Perceptions of healthcare quality in Ghana: Does health insurance status matter?

Stephen Kwasi Opoku Duku, Edward Nketiah-Amponsah, Wendy Janssens, Menno Pradhan

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

This study’s objective is to provide an alternative explanation for the low enrolment in health insurance in Ghana by analysing differences in perceptions between the insured and uninsured of the non-technical quality of healthcare. It further explores the association between insurance status and perception of healthcare quality to ascertain whether insurance status matters in the perception of healthcare quality. Data from a survey of 1,903 households living in the catchment area of 64 health centres were used for the analysis. Two sample independent t-tests were employed to compare the average perceptions of the insured and uninsured on seven indicators of non-technical quality of healthcare. A generalised ordered logit regression, controlling for socio-economic characteristics and clustering at the health facility level, tested the association between insurance status and perceived quality of healthcare. The perceptions of the insured were found to be significantly more negative than the uninsured and those of the previously insured were significantly more negative than the never insured. Being insured was associated with a significantly lower perception of healthcare quality. Thus, once people are insured, they tend to perceive the quality of healthcare they receive as poor compared to those without insurance. This study demonstrated that health insurance status matters in the perceptions of healthcare quality. The findings also imply that perceptions of healthcare quality may be shaped by individual experiences at the health facilities, where the insured and uninsured may be treated differently. Health insurance then becomes less attractive due to the poor perception of the healthcare quality provided to individuals with insurance, resulting in low demand for health insurance in Ghana. Policy makers in Ghana should consider redesigning, reorganizing, and reengineering the National Healthcare Insurance Scheme to ensure the provision of better quality healthcare for both the insured and uninsured.

Original languageEnglish
Article numbere0190911
Pages (from-to)1-17
Number of pages17
JournalPLoS ONE
Volume13
Issue number1
DOIs
Publication statusPublished - 16 Jan 2018

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Health insurance
health insurance
Ghana
Insurance Coverage
Quality of Health Care
Insurance
Health Insurance
health services
Health Status
insurance
Health
Reengineering
Health Facilities
Catchments
Catchment Area (Health)
Economics
Administrative Personnel
Cluster Analysis
socioeconomics
households

Cite this

Duku, Stephen Kwasi Opoku ; Nketiah-Amponsah, Edward ; Janssens, Wendy ; Pradhan, Menno. / Perceptions of healthcare quality in Ghana : Does health insurance status matter?. In: PLoS ONE. 2018 ; Vol. 13, No. 1. pp. 1-17.
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Perceptions of healthcare quality in Ghana : Does health insurance status matter? / Duku, Stephen Kwasi Opoku; Nketiah-Amponsah, Edward; Janssens, Wendy; Pradhan, Menno.

In: PLoS ONE, Vol. 13, No. 1, e0190911, 16.01.2018, p. 1-17.

Research output: Contribution to JournalArticleAcademicpeer-review

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