Choice of Healthcare Providers among Insured Persons in Ghana (original) (raw)
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This paper examines factors National Health Insurance holders consider in selecting their primary healthcare providers in Ho Municipality. The general purpose of the study is to bring to light the leading factors that influence a patient's choice of a healthcare provider, specifically, the study assesses the distribution of insurance holder's selection of healthcare providers, examines insurance holder's choice of a healthcare provider across age line, determines salient factors that influence choice of a healthcare provider and investigates gender perception on indicator variables that influence choice of a healthcare provider. The research used cross-sectional design and multi-stage sampling technique to collect data on 400 sampled NHIS insurance holders with age 18 years and above. Preliminary analysis was used to explore the demographic characteristics of the study unit, Man Whitney U test was used to compare gender views on indicator variables while chi –square test and factor analysis were used to compare choice of a healthcare provider across age Original Research Article
Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana
2015
Background In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Methods Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Conclusion Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by ensuring constant availability of essential drugs, doctors, and shorter waiting time. However, individual enrolees may value each criterion differently. Thus, not all enrolees may be motivated by same concerns. This requires providers to be circumspect regarding the factors that may attract enrolees. The National Health Insurance Authority (NHIA) should also ensure timely release of funds to help providers procure the necessary medical supplies to ensure quality service.
Perception of quality of health delivery and health insurance subscription in Ghana
BMC Health Services Research, 2016
Background: National health insurance schemes (NHIS) in developing countries and perhaps in developed countries as well is a considered a pro-poor intervention by helping to bridge the financial burden of access to quality health care. Perceptions of quality of health service could have immense impacts on enrolment. This paper shows how perception of service quality under Ghana's insurance programme contributes to health insurance subscription. Methods: The study used the 2014 Ghana Demographic and Health Survey (GDHS) dataset. Both descriptive proportions and binary logistic regression techniques were applied to generate results that informed the discussion. Results: Our results show that a high proportion of females (33 %) and males (35 %) felt that the quality of health provided to holders of the NHIS card was worse. As a result, approximately 30 % of females and 22%who perceived health care as worse by holding an insurance card did not own an insurance policy. While perceptions of differences in quality among females were significantly different (AOR = 0.453 [95 % CI = 0.375, 0.555], among males, the differences in perceptions of quality of health services under the NHIS were independent in the multivariable analysis. Beyond perceptions of quality, being resident in the Upper West region was an important predictor of health insurance ownership for both males and females. Conclusion: For such a social and pro-poor intervention, investing in quality of services to subscribers, especially women who experience enormous health risks in the reproductive period can offer important gains to sustaining the scheme as well as offering affordable health services.
Demand for Health Insurance in Ghana: What Factors Influence Enrollment?
American Journal of Public Health Research, 2014
In 2003, there was a paradigm shift in Ghana's quest for a more humane, affordable and reliable mechanism of financing healthcare with the introduction of the national health insurance scheme. The scheme was to replace the hitherto obnoxious Cash and Carry System of paying for health care at the point of service, and to provide a better and much more humane financial arrangement that will enable the citizens to access health care service without having to pay at the point of service delivery and also ensure an improvement in the quality of basic health. This study employed descriptive statistics-Logit and Probit Models to investigate the factors that influence Ghanaians to enroll with the scheme. The results from the logit and probit models indicate that sex, marital status and cost of curative care were strong factors in influencing one's decision to join the scheme. Again the marginal effects and odd ratios gave a further indication that factors such as individuals' income, higher levels of education and poor ill health among others also influence Ghanaians to join the scheme. This research is of the view that any public education aimed at increasing enrollment should be guided by these factors.
Assessing the Influential Factors on the Use of Healthcare: Evidence From Ghana
2020
A socioeconomic inequality in the use of healthcare services in Ghana is investigated in this paper. The data employed in the study were drawn from Global Ageing and Adult Health survey conducted in Ghana by SAGE and was based on the design for the World Health Survey in 2003. Using binarylogistic model in R, the study found that education, insurance, employment, income, and health state areimportant gradientsto healthcareusein Ghana. Thus, Ghanaians who are self-employed and those in the informal sector are respectively far more likely to make use of healthcare as opposed to those in the public sector. Again, respondents who have no insurance coverage are relatively far more likely to make good use of healthcare services as against those who have.Also, Ghanaians who are in very good health are literally far less enthused to utilize healthcare as against their other colleagues.
The National Health Insurance Scheme in Ghana: Prospects and Challenges: a cross-sectional evidence
Global Journal of Health Science, 2011
The National Health Insurance Scheme (NHIS) in Ghana was established by the National Health Insurance Act, 2003 (Act 650) and National Health Insurance Regulations, 2004 (L.I. 1809) with the view to improving financial access of Ghanaians, especially the poor and the vulnerable, to quality basic health care services and to limit out-of-pocket payments at the point of service delivery. This study is to assess the effect of the Scheme on access to and utilization of healthcare services in the Akatsi District of the Volta region of Ghana. Both qualitative and quantitative data was collected through face-to-face interview with 320 individuals and three service providers using structured questionnaires. The result show that age, level of education and occupation are major determinants of membership of the scheme. The scheme has a positive effect on health seeking behaviour and utilization of health care services by removing significant financial barriers to access. Lack of health insurance serves as a significant barrier to access to modern health care services. Increasing coverage and membership coupled with improvement in geographical access will promote better and overall health outcomes for the people of Ghana.
Health Economics Review, 2019
Background Ghana’s National Health Insurance Scheme has improved access to care, although equity and sustainability issues remain. This study examined health insurance coverage, type of payment for health insurance and reasons for being uninsured under the National Health Insurance Scheme in Ghana. Methods The 2014 Ghana Demographic Health Survey datasets with information for 9396 women and 3855 men were analyzed. The study employed cross-sectional national representative data. The frequency distribution of socio-demographics and health insurance coverage differentials among men and women is first presented. Further statistical analysis applies a two-stage probit Hackman selection model to determine socio-demographic factors associated with type of payment for insurance and reasons for not insured among men and women under the National Health insurance Scheme in Ghana. The selection equation in the Hackman selection model also shows the association between insurance status and socio...
Perceptions of healthcare quality in Ghana: Does health insurance status matter?
PLOS ONE
This study's objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socioeconomic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare for both the insured and uninsured.
Journal of health, population, and nutrition, 2017
Many households in low- and middle-income countries face financial hardships due to payments for health care, while others are pushed into poverty. Risk pooling and prepayment mechanisms help to lessen the impact of the costs of care as well as assisting to achieve universal health coverage (UHC). Ghana implemented the National Health Insurance Scheme (NHIS) for the promotion of access to health services for all Ghanaians. In this paper, we examined the association between health insurance status and utilization of outpatient and inpatient health services in rural poor communities. The study was a cross-sectional household survey conducted in the Kassena-Nankana districts of Northern Ghana. We conducted interviews in 11,175 households and collected data on 55,992 household members. Multiple logistic regression models were used to identify factors associated with the utilization of outpatient and inpatient health services. The dependent variables were the utilization of outpatient an...