Knowledge and satisfaction of health insurance clients: a cross-sectional study in a tertiary hospital in Ghana

Abstract

Aim This study assesses client knowledge of, and satisfaction with services under the National Health Insurance Scheme (NHIS) in a tertiary healthcare facility.

Subject and methods A cross-sectional exit interview was conducted at the Korle-Bu Teaching Hospital in the Greater Accra region of Ghana. Respondents were classified into various groups based on the number of positive responses obtained for knowledge and satisfaction measures on a 5-point Likert scale. Descriptive statistics and multivariate logistic regression analyses were conducted to test and measure associations between client characteristics, their knowledge of the NHIS, and satisfaction with services.

Results Two hundred and four clients participated in the study, representing a 97% response rate. Seventy-nine clients (39%) had more knowledge of the NHIS, 115 (56%) were more satisfied with NHIS services, and 200 (98%) were more satisfied with healthcare services. Factors including education and years of enrolment were significantly associated with more knowledge of the NHIS. Similarly, knowledge of the NHIS, number of living children, and years of enrolment strongly correlated with more satisfaction with NHIS services. However, being a returning patient was strongly related with less knowledge of the NHIS and less satisfaction with NHIS services.

Conclusion Clients have less knowledge of the NHIS and are fairly satisfied with its services overall. However, they are more satisfied with healthcare provider services. More education and sensitization are necessary to increase knowledge and improve satisfaction and enrolment.