Lamptey Abena Agyeiwaa, Nsiah-Boateng Eric, Agyemang Samuel Agyei, Aikins Moses
Dental Department, Pentecost Hospital, Madina, Accra, Ghana.
School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Arch Public Health. 2017 Aug 28;75:36. doi: 10.1186/s13690-017-0205-9. eCollection 2017.
Healthcare providers' accreditation is one of the standard means of assuring quality services. This paper examines the pattern of National Health Insurance Scheme accreditation results among private healthcare providers in Ghana.
A cross-sectional quantitative analysis of administrative data from seven National Health Insurance Scheme healthcare provider accreditation surveys over the 2009-2012 period. Data on private healthcare providers that applied for formal accreditation between the study period were retrieved from the NHIS accreditation database using a checklist. Proportions were used to examine pattern of private healthcare provider accreditation results by region, type of care provider, and grade.
Overall, 1600 healthcare providers applied for accreditation over the study years, of which 1252 (78%) passed and were accredited. Majority of healthcare providers that passed the healthcare facility assessment were in Ashanti, Greater Accra, and Western regions, and were significantly higher than those in the other regions. Among the healthcare providers that passed the assessment, pharmacies (22%) and clinics (18%) constituted the largest groups, and were significantly higher than the other types of healthcare providers. Similarly, among those that passed, majority (62%) obtained grade C and D, representing a score of 50-59% and 60-69%, respectively, and were significantly higher than those that obtained the top three grades of A+ (90-100%), A (80-89%) and B (70-79%).
Majority of healthcare providers accredited to provide services to the insured are concentrated in three regions of the country, and are mainly pharmacies and clinics. Moreover, substantial proportion of the healthcare providers obtain average scores of the healthcare facility assessment, an indication that these care providers fall below the National Health Insurance Scheme applicable-predetermined standards.
医疗服务提供者的认证是确保服务质量的标准手段之一。本文研究了加纳私立医疗服务提供者的国家健康保险计划认证结果模式。
对2009 - 2012年期间七次国家健康保险计划医疗服务提供者认证调查的行政数据进行横断面定量分析。使用清单从国家健康保险计划认证数据库中检索研究期间申请正式认证的私立医疗服务提供者的数据。采用比例分析法按地区、护理提供者类型和等级来研究私立医疗服务提供者认证结果的模式。
总体而言，在研究年份中有1600家医疗服务提供者申请认证，其中1252家（78%）通过并获得认证。通过医疗机构评估的医疗服务提供者大多集中在阿散蒂、大阿克拉和西部地区，且显著高于其他地区。在通过评估的医疗服务提供者中，药店（22%）和诊所（18%）占比最大，且显著高于其他类型的医疗服务提供者。同样，在通过认证的机构中，大多数（62%）获得C级和D级，分别代表得分50 - 59%和60 - 69%，且显著高于获得A +（90 - 100%）、A（80 - 89%）和B（70 - 79%）这三个最高等级的机构。
经认证为参保人提供服务的大多数医疗服务提供者集中在该国的三个地区，主要是药店和诊所。此外，相当比例的医疗服务提供者在医疗机构评估中获得平均分，这表明这些护理提供者未达到国家健康保险计划适用的预定标准。
