尼日利亚卡诺州一家大型认证医疗机构的医生和牙医对国家健康保险计划下转诊制度的了解和实践。

Knowledge and Practice of the Referral System under the National Health Insurance Scheme among Medical and Dental Practitioners of A Large-Accredited Facility in Kano, Nigeria.

机构信息

Department of Family Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.

Department of Community Medicine, Bayero University/Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.

出版信息

West Afr J Med. 2024 Jan 31;41(1):16-24.

PMID:38412015

Abstract

BACKGROUND

Studies on healthcare professionals' knowledge about the National Health Insurance Scheme (NHIS) are scarce. Therefore, we assessed the knowledge and practice of the NHIS referral system among Medical and Dental practitioners in a tertiary hospital in Northwest Nigeria.

METHODS

This cross-sectional study involved 242 medical and dental practitioners randomly selected from nine departments for over 6-weeks. A structured self-administered questionnaire was used to collect data. Data were analyzed using descriptive and inferential statistics.

RESULTS

The respondents' mean age was 35.7±6.0 years; they were predominantly males (64.9%). Their mean overall knowledge score was 58.9±23.0%, with 66.9% of respondents having inadequate overall knowledge of the NHIS referral system. Practice department (Fishers 2 exact, P=0.0019), perceived knowledge of the referral system (ꭓ =8.169, P=0.004), and having been referred as an enrolee (ꭓ2 = 6.358, P=0.012) were associated with overall-knowledge. Obstetrics-and-Gynaecology (odds ratio[OR]=0.29, 95% confident interval [CI] [0.88-0.98]), Dental and-Maxillofacial-Surgery (OR=0.08, 95%CI[0.01-0.98]), and Otorhinolaryngology (OR=0.18, 95%CI[0.04-0.80]) respondents were less likely to have adequate overall-knowledge.Although 56.2%, 50.4%, 20.7%, and 89.7% were enrolees, had received treatment as enrolees, had been referred as enrolees and treated other enrolees, respectively, an unimpressive proportion had sighted a referral letter (64.9%) or authorization code on the letter (25.2%), referred an enrolee from their department previously (51.2%) or used the NHIS referral form to write referrals (38.8%).

CONCLUSION

The overall knowledge of the NHIS referral system was inadequate. The practice of the referral system was below expectation. Therefore, training medical and dental practitioners on the NHIS referral system is necessary. Training should target those who are least likely to have adequate overall knowledge.

摘要

背景

关于医疗保健专业人员对国家健康保险计划（NHIS）了解程度的研究很少。因此，我们评估了尼日利亚西北部一家三级医院的医疗和牙科从业者对 NHIS 转诊系统的知识和实践情况。

方法

这项横断面研究涉及 242 名随机从 9 个科室中挑选的医疗和牙科从业者，历时 6 周以上。使用结构化的自我管理问卷收集数据。使用描述性和推断性统计方法进行数据分析。

结果

受访者的平均年龄为 35.7±6.0 岁；他们主要是男性（64.9%）。他们的总体知识平均得分为 58.9±23.0%，66.9%的受访者对 NHIS 转诊系统的总体知识不足。执业科室（费舍尔精确检验，P=0.0019）、对转诊系统的认知（ꭓ=8.169，P=0.004）和作为参保人被转诊（ꭓ2=6.358，P=0.012）与总体知识相关。妇产科（优势比[OR]=0.29，95%置信区间[CI] [0.88-0.98]）、牙科和颌面外科（OR=0.08，95%CI[0.01-0.98]）和耳鼻喉科（OR=0.18，95%CI[0.04-0.80]）的受访者不太可能有足够的总体知识。尽管 56.2%、50.4%、20.7%和 89.7%的受访者是参保人、接受过参保人治疗、作为参保人被转诊并治疗过其他参保人，但只有 64.9%的人见过转诊信、25.2%的人见过信上的授权码、51.2%的人之前从自己的科室转诊过参保人、38.8%的人使用 NHIS 转诊表写转诊。