Abstract:
The implementation of Ghana’s National Health Insurance Scheme has
resulted in a tremendous increase in access to healthcare. However,
informal out-of-pocket payments are made in hospitals contrary to the
tenets of the scheme. Previous studies have not examined the magnitude
of these payments. A cross-sectional survey of out-patients in 17
hospitals in the Central, Brong Ahafo and Upper East Regions was
conducted in 2013. Employing SPSS version 20, data was analysed using
frequencies, chi-square and logistic regression. The dependent variable
was out-of-pocket payment. Insurance status was the key independent
variable, controlling for socio-demographic factors. The results indicate
that about 10% of patients pay informal out-of-pocket fees in hospitals.
The mean amount paid was GH¢13. The insured were about three times
more likely than the uninsured to visit the hospital five times or more
within one year. Regression analysis showed that the odd of insured
patients paying informal out-of-pocket fees in hospitals is lower by 68%,
holding other variables constant. Insurance status is a significant, but not
sufficient factor in reducing out-of-pocket payments in hospitals. While efforts are being made to sustain the national health insurance scheme,
measures must be taken to eliminate out-of-pocket payments in order to
provide financial protection to the insured