NHIS Accreditation Pattern Among Private Health Service Providers in Ghana

Abstract

Unsuccessful attempts at securing NHIS accreditation do not prevent a facility from providing services to the general public. Knowledge on how well these facilities perform during the accreditation process is therefore needed to inform policy on improving quality of healthcare delivery. The study was a cross sectional quantitative review of NHIS accreditation data on all private health care providers who applied to the NHIA for accreditation from July 2009 to July 2012, with the purpose of describing the pattern exhibited by Private Health Service Providers in the NHIS accreditation process. The accreditation data was extracted from the NHIS database and analysed using Microsoft Excel. One thousand two hundred and fifty-two (1,252) PHSPs passed accreditation out of the 1,593 applications received, with a 78.5% success rate. Pharmacies were the most accredited PHSPs, having 22% of total accredited PHSPs. This result is explained by the fact that Pharmacies and Chemical shops are mostly privately owned and are the first point of call for most sick Ghanaians. The success rate across the Regions, levels and batches was generally above 60% and there was no clear pattern to performance across the Regions and levels of care. The Region, level or batch with the most applications had the most failure and vice versa. Fourteen 14 (11%) of the reapplications were for upgrades, meaning only 109 (32%) of the 341 failed facilities re-applied. In conclusion the NHIS accreditation process has a high success rate, most accredited PHSPs are Pharmacy and Chemical shop levels and the conferment of provisional accreditation may be the reason for the low levels of re-application among the failed facilities.