Michael Godpower Chinedu, Aliyu Ibrahim, Grema Bukar Alhaji, Suleiman Abdullahi Kabiru
Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.
Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria.
J Patient Exp. 2019 Sep;6(3):247-252. doi: 10.1177/2374373518790072. Epub 2018 Jul 23.
The National Health Insurance Scheme (NHIS) of Nigeria was designed to eliminate known cultural, physical, and resource-related barriers to quality health-care access. Although choice of primary health-care facility (PHF) remains in the domain of the scheme enrollees, little is known about factors influencing their choice. Hence, the study of the perception of factors influencing PHF choice among NHIS enrollees of a northwest Nigerian hospital becomes imperative.
This was a cross-sectional study of 284 principal enrollees randomly selected from patients attending the NHIS clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, using a designed, pretested, investigator-administered questionnaire. Their sociodemographics and factors influencing their choice of the clinic were assessed.
Respondents' mean age was 40.9 ± 9.0 years and they were predominantly males (83.1%) with tertiary education. Median distance between their homes and PHF was 7.6 ± 12.5 km. Most respondents were aware of other accredited PHFs in the city and believed it was their right to choose a PHF. Among the various factors influencing their choice of index PHF were better functioning equipment (83.5% of respondents), more specialists/trained health workers (78.5%), ease in receiving specialist care (69.4%), and better overall quality of care (78.9%).
There are multiple factors associated with enrollee choice of PHF in this study. The NHIS enrollees value the presence of functioning equipment/facilities, ease in receiving specialist care, and overall high quality of care in their choice of PHF. Improving enrollee enrollment at accredited PHF may require addressing these factors.
尼日利亚国家健康保险计划（NHIS）旨在消除已知的文化、地理和资源相关障碍，以确保获得高质量的医疗保健服务。尽管选择初级保健机构（PHF）仍属于该计划参保人的权利范围，但对于影响他们选择的因素知之甚少。因此，研究尼日利亚西北部一家医院的NHIS参保人对影响PHF选择因素的看法变得至关重要。
这是一项横断面研究，从尼日利亚卡诺阿明努·卡诺教学医院NHIS诊所就诊的患者中随机选取284名主要参保人，使用经过设计、预测试且由调查员管理的问卷进行调查。评估了他们的社会人口统计学特征以及影响他们选择该诊所的因素。
受访者的平均年龄为40.9±9.0岁，他们主要是受过高等教育的男性（83.1%）。他们的住所与PHF之间的中位距离为7.6±12.5公里。大多数受访者知道该市其他经认可的PHF，并认为选择PHF是他们的权利。在影响他们选择该PHF的各种因素中，设备运行良好（83.5%的受访者）、有更多专科医生/训练有素的医护人员（78.5%）、接受专科护理方便（69.4%）以及整体护理质量更好（78.9%）。
本研究中有多个因素与参保人对PHF的选择相关。NHIS参保人在选择PHF时看重设备/设施的正常运行、接受专科护理的便利性以及整体高质量的护理。改善参保人在经认可的PHF的登记情况可能需要解决这些因素。
