,062 7,259

OFC -> UC 7,531 4,401 2,727 2,541 2,514 2,609 2,358 2,379 2,598

ต. ค 53 พ. ย 53 ธ. ค 53 ม. ค 54 ก. พ 54 ม�. ค 54 เม. ย

54 พ. ค 54 ม�. ย 54

The gap from out-CSMBS to become UC member

OCT 2010

NOV2010

FEB2011

DEC2010

JAN2011

MAR2011

APR2011

MAY2011

JUN2011

MONTH

AM

OU

NT

OFC NULL

OFCNULL

System analysis for re-uninsured

1. Children between 0-5 yr.

2. Out from other schemes

2.1 Quit /retire/fire from SSS

2.2 Quit /retire/fire from CSMB which will

cover

- Their children beyond 20 yr.

- Their couple and parents

newborn

newborn

The Development of UC Coverage

60

70

80

90

100

110

69.2

92.47 93.01 95.47 96.2597.82 98.75 99.16 99.47 99.15 99.37 99.82

17

YEAR

%

2012

18

The benefits from applying civil registration

2002 : Establish the UC enrollment system

2005 : Establish Civil servant database

2007 : Improved the HIV/AIDs’ patients

database

2011 : Enhance the Birth registry

2012 : Move forward to Birth defect

registry

19

Birth and birth defect registry

Delivery Registration (DR) in hospital

20

Newborn

Delivery certificate

No Birth certificate

No Delivery certificate

Birthcertificate

In Hospital

Local administrati

on (MOI )

Outside hospital

700,000-800,000 newborns/year

Around 7 %(50,000-60,000

cases/yr)

21

The implementation of birth registry in Thailand

In the year 2011, the collaboration among the

Ministry of interior (MOI), UNICEF, MOPH and

NHSO were taken place for establishing of

birth registry by linking the birth data from

hospital’s delivery room to MOI’s database.

The data will be further prepared for issuing

the national ID and birth certificate later.

Project plan

22

Phase 1 : 2011 implemented in 40 pilot public hospitals

Phase 2 : 2012 Expanded more to 538 hospitals

Phase 3 : 2013Going nation wide in every public hospitals

Process of birth registry

Delivery certificate Get 13 digits

Key in delivery record

Print out delivery certificate

Issue Birth certificate

1. Through HIS2. upload the birth

data (complied with standard data structure) from the delivery room to MOI database for preparing the national ID and birth certificate.

.

Hospital Local administrative organization

24

The data included in birth registry

1. General data for Newborn

2. Family status

3. Doctor /nurse information

4. Add on some more details

involving the abnormal newborn

5. Mother’ s illness

25

ISSUE

local administrative org.

local administrative org. NHSO

Monitoring data for follow up

Still not get birth certificate

local administrative org.

Still not get birth certificate NHSO

Monitoring data for follow up

Birth registry scenariosBest case

Expected to

Worst case

Delivery certificate

Delivery certificate

Birth certificate

Follow up the

incomplete

civil registration

Delivery certificate

26

Move forward to birth defect registry in 2012

Normally, around 2-3% of newborns (approximately

24,000 to 40,000 per year) were found to have

congenital anomalies.

As Thailand still lacks the database for children with

birth defects, particularly for children with 0-7 years,

which is an obstacle in the reduction and prevention of

neonatal congenital.

In the year 2012, a strategy for establishing the birth

defect registry has been proposed by extending the

birth registry program with new designed framework.

27

The data included in birth registry

1. General data for Newborn

2. Family status

3. Doctor /nurse information

4. Add on some more details

involving the abnormal newborn

5. Mother’ s illness

Detection for congenital anomaly

Congenital anomaly

Click the category of birth defectsCategory of birth defects

30

1 .Since the time of birth : connected the

delivery records from hospital directly to MOI

database for further issuing the birth certificate

at the local administrative organization

Birth defect database

Individual records in NHSO

1. Leukemia 2. Lymphoma3. Haemophilia4. Heart surgery5. Epilepsy6. Cataract 7. Cleft palate8. HIV9. Diabetes Mellitus

hypertension & dyslipidemia

10. TB 11. Stroke

1. Screening for metabolic syndromes (sss, csmbs)

2. Screening for stroke3. Thalassemia4. Vaccine5. Thyroid6. Screening for CA cervix7. Disabilities 8. Sealant9. Denture in elderly

disease management

Prevention & Promotion

1. Pre-hospital care (EMS)

2. Trauma3. Poisoning4. Stroke

Emergency care

OP, IPdata

33

2. Add on with health services data :

Retrieving the healthcare services data from inpatient , outpatient databases with matched ICD codes begin with “Q”

1 .Since the time of birth : connected the

delivery records from hospital directly to MOI

database for further issuing the birth certificate

at the local administrative organization

Birth defect database

Single window for Birth Defect registry1. Since the time of birth : connected the delivery records from hospital directly to MOI database for further issuing the birth certificate at the local administrative organization

2. Add on with health services data : Retrieving

the healthcare services data from inpatient

& outpatient databases with matched ICD codes begin with “Q”

3. Birth Defect Registry website : If new case is

founded, the health worker can register via

“ the birth defect registry website”.

Birth defect database

Summary report

year

NHSO regionprovince

No. of children grouped by diseases

QU

ES

TIO

NS

ANSWERS&