Abstract:
This retrospective study aimed to analyze the situation and expenditures of the Community Health Security Fund (CHSF) in Lampang Province for the fiscal year 2024. Secondary data were obtained from the CHSF database of Health Region 1, Lampang Province, covering 78 funds categorized into large, medium, and small sizes. Data were collected using a structured extraction form, focusing on expenditures by programs, projects, or activities approved by the fund committees across six areas. Descriptive statistics were applied, and findings were reported as numbers and percentages. The allocation of funds by size demonstrated a direct relationship with population coverage. Two large-sized funds covered an average population of 51,766 persons and received the highest average allocation of 2,329,470 Baht. Thirty-three medium-sized funds covered an average population of 7,491 persons with an average allocation of 337,123 Baht, while 43 small-sized funds covered an average population of 3,873 persons and received an average allocation of 174,324 Baht. Actual contributions slightly exceeded projections, with an average difference of 8,353 Baht. However, the medium- and small-sized funds were unable to meet the required contribution rate (30.77%). The overall budget disbursement rate for the province was 83.28%, reflecting efficient fund management. The highest expenditure was observed in Area 2 (supporting and promoting health promotion and disease prevention activities) at 91.30%, whereas the lowest was in Area 5 (supporting and promoting activities in response to epidemics or disasters) at 6.78%. Self-assessment results indicated that most CHSFs in Lampang Province were rated at Level A (81.18%), followed by Level A+ (10.26%) and Level B (3.85%). It is recommended that the National Health Security Office revise the contribution criteria to strengthen the financial stability of CHSFs. Moreover, enhancing the capacity of fund committees should be prioritized through budget allocation in Area 4, particularly by supporting continuous workshops. In addition, budget allocation for emergency preparedness should be emphasized to ensure that CHSFs in Lampang Province are adequately equipped to respond promptly to emergencies