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加纳国家健康保险计划中女性的医疗服务质量预测因素。

Predictors of Health Care Service Quality among Women Insured Under Ghana's National Health Insurance Scheme.

机构信息

Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences.

Centre for Health Policy Advocacy, Innovation and Research in Africa (CHPAIR-Africa), GH.

出版信息

Ann Glob Health. 2018 Nov 5;84(4):640-649. doi: 10.9204/aogh.2371.

Abstract

BACKGROUND

Insured women in Ghana are more likely to use maternity care services than their uninsured counterparts. To improve service quality among insured women in Ghana, better understanding of the factors that predict quality standards of primary health care services is essential.

OBJECTIVE

To examine predictors of health care service quality among insured women under the National Health Insurance Scheme (NHIS) in Ghana.

METHODS

Data from the 2014 Ghana Demographic Health Survey was analysed. Cluster analysis was applied to construct a dependent variable; service care quality. Socio-demographic/background characteristics were used as independent variables. Descriptive and inferential analyses were performed followed by multiple regression to predict service quality among the insured population of women aged 15-49 years. SPSS version 21 was used during the clustering while STATA version 14 was used to perform the inferential and regression analyses.

FINDINGS

Overall, geographical region of respondents was significant to expressions of insured service quality (χ2=495.4, p ≤ 0.001). Literacy levels were significant at χ2=69.232 and p ≤ 0.001 for service quality. On place of residence, the estimation show urban residency was more positively correlated with indicating quality ratings of health services compared to rural residency (χ2=70.29, p ≤ 0.001). Highest educational level had the highest predictive influence with a coefficient of 0.15.

CONCLUSIONS

A more supportive health insurance system approach that shifts towards introducing valued-based care models for patients, insurers and health care providers could be supportive in improving quality standards among insured population groups in Ghana.

摘要

背景

加纳的参保女性比未参保女性更有可能使用产妇保健服务。为了提高加纳参保女性的服务质量,必须更好地了解预测初级保健服务质量标准的因素。

目的

探讨加纳国家健康保险计划(NHIS)中参保女性的医疗保健服务质量预测因素。

方法

对 2014 年加纳人口与健康调查的数据进行了分析。采用聚类分析构建了一个因变量;服务质量。社会人口学/背景特征被用作自变量。进行了描述性和推断性分析,然后进行了多元回归分析,以预测 15-49 岁参保女性人群的服务质量。在聚类分析中使用了 SPSS 版本 21,在推断和回归分析中使用了 STATA 版本 14。

结果

总体而言,受访者所在的地理位置对参保服务质量的表达具有显著意义(χ2=495.4,p≤0.001)。文化程度在服务质量方面也具有显著意义(χ2=69.232,p≤0.001)。在居住地方面,估计显示与农村相比,城市居住与表明卫生服务质量评分呈正相关(χ2=70.29,p≤0.001)。最高教育水平具有最高的预测影响,系数为 0.15。

结论

加纳可以采取更具支持性的医疗保险制度方法,转向为患者、保险公司和医疗保健提供者引入基于价值的护理模式,这有助于提高参保人群的质量标准。

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本文引用的文献

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National health insurance subscription and maternal healthcare utilisation across mothers' wealth status in Ghana.
Health Econ Rev. 2017 Dec;7(1):16. doi: 10.1186/s13561-017-0152-8. Epub 2017 Apr 26.
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