Assessment Of Quality Health Care Among The Insured And Uninsured Patients In The Sefwi Wiawso Municipality Of The Western North Region, Ghana.

Abstract

Background: In 2004, Ghana began the implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. Evidence suggests most health facilities are faced with challenges in the delivery of quality healthcare services. Objective: To assess the perception of quality of healthcare among NHIS insured and uninsured patients in the Sefwi Wiawso Municipality. Methods: The study adopted a cross-sectional study design that used mixed methods data collection approach. A total of 380 participants were selected for the quantitative approach using a simple random technique and [0 out of the 380 participants selected using purposive sampling technique. Structured questionnaire was used to gather data for the quantitative data and semi-structured interview guide was used in gathering data for qualitative data. In analysing the quantitative data, T-test was used to assess the difference in perception on the quality of care between insured and non-insured patients. Chi square was used to test for the association between the variables and multiple logistic regressions was used to determine the strength of association between the dependent and independent variables at a 5% probability level. In analysing the qualitative data, manual coding was used to generate themes that resonated with objectives of the study. Results: There was no statistical difference between the quality of care experienced by NHIS insured and non-insured. There was |.2times greater the odds of experiencing quality healtheare among those aged 51-60 years compared to those aged 18-30 years (COR = 9.88, 95% Cl= 1.30, 74.96). Also, there was a significant association between showing empathy and quality of healthcare (COR=4.05; 95%CI=1.71, 9.62). The quality of healthcare delivery Was confirmed by participants through the qualitative findings. Conclusion: The study concludes that there is no difference between the quality of healthcare among insured and uninsured NHIS users. The study also concludes that patients’ socio demographic characteristics such as educational level, employment status, monthly income and marital status influence quality of healthcare. Again, the study concludes that health facility factors such as thoroughness during consultation, adequate physical examination, show of empathy and short waiting time enhances quality healthcare. It is recommended for the National Health Insurance Authority (NHIA) to reconsider expanding the range of service coverage to cater for expensive medications and other complex surgeries to reduce the cost borne by patients.