Perception of quality health care delivery under capitation payment: a cross-sectional survey of health insurance subscribers and providers in Ghana

Autor: Koos van der Velden, Ernst Spaan, Eric Nsiah-Boateng, Francis-Xavier Andoh-Adjei, Felix Ankomah Asante
Rok vydání: 2018
Předmět:
Adult
Male
Multivariate analysis
National Health Programs
Attitude of Health Personnel
media_common.quotation_subject
Health Personnel
Capitation Payment Method
Logistic regression
Ghana
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
03 medical and health sciences
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
Environmental health
Health care
Medicine
Humans
Quality (business)
030212 general & internal medicine
Perceived quality of care
Health care providers
media_common
Quality of Health Care
Principal Component Analysis
lcsh:R5-920
Descriptive statistics
business.industry
030503 health policy & services
1. No poverty
Middle Aged
Health insurance subscribers
Capitation payment
Cross-Sectional Studies
lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4]
Socioeconomic Factors
Health Care Surveys
Respondent
Capitation fee
Female
Capitation Fee
0305 other medical science
Family Practice
business
lcsh:Medicine (General)
Attitude to Health
Delivery of Health Care
Research Article
Zdroj: BMC Family Practice, 19
BMC Family Practice, Vol 19, Iss 1, Pp 1-12 (2018)
BMC Family Practice
ISSN: 1471-2296
Popis: Background Ghana introduced capitation payment method in 2012 but was faced with resistance for its perceived poor quality of care. This paper assesses National Health Insurance Scheme subscribers and care providers’ perception of quality of care under the capitation payment method. Methods This is a cross-sectional survey of subscribers and care providers perception of quality of care in three administrative regions of Ghana using a 5-point Likert scale for the assessment based on a set of quality of care measures. We performed descriptive analysis to determine average perception of quality of care scores for each of the measures used. Bivariate and multivariate analyses were also performed to examine relationships between respondent’s characteristics and their perception of quality of care. Results In general, subscribers expressed positive perception about the quality of care though subscribers in Ashanti were less positive compared to those in the Central region. A chi-square analysis, however, showed significant differences in subscribers’ perception of quality of care by occupation (p = 0.002), region (p = 0.007) length of NHIS membership (p = 0.006), and age (p = 0.014). Multivariate logistic regression analysis also showed that different factors, other than region of residence, were significantly associated with perceived good quality of care. Analysis of health care providers’ responses also showed significant differences in their perception of quality of care by region (p = 0.001). Multivariate logistic model showed that health care providers in the Volta region (OR = 0.14, 95% CI: 0.03–0.58) were significantly less likely to perceive quality of care as good compared to those in the Ashanti region. Conclusion Subscribers and care providers across the three regions have relatively good perception of the quality of health care in general though subscribers in Ashanti were less positive than those in the Central region. It is, therefore, plausible that capitation payment may have influenced the relatively low perception of quality of care in the Ashanti region. Electronic supplementary material The online version of this article (10.1186/s12875-018-0727-4) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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