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Abstract
The creation of the National Health Insurance Scheme (NHIS) in 2005 to replace the traditional “cash and carry” healthcare financial model, was anticipated to offer a safe, reliable, affordable and national coverage healthcare system for the Ghanaian populace. The scheme has recorded several challenges; as a result, policymakers and donor agencies are reconsidering the current NHIS model and are thinking of crafting a better alternate and sustainable financial model for the NHIS. This study seeks to propose a multifactor authentication framework for the national health insurance scheme in Ghana using soft-computing machine learning techniques to minimize the current challenges. It was observed that the proposed system used 1.02 sec to vet 25 claim forms, while the human professional used 120 sec for a single document. The accuracy (91.50%) and F1 (88.52) score measure obtained shows a higher rate of the vetting process by the proposed system.
Highlights
Access to eminence health service has been an issue globally
Twenty-five (25) NHIS in Ghana (NHISGh) claims forms from two health centres in the Dorma district, Bono Region were used to analyze the proposed framework. 10-fold cross-validation was used in this study due to the size of our data size
A secure authentication mechanism was introduced with the help of biometric verification into the proposed enhancement of the existing NHISGh claims processes
Summary
Access to eminence health service has been an issue globally. A study by the World Health Organisation (WHO) revealed that approximately four hundred (400) million people worldwide do not have access to affordable health service (Dalinjong et al, 2017). Where every individual have access to good and quality health care services when the need arises without any financial barriers (Dalinjong et al, 2017; Parmar et al, 2014; Williams et al, 2017), quality healthcare, according to (Alhassan et al, 2015) can be cluster into perceived and technical, where perceived centres on experiences, opinions and contentment with the service delivery processes. The HCF systems are typically designed to incorporate both informal and formal sectors, cities and rural settlements and all types of income earners. As such, it has become a challenge for its managers to maintain the system with adequate cash flow effectively. Several developing and developed countries keep researching for ways and opportunities to provide adequate funding for their health care system (Addae-Korankye, 2013; Aniah, 2016)
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