Inferential analysis of factors influencing the expectation gap in national health insurance: Evidence from South Africa

Abstract

Purpose: This study investigates the expectation gap between healthcare users' demands and the South African government's National Health Insurance (NHI) proposal in Tshwane Municipality. Methodology: The research employs a conjoint analysis approach and a market simulator to examine various parameters influencing healthcare users' expectations. A sample of 281 respondents from diverse population groups participated in the study. Results: Findings reveal that healthcare users strongly demand immediate access to medication, consultations, and comprehensive services, and they prefer doctor-led care. The government's NHI proposal lacks specific timeframes for addressing these concerns, leading to uncertainty and dissatisfaction among users. Theoretical contribution: This study contributes to the literature on healthcare policy implementation by highlighting the importance of aligning user expectations with government proposals. It demonstrates the application of conjoint analysis in healthcare policy research. Practical implications: The research suggests that providing precise and detailed information about NHI services and timeframes can help manage healthcare users' expectations. It also emphasizes the need for the government to address specific concerns such as waiting times and service comprehensiveness in the NHI implementation. Sustainable Development Goals (SDGs): SDG 3: Good Health and Well-being; SDG 10: Reduced Inequalities; SDG 16: Peace, Justice and Strong Institutions; SDG 17: Partnerships for the Goals