Health Status and Barriers to Healthcare Access among “Son-in-Law Westerners”: A Qualitative Case Study in the Northeast of Thailand

Abstract

The northeast of Thailand is well-known as a popular destination where many male Westerners marry Thai women and settle down there. However, little is known about their health and well-being. This study aims to explore the Western husbands’ health status and identify barriers hindering their healthcare access. A qualitative case study was conducted from November 2020 to May 2021. In-depth interviews and focus group discussions with 42 key informants who were involved with social and health issues among these expatriates were carried out. The social determinants framework was adapted for guiding the interviews. Data were triangulated with field notes, document reviews, and researchers’ observations. Inductive thematic analysis was applied. Results showed that most male expatriates who married Thai women in the northeast were in their retirement years and had non-communicable diseases, health risk behaviors, and mental health problems. Most of them did not purchase health insurance and held negative impressions toward Thai public hospitals’ quality of care, which was denoted as the main barrier to accessing healthcare services. Other significant barriers consisted of high treatment costs commonly charged by private hospitals and language issues. While the improvement of healthcare quality and the provision of friendly health services are important, public communication with foreign residents, especially male expatriates, is recommended to increase understanding and improve perceptions of the Thai healthcare systems. A regular population-based survey on the health and well-being of expatriates in Thailand, a cost study of a health insurance package, a survey study on willingness to pay for health insurance premiums, and a feasibility survey exploring the opportunity to establish either voluntary or compulsory health insurance among this group should be undertaken.

A Comparative Study of Retiree Expats and Younger Expats: Factors Influencing Expatriates' Selection of Healthcare Facilities in Bali

“…The aim was to gain an overview of expatriate preferences in healthcare facility selection and their relationship with these theories. According to recent studies, the preferences of expatriates in choosing healthcare facilities vary depending on individual needs and preferences (Abdullah AlNemer, 2018;Alkhamis, 2018;AlNemer, 2018;Julchoo et al, 2021;Kohno et al, 2022;Prithari et al, 2019;Freundt & Bortoluzzo, 2023;Kim et al, 2018) .…”

“…Key considerations include the quality of professional staff, specialized or expert services in addressing specific health issues (Julchoo et al, 2021;Kim et al, 2018), specialist health services, and the public's trust and reputation of the healthcare facility. Other factors include telemedicine services (24-hour online medical consultations) (H. Y.…”

“…Other factors include telemedicine services (24-hour online medical consultations) (H. Y. Kim et al, 2018), ease of transportation access, and recommendations from friends, family, or others who have previously used the same healthcare facilities (Brahmana et al, 2018;Freundt & Bortoluzzo, 2023;Julchoo et al, 2021) . They also consider whether the healthcare facility can provide clear information about their health insurance policies (Abdullah AlNemer, 2018;Alkhamis, 2018) , good service quality with responsiveness and empathy (Prithari et al, 2019), cultural suitability for expatriates as well as positive recommendations from other expatriates (Freundt & Bortoluzzo, 2023), and healthcare facilities which respect their religious beliefs and practices, and provide friendly and empathetic service (Kohno et al, 2022).…”

“…Y. Kim et al, 2018). However, existing research limitedly addresses the factors expatriates consider when selecting healthcare facilities, particularly in Bali (Abdullah AlNemer, 2018;Alkhamis, 2018;AlNemer, 2018;Julchoo et al, 2021;Kohno et al, 2022;Nakai et al, 2021;Prithari et al, 2019). In this study, three interconnected theoretical perspectives will be applied: physiological needs theory, cultural acculturation, and consumer behavior theory.…”

“We were leery of going”: qualitatively exploring Canadian international retirement migrants’ travel-related decisions during the COVID-19 pandemic

“…For example, navigating the Canadian travel medicine insurance policies has proven to be a significant challenge for international retirement migrants where they have reported having to wait for insurance approvals from Canada which many US health care professionals are unfamiliar with [ 8 ]. Other challenges to obtaining travel health insurance include language barriers, a lack of trust in health care systems abroad, along with migrants perceived need of health care while abroad [ 15 ].…”