Department of Health Studies, University of South Africa, Muckleneuk, Pretoria, South Africa.
BMC Health Serv Res. 2022 Aug 6;22(1):1006. doi: 10.1186/s12913-022-08367-7.
Research studies as well as anecdotal evidence suggest that there are challenges regarding the NHI plan implementation. These include problems such as an increase in illnesses and a shortage of personnel to drive the project in South African public hospitals. This is exacerbated by the existing situation of most government-funded healthcare institutions, which are characterized by bad administration, insufficient budget, inadequate infrastructure, and insufficient drug supply, as highlighted in several studies. The hospital under investigation is one such facility, with a history of patients sleeping on the floor and people being turned away owing to a shortage of experts and an overburdened staff. This situation is concerning, given that the government claims to be providing appropriate funds to the institution. The hospital under research is highly regarded by the surrounding community. However, a visit by the Health MEC in 2014 revealed that the facility had insufficient sanitary standards and a high complaint rate. Based on the foregoing, as well as the difficulties that both employees and patients are confronted with at the selected hospital, the question that emerges is whether the hospital is fit for the implementation of the NHI.
The aim of this study was to assess the preparation for the launch of the national health insurance scheme at a Johannesburg hospital.
The study was conducted at a hospital situated in eastern suburbs of Johannesburg, Gauteng, South Africa.
The study employed a qualitative method with an explorative, descriptive, qualitative study design. The population consisted of selected hospital employees, such as doctors, dispensary officers, hospital managers, human resources workers, facility managers, and administration record officials who were employed at the selected hospital. Purposive sampling was used to select participants.
Category saturation was used to determine the sample size. The participants for the study were chosen using purposeful sampling, with the researcher aiming for those who were familiar with the NHI scheme at the institution. Semi structured interviews and a focus group discussion were used to gather data. The data from the focus group discussion and semi-structured interviews were analysed using thematic analysis.
The investigation found that the hospital was preparing to for the NHI implementation, but that was riddled with lack of resources, poor infrastructure, lack of training, delays in development and poor technological advances.
The paper suggests that human resources be increased, infrastructure be upgraded, medicines and equipment be increased, and enough training on NHI implementation be provided.Contribution: The paper adds to the body of knowledge regarding the NHI in South Africa.
本研究旨在评估约翰内斯堡一家医院启动全民健康保险计划的准备情况。
研究表明，南非的 NH I 计划实施面临诸多挑战，包括医院人员短缺等问题，这可能会影响该计划的实施。
研究在南非豪登省约翰内斯堡东郊的一家医院进行。
本研究采用定性方法，具有探索性、描述性和定性研究设计。研究对象包括在选定医院工作的员工，如医生、药房工作人员、医院经理、人力资源工作者、设施经理和行政记录官员。采用目的抽样法选择参与者。
类别饱和法用于确定样本量。研究参与者是通过目的性抽样选择的，研究人员选择的是那些熟悉该机构 NH I 计划的人。半结构化访谈和焦点小组讨论用于收集数据。使用主题分析对焦点小组讨论和半结构化访谈的数据进行分析。
研究发现，医院正在为 NH I 的实施做准备，但存在资源匮乏、基础设施差、缺乏培训、发展延迟和技术进步缓慢等问题。
该研究提出增加人力资源、升级基础设施、增加药品和设备，并提供足够的 NH I 实施培训。
本文为南非 NH I 的研究提供了新的视角和贡献。
