Abstract
BackgroundGhana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. This paper assesses National Health Insurance Scheme subscribers and care providers’ perception of quality of care under the capitation payment method.MethodsThis is a cross-sectional survey of subscribers and care providers perception of quality of care in three administrative regions of Ghana using a 5-point Likert scale for the assessment based on a set of quality of care measures. We performed descriptive analysis to determine average perception of quality of care scores for each of the measures used. Bivariate and multivariate analyses were also performed to examine relationships between respondent’s characteristics and their perception of quality of care.ResultsIn general, subscribers expressed positive perception about the quality of care though subscribers in Ashanti were less positive compared to those in the Central region. A chi-square analysis, however, showed significant differences in subscribers’ perception of quality of care by occupation (p = 0.002), region (p = 0.007) length of NHIS membership (p = 0.006), and age (p = 0.014). Multivariate logistic regression analysis also showed that different factors, other than region of residence, were significantly associated with perceived good quality of care. Analysis of health care providers’ responses also showed significant differences in their perception of quality of care by region (p = 0.001). Multivariate logistic model showed that health care providers in the Volta region (OR = 0.14, 95% CI: 0.03–0.58) were significantly less likely to perceive quality of care as good compared to those in the Ashanti region.ConclusionSubscribers and care providers across the three regions have relatively good perception of the quality of health care in general though subscribers in Ashanti were less positive than those in the Central region. It is, therefore, plausible that capitation payment may have influenced the relatively low perception of quality of care in the Ashanti region.
Highlights
Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care
This was followed by a publication in the Daily Guide newspaper of 25/01/2012 which quoted the President of the Ashanti Development Union (ADU), a civil society group, as saying “information reaching my office indicates that since the implementation of the policy in the region three weeks ago hospital attendance has gone down considerably” a situation that suggests perceived poor quality of care on the part of health insurance subscribers in the region following the introduction of the capitation payment policy [2]
About 56% of respondents were above the average age of 44.31 years (SD = 17.68), 78% were females, and 35% were in the Ashanti region
Summary
Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. In a press release carried by the Ghanaian Times newspaper of 02/01/2012, the Chairman of the Association of Private Medical and Dental Practitioners was quoted to have stated that “the system (capitation payment) is detrimental to quality health care provision and a major threat to the survival of private health facilities” This was followed by a publication in the Daily Guide newspaper of 25/01/2012 which quoted the President of the Ashanti Development Union (ADU), a civil society group, as saying “information reaching my office indicates that since the implementation of the (capitation) policy in the region three weeks ago hospital attendance has gone down considerably” a situation that suggests perceived poor quality of care on the part of health insurance subscribers in the region following the introduction of the capitation payment policy [2]. It will provide guidance to other low/middle-income countries considering capitation payment as a provider payment method in their health insurance scheme and add to existing literature on factors that influence quality of care perception of both healthcare providers and users of healthcare services
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
