Evidence mapPaperPMID 41856576Full record

ArticleBMJ open2026

Distribution disparities among medical specialists in Thailand: an equity analysis of the national health workforce database (2015-2024).

Peerasit Sitthirat, Piwat Suppawittaya, Seksan Yoadsanit, Pharanyoo Osotthanakorn, Samrit Srithamrongsawat, Paibul Suriyawongpaisal, Phanuwich Kaewkamjonchai, Viroj Tangcharoensathien

Abstract readMulticenter Study
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Peerasit SitthiratChakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand peerasit.sit@mahidol.ac.th.ORCID http://orcid.org/0000-0002-7984-4745
Piwat SuppawittayaFaculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Seksan YoadsanitFaculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pharanyoo OsotthanakornDepartment of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Samrit SrithamrongsawatDepartment of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID http://orcid.org/0000-0001-7466-0114
Paibul SuriyawongpaisalDepartment of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Phanuwich KaewkamjonchaiChakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.
Viroj TangcharoensathienInternational Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEnsuring equity in medical specialist distribution is essential for achieving universal health coverage (UHC). This study explored the changes in the availability and distribution of medical specialists in Thailand from 2015 to 2024 and assessed the equity impacts on workforce.

designA retrospective longitudinal analysis of national administrative workforce data.

settingPublic and private hospitals across Thailand, covering 1471 facilities in 77 provinces. PRIMARY OUTCOME AND EXPLANATORY VARIABLES: The primary outcomes were specialist-to-population ratios and geographical equity measured using the Gini coefficient (G), where values closer to 0 indicate greater equity. Explanatory variables included specialty type, geographical region and the timing of major workforce policies, including mandatory service and specialty-specific legislative interventions.

resultsBetween 2015 and 2024, the GPs and specialists in Thailand expanded significantly, with improvements in both density and distribution. The Gini coefficient for GPs showed the largest equity improvement (G=0.42 in 2015 and G=0.22 in 2024), reflecting the impact of mandatory service programme and rural recruitment programmes. Among specialists, emergency and family medicine have shown rapid growth and significant reductions in distribution inequity, reflecting the success of legislative policies. Sustainability of workforce policies was challenged by the 'leaking stock' phenomenon due to attraction of career opportunities and economic drives.

conclusionWorkforce targeted interventions have led to improvements in the availability and equitable distribution of GPs and medical specialists over the past decade. Further policy, such as retention incentives and assisted technology, is needed to achieve equitable distribution across all specialties, particularly in low-density fields. Thailand's experience offers the lessons for other low- and middle-income countries as the evidence-based and equity-focused workforce policies for UHC advancement.

Indexed as

Delivery of Health CareHealthcare DisparitiesHealth WorkforceHospitalsSpecializationDatabases, FactualHumansLongitudinal StudiesRetrospective StudiesThailandHealth EquityHealth policyHuman resource management

Identifiers

PMID41856576
PMCPMC13007125

What Socratic holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.