scholarly journals The interaction of healthcare service quality and community-based health insurance in Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256132
Author(s):  
Bekele Belayihun Tefera ◽  
Mengistu Asnake Kibret ◽  
Yordanos B. Molla ◽  
Girma Kassie ◽  
Aynalem Hailemichael ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Service Quality ◽  
Interpersonal Communication ◽  
Health Centers ◽  
Structural Quality ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Quality Of Health Services

Community-based health insurance (CBHI) as a demand-side intervention is presumed to drive improvements in health services quality, and the quality of health services is an important supple-side factor in motivating CBHI enrollment and retention. There is, however, limited evidence on this interaction. This study examined the interaction between quality of health services and CBHI enrollment and renewal. A mixed-method comparative study was conducted in four agrarian regions of Ethiopia. The study followed the Donabedian model to compare quality of health services in health centers located in woredas/districts that implemented CBHI with those that did not. Data was collected through facility assessments, client-exit interviews, and key informant interviews. In addition to manual thematic analysis of qualitative data, quantitative descriptive and inferential analyses were done using SPSS vs 25. The process related (composite index including provider-client interpersonal communication) and outcome related (client satisfaction) measures of service quality in CBHI woreda/districts differed significantly from non-CBHI woredas/districts, but there were no significant differences in overall measures of structural quality between the two. The study found better diagnostic test capacity, availability of tracer drugs, provider interpersonal communication, and service quality standards in CBHI woredas. A higher proportion of clients at CBHI health centers gave high ratings of overall satisfaction with services. Individual and household factors including family size, age, household health care-related expenditures, and educational status, played a more significant role in CBHI enrollment and renewal decisions than health service quality. Key-informants reported in interviews that participation in the scheme increased accountability of health facilities in CBHI woredas/districts, because they promised to provide quality services using the CBHI premium collected at the beginning of the year from all enrolled households. This study indicates a need for follow-up research to understand the nuanced linkages between quality of care and CBHI enrollment.

scholarly journals Feasibility and Desirability of Scaling up Community –based Health Insurance (CBHI) in rural communities in Uganda. Lessons from Kisiizi hospital CBHI scheme.

2019 ◽  
Author(s):  
ALEX KAKAMA AYEBAZIBWE
Keyword(s):  
Health Insurance ◽  
Health Financing ◽  
Scaling Up ◽  
Healthcare Services ◽  
Community Based ◽  
Leadership And Management ◽  
Community Based Health Insurance ◽  
Community Associations ◽  
Key Informant

Abstract Background Community-based health Insurance (CBHI) schemes have been implemented world over as initial steps for National Health Insurance. The CBHI concept developed out of a need for financial protection against catastrophic health expenditure to the poor after failure of other health financing mechanisms. CBHI schemes reduce out-of-pocket payments, and improve access to healthcare services in addition to raising additional revenue for health sector. Kisiizi hospital CBHI scheme has 41,500 registered members since 1996, organised in 210 community associations known as ‘Bataka’ or ‘Engozi’ societies. Members pay annual premium fees and a co-payment fee before service utilisation. This Study aimed at exploring the feasibility and desirability of scaling up CBHI in Rubabo County, with objectives of; exploring community perceptions and determining acceptability of CBHI, identifying barriers and enablers to scaling up CBHI and documenting lessons regarding CBHI expansion in a rural community. Method: Explorative study using qualitative methods. Key informant interviews and Focus Group Discussions (FGD) were used in data collection. Twenty two key informant interviews were conducted using semi-structured questionnaires. Three FGD for scheme members and three for non-scheme members were conducted. Data was analysed using thematic approach. Results : Scaling up Kisiizi hospital CBHI is desirable because: it conforms to the government social protection agenda, conforms to society values, offers a comprehensive benefits package, and is a better healthcare financing alternative for many households. Scaling up Kisiizi hospital CBHI is largely feasible because of a strong network of community associations, trusted quality of services at Kisiizi Hospital, affordable insurance fees, and trusted leadership and management systems. Scheme expansion faces a few obstacles: long distances and high transport costs to Kisiizi hospital, low levels of knowledge about insurance, overlapping financial priorities at household level and inability of some households to pay insurance fees. Conclusions CBHI implementation requires the following considerations: Conformity with society values and government priorities, a comprehensive benefits package, trusted quality of healthcare services, affordable fees, and trusted leadership and management systems. Key words Community-based Health Insurance, Universal Health Coverage, Health financing, Enrolment

scholarly journals IMPLEMENTASI PERILAKU CARING PERAWAT PELAKSANA TERHADAP KEPUASAN PASIEN DI RUANG RAWAT INAP RUMAH SAKIT GRANDMED LUBUK PAKAM

2021 ◽  
Vol 1 (1) ◽  
pp. 110-114
Author(s):  
Rahmad Gurusinga ◽  
Tati Murni Karo-karo ◽  
Arfah May Syara ◽  
Syatriawati Suhaimi ◽  
Sari Desi Esta Ulina Sitepu ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health Services ◽  
Service Quality ◽  
Nursing Service ◽  
Caring Behavior ◽  
The People ◽  
Nursing Services ◽  
Quality Of Health Services

A hospital is said to be successful in providing health services if it is supported by several factors, one of which is quality nursing services. service quality. One form of nursing service that can be applied is the caring behavior of nurses because nurses are the people who interact with patients the most. This paper aims to provide the Implementation of Caring Behavior for Implementing Nurses on Patient Satisfaction in the Inpatient Room at Grandmed Lubuk Pakam Hospital. The method of implementing activities using questionnaires that are targeted in PKM activities are implementing nurses and inpatients. From the results of the activities carried out there was an increase in patient satisfaction up to 64.3%. With this PKM activity, it is hoped that it can improve the quality of health services at Grandmed Hospital and can further increase the satisfaction of visiting patients.

scholarly journals Analysis of Outpatient Satisfaction and the Quality of Health Services

2020 ◽  
Vol 2 (1) ◽  
pp. 26-33
Author(s):  
Sumayyah Jamal H. M. Arifin ◽  
Muntasir . ◽  
Erny Erawati Pua Upa
Keyword(s):  
Health Services ◽  
Health Center ◽  
Health Department ◽  
Health Centers ◽  
Outpatient Services ◽  
Exclusion Criteria ◽  
Internal Factors ◽  
Quality Of Health Services ◽  
Descriptive Survey

Quality is an important factor in health services. Bakunase Health Center is one of the primary accredited health centers in Kupang City. Based on data from the Health Department, there has been a decrease in the number of visits over the last three years. This happens due to external factors and internal factors. The external factor is the increasing degree of public health, while the internal factor is the decrease in the patients’ commitment to treatment. The purpose of this study is to describe the level of outpatient satisfaction with the quality of health services at Bakunase Health Center of Kupang City in 2020. This was a descriptive survey with a quantitative approach. The population in this study was all patients who visited and used outpatient services at Bakunase Health Center in Kupang City from January to October 2019. Accidental sampling was used in selecting the samples from each outpatient sub-group in 7 polyclinics at Bakunase Health Center using inclusion and exclusion criteria. The results indicated that the level of conformity between expectations and reality of the services are as follows:  98.78% tangible, 98.66% reliable, 98.33% responsive, 98.79% assurance 98.74% empathy. Based on the Cartesian Importance Performance Analysis (IPA) diagram, quadrant A was filled by one attribute from the responsiveness dimension, quadrant B was filled by most attributes from the reliability dimension, quadrant C was filled by most attributes from the empathy dimension and quadrant D was filled by one attribute from the responsiveness dimension.

scholarly journals The Effect of Ethiopia’s Community-Based Health Insurance Scheme on Revenues and Quality of Care

2020 ◽  
Vol 17 (22) ◽  
pp. 8558
Author(s):  
Zemzem Shigute ◽  
Anagaw D. Mebratie ◽  
Robert Sparrow ◽  
Getnet Alemu ◽  
Arjun S. Bedi
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Community Based Health Insurance ◽  
The Impact

Ethiopia’s Community-Based Health Insurance (CBHI) scheme was established with the objectives of enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources and enhancing the quality of health care. Previous analyses have shown that the scheme has enhanced health care access and led to reductions in OOP. This paper examines the impact of the scheme on health facility revenues and quality of care. This paper relies on a difference-in-differences approach applied to both panel and cross-section data. We find that CBHI-affiliated facilities experience a 111% increase in annual outpatient visits and annual revenues increase by 47%. Increased revenues are used to ameliorate drug shortages. These increases have translated into enhanced patient satisfaction. Patient satisfaction increased by 11 percentage points. Despite the increase in patient volume, there is no discernible increase in waiting time to see medical professionals. These results and the relatively high levels of CBHI enrollment suggest that the Ethiopian CBHI has been able to successfully negotiate the main stumbling block—that is, the poor quality of care—which has plagued similar CBHI schemes in Sub-Saharan Africa.

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