198 3年泰国第一次采用健康卡项目。本文对 Khon Kaen省健康卡的购买和利用类型研究 ,发现职业 ,教育水平和疾病是影响购置健康卡的显著因素。而且与该项目的逆向选择有关 ,有疾病症状的家庭更可能买卡 ,较多地利用卫生服务。建议健康卡体制改革为乡村地区以社区为基础的强制性健康保险计划 In 1983, Thailand used the health card program for the first time. This article examines the type of purchase and use of health cards in Khon Kaen province and finds that occupation, education level, and illness are significant factors affecting the purchase of health cards. And related to the adverse selection of the project, families with symptoms of illness are more likely to buy cards and make more use of health services. Recommendations for the reform of the health card system as a community-based compulsory health insurance plan in rural areas