SROI of Contracted Private Physiotherapy Clinics for Intermediate Care

Thailand’s Universal Coverage Scheme has expanded coordinated intermediate care by contracting private physiotherapy clinics nationwide; however, evidence remains limited on whether the program generates sufficient social value relative to investment, and whether that value is equitably distributed across provinces. This project applies a Social Return on Investment (SROI) framework to quantify multi-stakeholder benefits, beyond conventional clinical outcomes. This is done by monetizing both tangible and intangible impacts relevant to patients, families/caregivers, community rehabilitation services, and payers. Using an explanatory sequential mixed-methods design, Phase 1 conducts a retrospective evaluative SROI using NHSO administrative data (2023–2025), supported by a rapid scoping review and expert validation, to calculate national and province-specific SROI ratios and assess the magnitude of provincial variation. Phase 2 then uses follow-up qualitative interviews with key stakeholders (payer/policy, referring hospitals/case managers, and contracted clinics) to explain why returns differ across provinces and to identify actionable barriers and facilitators driving higher or lower value. The expected outputs are policy-relevant SROI estimates at both national and provincial levels, evidence on the equity of returns, and practical recommendations to strengthen contracting strategy, refine the benefit package, and guide targeted scale-up of coordinated intermediate care within Thailand’s UHC framework.