タイにおける高齢者介護の提供状況とその特徴

―福祉多元主義の視角から―

抄録

Ageing is a global challenge for elderly care, and Thailand, as a low- and middle-income country (LMIC), is developing a formal long-term care (LTC) system. In this study, we adopted a welfare pluralism perspective to examine the full scope of an LTC provision in Thailand, focusing on informal care provided by families and relatives as well as formal care provided by the state and private sector.

Families and relatives play a primary role in informal care, with children—especially daughters—taking on most of the responsibilities. However, the proportion of care provided by individuals other than daughters is increasing, especially in Bangkok. On the formal care side, the Thai government is actively developing a community-based LTC system in which volunteers from the local community play a key role in providing care, and the government provides financial and technical support for their activities through the tax-funded universal health care system. Furthermore, the government encourages private care services through regulatory policies. Although the private sector is expanding, these services are entirely self-funded, making them accessible only to high-income groups in urban areas.

In this study, we identify three notable features of LTC provision in Thailand: (1) the unique role of community volunteers as care providers; (2) the increasing importance of community volunteers and the changing nature of their care provision; and (3) the promotion of private and community care services through regulatory policies. In addition, we highlight that the distribution of care provision across sectors varies widely across the country, with large differences between urban and rural areas and between income groups.