Purpose The purpose of this paper is to discuss the successes of Thailand’s healthcare system along with challenges it is facing, examining documents and policies used by those charged with developing and implementing health services. Design/methodology/approach The search pool comprised PubMed and Google Scholar from the period 2001-2015. Selection criterion for inclusion was sources dealing with out-of-pocket (OOP) expenditure and healthcare utilization in Thailand. In total, 33 studies met the criterion of containing sufficient data to be included in the meta-analysis. Findings The authors found a small positive effect size on OOP expenditure and healthcare utilization, obtaining values of 0.1604 (95% CI 0.1320-0.1888, p<0.0001) and 0.2788 (95% CI 0.0917-0.4659, p=0.0035), respectively. Originality/value To review and meta-analyze the literature dealing with the outcomes of Thailand’s healthcare system to understand whether Thailand’s healthcare system is achieving its mandate or not. The results of this paper can help policy makers to understand and evaluate Thailand’s healthcare system.

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Due to peer pressure playing a crucial role in the decision to drink, people who have a more fragile temperament might be expected to be at higher risk. Moreover, many studies have investigated the influence of peer pressure on alcohol consumption, but few have examined the relationship between heavy drinking and peer pressure via a spatial autoregressive model (SAR) in low/middle-income countries, such as Thailand. This paper investigated the connection between heavy drinkers over the age of 15 years who drink more than or equal to 60 grams of unmixed alcohol at least once per month based on the Thai Survey of Cigarette Smoking and Alcoholic Drinking Behavior, 2014. Further, the drinkers were assumed to socialize with two peer groups: immediate family and close friends. Our paper considered a SAR model because SAR can overcome the reflection problem encountered using a linear-in-means model and the correlated effect problem found with hierarchical models. The main finding was the discovery of a significant and positive peer effect on alcohol consumption among heavy drinkers. In addition, there was evidence of education having an effect, but no evidence of income affecting on alcohol consumption. Specifically, a higher level of education was linked with lower levels of alcohol consumption. The results not only help us to understand the peer effect and alcohol consumption behavior, but policymakers can also apply peer effect-based strategies to formulate effective policies to decrease the alcohol consumption rate in Thailand.