Karmacharya Biraj Man, Marasini Sabina, Sharma Sudim, Adhikari Mukesh, Pandey Samip, Shrestha Ruby Maka, Jnawali Sambhu Prasad, Baral Upama, Koju Pramesh, Xu Dong Roman
Department of Public Health and Community Programs, Dhulikhel Hospital, Dhulikhel, Nepal.
Kathmandu University School of Medical Sciences, Dhulikhel, Nepal.
BMC Health Serv Res. 2025 May 31;25(1):779. doi: 10.1186/s12913-025-12893-5.
Patient satisfaction is increasingly recognized as a key measure of quality care, reflecting patients’ judgments on its quality and effectiveness. Ensuring that patient expectations and needs are met is a professional responsibility of healthcare providers. This study aims to assess the satisfaction of patients enrolled in the National Health Insurance Program (NHIP) across its various components.
We conducted a cross-sectional study at 22 health facilities across 3 provinces of Nepal. We utilized client-exit interviews among 468 patients enrolled and utilizing the health services under NHIP using convenience sampling. We used a Health Insurance Satisfaction Questionnaire (HISQ) incorporating the various dimensions of the NHIP along with various contextual sociodemographic characteristics. We calculated mean score and percentages of patient satisfaction across the four domains of health insurance. To determine the association between various dimensions of patient satisfaction and sociodemographic characteristics of the patient, we used multi-ordinal logistic regressions.
Among 468 patients, the mean age was 46 ± 16 years and over half (57.9%) had attained a secondary or higher level of education. Most respondents (76.5%) had been enrolled in the National Health Insurance Program (NHIP) for over one year, with 18.8% enrolled as a subsidized group. Regarding the satisfaction level of insured clients with NHIP, highest proportion (98.9%) of satisfied patients were in service utilization. Similarly, the domains of knowledge and administrative had satisfaction rates of 70.1% and 85.5% respectively. Conversely, satisfaction rate was observed lowest in service availability domain (60.7%). Sociodemographic factors influenced knowledge of NHIP, with education above secondary level (AOR: 7.71; 95% CI: 3.39–17.50) and age over 60 years (AOR: 1.56; 95% CI: 1.05–2.32) being significant predictors. Other sociodemographic variables such as family size, subsidy status, and occupation were associated with multiple dimensions of satisfaction ( < 0.05).
As lower satisfaction in the service availability and knowledge domains were identified, it is essential to maintain and disseminate information about the NHIP schemes across the country. Additionally, consistent monitoring and supply of medicines and drugs can help restore consumer trust in the insurance program, as many are currently burdened by out-of-pocket expenses for these necessities despite being enrolled as NHIP beneficiaries.
The online version contains supplementary material available at 10.1186/s12913-025-12893-5.
患者满意度日益被视为优质医疗服务的关键衡量指标，反映了患者对医疗服务质量和效果的判断。确保满足患者的期望和需求是医疗服务提供者的职业责任。本研究旨在评估参加国家医疗保险计划（NHIP）的患者对其各个组成部分的满意度。
我们在尼泊尔3个省的22家医疗机构开展了一项横断面研究。我们采用便利抽样的方法，对468名参加并使用NHIP提供的医疗服务的患者进行了出院访谈。我们使用了一份医疗保险满意度问卷（HISQ），该问卷纳入了NHIP的各个维度以及各种背景社会人口学特征。我们计算了医疗保险四个领域的患者满意度平均得分和百分比。为了确定患者满意度的各个维度与患者社会人口学特征之间的关联，我们使用了多序逻辑回归分析。
在468名患者中，平均年龄为46±16岁，超过一半（57.9%）的患者接受过中等或更高水平的教育。大多数受访者（76.5%）参加国家医疗保险计划（NHIP）超过一年，18.8%为补贴组。关于参保客户对NHIP的满意度，满意度最高的比例（98.9%）出现在服务利用方面。同样，知识和管理领域的满意度分别为70.1%和85.5%。相反，服务可及性领域的满意度最低（60.7%）。社会人口学因素影响了对NHIP的了解，中等以上教育程度（调整后比值比：7.71；95%置信区间：3.39 - 17.50）和60岁以上年龄（调整后比值比：1.56；95%置信区间：1.05 - 2.32）是显著的预测因素。其他社会人口学变量，如家庭规模、补贴状况和职业，与多个满意度维度相关（P < 0.05）。
由于发现服务可及性和知识领域的满意度较低，在全国范围内维护和传播有关NHIP计划的信息至关重要。此外，持续监测和药品供应有助于恢复消费者对保险计划的信任，因为尽管许多人已登记为NHIP受益人，但目前仍需自掏腰包支付这些必需品的费用。
在线版本包含可在10.1186/s12913 - 025 - 12893 - 5获取的补充材料。
