Thailand
Universal coverage paired with district health system delivery and dedicated palliative funding, the Asian comparator for a community health worker route.
8 domains reviewed · 8 high-confidence · 3 dated estimates · 9 material gaps
WHO region: South-East Asia. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 8 of 9
- Hospice: 2 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 15
- Newest source 2026
Lessons from Thailand
- Permissive national prescribing law did not raise consumption to need. Hospital-level rules, special forms and clinician attitudes became the barrier. Reform has to reach facility rules and prescriber training, not only the statute.111,113
- A dedicated grant from the national insurer to district palliative networks gave palliative care its own funded line inside universal coverage. It is a concrete model for national health insurance programmes.115
- Liberal physician prescribing coexisted with near-universal bans on nurse prescribing. Physician access and task shifting are separate reforms.111
- District health systems linking hospitals, subdistrict centres and homes carried care outward. Health systems with district structures and community health workers have the closest equivalent.115
- A paid, community-selected caregiver cadre attached to a district hospital, with spiritual care and several funding sources, can extend home care for dependent patients and has been scaled to other provinces.116
- Screening family caregivers for severe anxiety and depression can help identify those at risk of high caregiving burden.668
Palliative care
Is morphine available in Thailand?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 0.29 mg per personSOURCE-CHECKED
Morphine consumption, Thailand, 1999113
Last checked 2026-09-24.
Cite this figure: - 1.16 mg per personSOURCE-CHECKED
Morphine consumption, Thailand, 2010113
Last checked 2026-09-24.
A second source cites a Pain and Policy Studies Group figure of 0.77 mg on an unstated year.
Cite this figure:
Immediate-release oral morphine has been produced by the Government Pharmaceutical Organization since 2010. Consumption rose steadily but stayed well below global and Asian averages, and patients can receive oral morphine only at a hospital pharmacy.111,113
How does Thailand regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
- 96.40 percentSOURCE-CHECKED · 2012 DATA
Government hospitals requiring a special signed opioid form at every visit, Thailand, 2012111
Last checked 2026-09-24.
Cite this figure:
A 2006 ministerial notification raised the amount of opioids a hospital may hold. Day-to-day rules on forms, dose limits and collection are set hospital by hospital, and nearly all require a special signed form.111
Which statute governs narcotics, and have hospital-level rules been standardised nationally since 2012?
Help answer it:Search PubMedWho can prescribe morphine in Thailand?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
- 75.60 percentSOURCE-CHECKED · 2012 DATA
Government hospitals prohibiting advanced practice nurses from prescribing oral opioids, Thailand, 2012111
Last checked 2026-09-24.
Seven community hospitals permitted nurses to prescribe oral morphine.
Cite this figure:
Any physician in a government hospital may prescribe oral morphine on clinical judgement without special registration, which the survey authors call more permissive than some European rules. Most hospitals bar advanced practice nurses from prescribing, and physicians and regulators showed knowledge and attitude gaps.111,113
Has district palliative policy defined a nurse prescribing scope since 2012?
Help answer it:Search PubMedHow does palliative care reach patients in Thailand?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 61 networksSOURCE-CHECKED · 2015 DATA
District health system palliative networks funded by the National Health Security Office, Thailand, 2015115
Last checked 2026-09-24.
At 135,000 baht per network per year.
Cite this figure:
Care is organised through the district health system, linking community hospitals, subdistrict health centres and home visits, under a 2014 ministry policy extended to homes from 2016. Local models add community caregivers, and one hospital's model has scaled across provinces since 2020.115,116
How many hospital palliative units exist by province, and what is the formal role of village health volunteers?
Help answer it:Search PubMedWho pays for palliative care in Thailand?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
- 72 percentSOURCE-CHECKED
Population covered by the Universal Coverage Scheme, Thailand, 2002114
Last checked 2026-09-24.
47.8 million people.
Cite this figure:
The tax-funded Universal Coverage Scheme covers most of the population, and the National Health Security Office has funded district palliative networks directly with a dedicated grant.114,115
What does the scheme now pay for a home palliative visit and for morphine dispensing?
Help answer it:Search PubMedHow are palliative care clinicians trained in Thailand?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
In 2012 most hospitals offering palliative care had only briefly trained staff, and few had both a doctor and a nurse with substantial training. A community caregiver curriculum at one hospital includes palliative care.112,116
Is palliative medicine a recognised subspecialty, and how many hold it?
Help answer it:Search PubMedHow does Thailand prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
In 14 tertiary hospitals, one quarter of palliative inpatients in pain were not prescribed analgesics. At the largest referral center in southern Thailand, opioid use for cancer patients was lower than the global average, which the authors linked to opiophobia. In Bangkok in 2011 to 2012, people on methadone reported low doses, intense police surveillance of clinics and no methadone in prisons.667,666,665
Has Thailand changed methadone dosing or prison access since 2012, and is naloxone distributed in communities?
Help answer it:Search PubMedHow do children get palliative care in Thailand?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
How many Thai children with life-limiting conditions receive palliative care, which hospitals run pediatric palliative teams, and are pediatric opioid formulations available?
Help answer it:Search PubMedHospice care in Thailand
How the hospice model works here, who can use it, who pays and who it reaches. Covered 2 of 4.
What does hospice care look like in Thailand?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Thai literature mostly uses palliative care, and hospice appears as a small set of hospice wards and faith-based organizations caring for people with AIDS or cancer, alongside community home care. Thailand is described as having few hospices.304,305
Who runs Thailand's hospice wards and faith-based hospices (temples, Christian groups, state hospitals), and since when?
Help answer it:Search PubMedWho can get hospice care in Thailand?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
What entry criteria and referral routes do Thai hospice wards and faith-based hospices use, and how late do patients arrive?
Help answer it:Search PubMedWho pays for hospice care in Thailand?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Does the Universal Coverage Scheme pay for care in hospice wards or faith-based hospices, or do they rely on donations?
Help answer it:Search PubMedHow many people reach hospice in Thailand?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
Thailand has few hospices and a limited range of palliative care services. The study names referral systems, patient access to opioids and inequities in care distribution as unresolved problems.304
How many hospice beds or faith-based hospice programs exist in Thailand, and where?
Help answer it:Search PubMedWhat fills the gap in Thailand
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
In a small qualitative study of 10 older people in the palliative stage, family caregivers described caring to repay the older person's past kindness. They adjusted their care so the person would not feel abandoned or a burden, and followed Thai ancestral traditions so the person could die peacefully.472
- Faith communities
Twelve Thai patients with terminal cancer described Buddhist practices, including clean living and making merit, as part of how they came to accept death. Letting go and finding calm before dying were central to their idea of a peaceful death.473
- Community health workers and home-based care
One district hospital in Khon Kaen created a full-time, 24-hour community caregiver cadre, selected through a community-led process, for dependent patients at home. The model combined Buddhist-integrated spiritual care with five funding streams, and since 2020 it has been scaled to 22 districts across 15 provinces.116
Subnational evidence- Traditional and complementary healers
Family caregivers of people with AIDS in rural Southern Thailand moved between modern medicine, traditional and folk medicine, supernatural healing rites, religious performances and home remedies. This narrative study followed eight caregivers and predates wide antiretroviral access.474
Subnational evidence
Sources cited here
- 111Thongkhamcharoen R, Phungrassami T, Atthakul N.
Regulation of opioid drugs in Thai government hospitals: Thailand national survey 2012. Indian Journal of Palliative Care 2014;20(1):6-11. DOI 10.4103/0973-1075.125548. Survey of government hospitals in 2012: a 2006 ministerial notification raising the opioids a hospital may hold; physicians prescribing oral morphine on their own judgement without registration; hospital-level rules on special forms, amounts, nurse prescribing and caregiver collection; oral morphine dispensed only at hospital pharmacies; immediate-release oral morphine produced by the Government Pharmaceutical Organization and endorsed by the Thai FDA since 2010. Full text read.
- 113Srisawang P, Harun-Or-Rashid M, Hirosawa T, Sakamoto J.
Knowledge, attitudes and barriers of physicians, policy makers/regulators regarding use of opioids for cancer pain management in Thailand. Nagoya Journal of Medical Science 2013;75(3-4):201-212. Morphine consumption per person from 1999 to 2010, and knowledge and attitude gaps among physicians and narcotics regulators in 2011. Full text read.
- 115Kitreerawutiwong N, Mekrungrengwong S, Keeratisiroj O.
The development of the community-based palliative care model in a district health system, Phitsanulok Province, Thailand. Indian Journal of Palliative Care 2018;24(4):436-445. DOI 10.4103/IJPC.IJPC_34_18. The 2014 Ministry of Public Health palliative care policy and National Health Security Office funding of district health system palliative networks from 2015. Full text read.
- 116Tonboot S, Singkheaw P, Raksasataya A, Poonpipat N, Phrawong S, Rintra W, et al.
Community caregivers and innovative financing: a qualitative analysis of Thailand's Ubolratana Hospital model using the consolidated framework for implementation research. Health Policy and Planning 2026;41(8):1375-1387. DOI 10.1093/heapol/czag091. A single hospital's community caregiver programme with blended public and philanthropic funding, an extended training curriculum including palliative care, and scale-up since 2020. Full text read.
- 114Sumriddetchkajorn K, Shimazaki K, Ono T, Kusaba T, Sato K, Kobayashi N.
Universal health coverage and primary care, Thailand. Bulletin of the World Health Organization 2019;97(6):415-422. DOI 10.2471/BLT.18.223693. The Universal Coverage Scheme launched in 2002 under the National Health Security Office. Full text read.
- 112Phungrassami T, Thongkhamcharoen R, Atthakul N.
Palliative care personnel and services: a national survey in Thailand 2012. Journal of Palliative Care 2013;29(3):133-139. Abstract read. Share of government hospitals with trained palliative staff and services.
- 667Pairojkul S, Thongkhamcharoen R, Raksasataya A, et al.
Integration of Specialist Palliative Care into Tertiary Hospitals: A Multicenter Point Prevalence Survey from Thailand. Palliat Med Rep 2021;2(1):272-279. Point prevalence survey of inpatients in 14 tertiary hospitals across four regions; tertiary care only. Abstract read.
- 666Limsomwong P, Ingviya T, Fumaneeshoat O
The trend of opioid prescriptions among cancer patients in a tertiary hospital: A multimethod quantitative study. Front Oncol 2023;13:1138169. Review of records for 20,192 outpatients with cancer receiving opioids, 2016 to 2020, at Songklanagarind Hospital; single-site. Abstract read.
- 665Hayashi K, Ti L, Ayutthaya PPN, et al.
Barriers to retention in methadone maintenance therapy among people who inject drugs in Bangkok, Thailand: a mixed-methods study. Harm Reduct J 2017;14(1):63. Survey of 158 and interviews with 16 people on methadone in Bangkok; data from 2011 to 2012, predating current policy. Abstract read.
- 668Wittayapun Y, Summart U, Pongkaew O, et al.
Predictors of Family Caregivers Burden across Palliative Settings in the South of Thailand. J Caring Sci 2025;14(4):217-225. Cross-sectional survey of 305 family caregivers in two southern health service networks; regional scope. Abstract read.
- 304Chaiviboontham S, Pokpalagon P
Palliative care model in Thailand. Int J Palliat Nurs 2021;27(3):132-146. Convergent mixed-methods study of palliative care models at three levels of health care and one religious organization, purposive sample. Abstract read.
- 305Pokpalagon P, Chaiviboontham S, Phinitkhajorndech N
Spiritual needs, spiritual well-being, and Buddhist practices of patients with terminal illness, Thailand. Palliat Support Care 2024;22(4):718-725. Cross-sectional multicenter study of 170 terminally ill patients in home care, two faith-based organizations (AIDS and cancer) and a hospice ward; describes settings, not national coverage. Abstract read.
- 472Supaporn K, Isaramalai SA, Suttharangsee W
Exploring caregivers' perspectives on improving care for older people at the end of life in Thailand. Int J Palliat Nurs 2019;25(7):326-332. Qualitative interviews and observation with 10 older people in the palliative stage and their home caregivers. Abstract read.
- 473Upasen R, Thanasilp S
Death acceptance from a Thai Buddhist perspective: A qualitative study. Eur J Oncol Nurs 2020;49:101833. Interviews with 12 patients with terminal cancer on death acceptance, including merit-making and Buddhist practice. Abstract read.
- 474Nilmanat K, Street A
Search for a cure: narratives of Thai family caregivers living with a person with AIDS. Soc Sci Med 2004;59(5):1003-10. Longitudinal narrative case study of eight family caregivers in rural Southern Thailand; older study from the pre-antiretroviral scale-up era. Abstract read.