Public engagement in the development of the National Health Insurance: a study involving patients from a central hospital in South Africa.

Mapping Intimacies ◽

10.21203/rs.2.10819/v2 ◽

2019 ◽

Author(s):

Lizeka Amanda Tandwa ◽

Ames Dhai

Keyword(s):

South Africa ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Policy Making ◽

Public Involvement ◽

Structured Interview ◽

P Value ◽

Cross Sectional ◽

Policy Making Process

Abstract Background: Public involvement of citizens in the legislative development process is a constitutional requirement in South Africa. Patient engagement refers to the active involvement of patients in the decision-making processes at multiple levels in the health system. In order for patients to be engaged, they need to be provided with relevant information and an opportunity to be involved in the policy-making process. Methods: This was cross sectional and quantitative study with descriptive and comparative analyses. Two hundred and forty-four patients from the follow-up clinics at the Internal Medicine Department of Charlotte Maxeke Johannesburg Academic Hospital in the Gauteng Province, South Africa. The patients were interviewed through a structured interview process, using a questionnaire. Descriptive statistics and logistic regression univariate and multivariate analyses were run. Results: The majority (79.51%) of the participants were not aware of the proposed National Health Insurance (NHI) in South Africa even though process commenced in 2011. Most of the participants (86%) who were aware of the NHI had not received an opportunity to be involved in the policy making process of the NHI. About ninety-one percent of the participants (91.39%) knew that they had a right to be involved in the policy making process of the NHI. The odds of awareness were higher for male (OR: 2.08, 95% CI: 1.11 – 3.9, p value: 0.02) than female participants. The odds of awareness were higher for White (OR: 2.36, 95% CI: 1.06 – 5.26, p value: 0.04) and Indian (OR: 2.76, 95% CI: 0.10 – 7.60, p value: 0.05) participants when compared to Black participants. The odds of awareness were higher for retired (OR: 3.13, 95% CI: 1.35 – 7.25, p value: 0.008) than unemployed participants. Conclusions: Without the awareness and information about the NHI, patients are not equipped to be involved in the NHI policy process in a meaningful way.

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Public engagement in the development of the National Health Insurance: a study involving patients from a central hospital in South Africa.

10.21203/rs.2.10819/v3 ◽

2020 ◽

Author(s):

Lizeka Amanda Tandwa ◽

Ames Dhai

Keyword(s):

South Africa ◽

Health Policy ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Policy Process ◽

Policy Making ◽

Structured Interview ◽

P Value ◽

Policy Making Process

Abstract Background The National Health Insurance (NHI) is a proposed health policy in South Africa that aims to change the structure of the health system. Public involvement in the legislation development process is a constitutional requirement in South Africa. Patients are key stakeholders in health policy processes and should to be engaged in NHI policy processes. In order for patients to be engaged, they need to be provided with relevant information and an opportunity to be involved in the policy-making process. Methods This was cross sectional study. Two hundred and forty-four patients from the follow-up clinics at the Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital in the Gauteng Province, South Africa. The patients were interviewed using a structured interview process, using a questionnaire. Descriptive statistics and logistic regression analyses were run. Results The majority (79.51%) of the participants were not aware of the proposed National Health Insurance (NHI) in South Africa even though the NHI policy process commenced in 2011. Most of the participants (86%) who were aware of the NHI responded that they had not been provided with an opportunity to be involved in the policy making process of the NHI. The odds of awareness were higher for male (OR: 2.08, 95% CI: 1.11 – 3.9, p value: 0.02) than female participants. The odds of awareness were higher for White (OR: 2.36, 95% CI: 1.06 – 5.26, p value: 0.04) and Indian (OR: 2.76, 95% CI: 0.10 – 7.60, p value: 0.05) participants when compared to Black participants. The odds of awareness were higher for retired (OR: 3.13, 95% CI: 1.35 – 7.25, p value: 0.008) than unemployed participants. Conclusions The South African Department of Health cannot claim that they have met the constitutional requirement to involve the public in the setting of this study, since majority of the patients in this study were not aware of the NHI. This requirement is essential to the validity of the NHI policy process. Without the awareness and information about the NHI, patients are not equipped and cannot be involved in the NHI policy process in a meaningful way.

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Awareness of Health Care Practitioners About the National Health Insurance in Tshwane District, South Africa

The Open Public Health Journal ◽

10.2174/1874944501811010093 ◽

2018 ◽

Vol 11 (1) ◽

pp. 93-103 ◽

Cited By ~ 3

Author(s):

L.H. Mabuza ◽

G.A. Ogunbanjo ◽

K.E. Hlabyago ◽

M. Mogotsi

Keyword(s):

South Africa ◽

Health Care ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

School Health ◽

Health Coverage ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health Care Practitioners

Background: In 2012, the National Department of Health of South Africa launched the National Health Insurance (NHI) pilot program in 11 districts, towards universal health coverage for all South Africans. Health Care Practitioners (HCPs) are important role-players in its implementation. We decided to evaluate to what extent the HCPs were aware of the NHI program after three years of the pilot phase. Objective: To evaluate the awareness of HCPs about the NHI in the pilot Tshwane district of South Africa. Method: A cross-sectional survey was conducted among 1753 HCPs in Tshwane district. At 95% confidence level and 5% error margin, the sample size was 315 HCPs, but we over-sampled to 480. The study was conducted in 25 health facilities within the district. A pre-tested self-administered questionnaire was used. Results: A high proportion of HCPs were unaware of the objectives of the NHI program (p < 0.001); number of NHI pilot sites [(281; 59.4%) versus (145; 30.7%), p < 0.001]; rationale used to select pilot sites [(223; 46.9%) versus (193; 40.5%), p = 0.047]; role of the Integrated School Health Services (ISHP) [(250; 52.7%) versus (70; 14.8%), p < 0.001]; and specialists constituting the District Clinical Specialist Team (DCST) (p < 0.001). However, awareness regarding the Ward-Based Outreach Team (WBOT) leader was high [(236; 49.9%) versus (135; 28.5%), p < 0.001]. Conclusion: HCPs in Tshwane district demonstrated poor awareness of the NHI. This reveals that any awareness effort towards the NHI has not taken effect among the HCPs in this district.

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Determinan Keputusan Pekerja Mandiri menjadi Peserta Jaminan Kesehatan Nasional

Disease Prevention and Public Health Journal ◽

10.12928/dpphj.v14i1.1804 ◽

2020 ◽

Vol 14 (1) ◽

pp. 21

Author(s):

Jumatra Laila ◽

Asmaripa Ainy ◽

Dian Safriantini

Keyword(s):

Health Insurance ◽

Family Support ◽

National Health Insurance ◽

National Health ◽

Health Workers ◽

Cross Sectional Study ◽

Health Facilities ◽

P Value ◽

Cluster Sampling ◽

Cross Sectional

Background: National health insurance is mandatory for all Indonesians. In Ogan Ilir Regency, the lowest percentage (24,14%) of its participants in December 2016 was found in Indralaya Utara Sub-district, and self-employed participants in this sub-district were only 6,99%. This study aimed to analyze the determinants of the self-employed’s decision to become national health insurance participants in Indralaya Utara Sub-district. Method: This was a cross-sectional study. The population was self-employed in Indralaya Utara Sub-district. The sample was 108 respondents who were selected using cluster sampling and consecutive sampling techniques. Data analysis was conducted by univariate and bivariate with chi-square statistical test. Results: The results illustrated that 18,52% of respondents decided to become national health insurance participants. Variables with p-value<0,005 were: knowledge about national health insurance (p-value=0,011), trust (p-value=0.000), perception about national health insurance (p-value=0,000), attitude (p-value=0,000), income (p-value=0,002), family support (p-value=0,005). Variables with p-value≥0,005 were: education (p-value=0,234), perception about health facilities (p-value=0,162), distance to health facilities (p-value=0,355), health workers support (p-value=0,112). Conclusion: In conclusion, percentage of self-employed who decided become national health insurance participants was still small. Associated factors to the decision of self-employed as participants were: knowledge about national health insurance, trust, perception about national health insurance, attitude, income and family support. It is suggested that the Social Security Administrative Body for Health should routinely conduct socialization on national health insurance to improve the percentage of its participation for self-employed and the benefits of national health insurance could be felt by the entire community.

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DETERMINANT OF INDEPENDENT NATIONAL HEALTH INSURANCE OWNERSHIP IN INDONESIA

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.19/no.2/art.177 ◽

2019 ◽

Vol 19 (2) ◽

pp. 109-115

Author(s):

Bela Sari ◽

Haerawati Idris

Keyword(s):

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Junior High School ◽

P Value ◽

Health Coverage ◽

Chi Square ◽

Cross Sectional ◽

Cross Sectional Design ◽

Chi Square Analysis

The increasing of Independent National Health Insurance (NHI) membership is one of the indicators to achieve Universal Health Coverage. One of the challenges in extending such coverage is reaching it out to the informal sector. This study was aimed to analyze the determinants of Independent NHI ownership in Indonesia. This study used cross-sectional design, and the data were derived from Indonesian Family Live Survey (IFLS) 2014. 6,888 individuals aged ≥40 years were the sample of this study. To analyze the data, chi-square analysis and logistic regression were used. Based on the analysis, the proportion of respondent with Independent NHI is 16.6%. The ownership of independent NHI is influenced by the following factors: age 40-55 (PR=1.72 95%CI 1.41-2.09, p-value <0.001), Sumatra Island (PR=7.67 95%CI 5.55-10.59 p-value<0.001), very rich (PR = 2.26 95%CI 1.85-2.75 p-value <0.001), history of chronic disease (PR=1.33 95%CI 1.15-1.53 p-value<0.001), junior high school (PR = 2.21 95%CI 1.92-2.55 p-value<0.001), and urban (PR=1.79 95%CI 1.57-2.04 p-value <0.001). Region is the most dominant variable related to NHI ownership (p-value <0.001; Exp B= 7.03; 95% CI: 5.06-9.77). Independent NHI membership has not been maximal, yet. To increase this participation, the Social Security Administrator should approach each region with low NHI membership through promotion, socialization, and education about registration and the benefits of independent NHI.

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Public engagement in the development of the National Health Insurance (NHI): knowledge, awareness and participation of patients from the Internal Medicine Department at Charlotte Maxeke Johannesburg Academic Hospital in the NHI Policy Process

10.21203/rs.2.10819/v1 ◽

2019 ◽

Author(s):

Lizeka Amanda Tandwa ◽

Ames Dhai

Keyword(s):

Internal Medicine ◽

South Africa ◽

Health Insurance ◽

Policy Process ◽

Policy Making ◽

Development Process ◽

Public Involvement ◽

Academic Hospital ◽

Medicine Department ◽

Policy Making Process

Abstract Background Public involvement of citizens in the legislative development process is a constitutional requirement in South Africa. Relevant stakeholders should be engaged in the process. Patient engagement refers to the active involvement of patients in the decision-making processes at multiple levels in the health system. In order for patients to be engaged, they need to be provided with relevant information and an opportunity to be involved in the policy-making process. Methods This was cross sectional and quantitative study with descriptive and comparative analyses. 244 patients from the follow-up clinics at the Internal Medicine Department at Charlotte Maxeke Johannesburg Academic Hospital in the Gauteng Province, South Africa. The patients were interviewed through a structured interview, using a questionnaire. Descriptive statistics and logistic regression univariate and multivariate analyses were performed. Results The majority (79.51%) of the participants were not aware of the proposed National Health Insurance (NHI) in South Africa even though the initiation of this process commenced in 2011. Of the participants who were aware of the NHI (20.49%), the range of the knowledge questions answered correctly was between 50% and 68%. Most (86%) of the participant who were aware of the NHI had not received an opportunity to be involved in the policy making process of the NHI. Even though most of the participants were not aware of the NHI, the majority of the participants were interested in being involved in NHI policy development process. There were associations observed between sex, race, employment status and education level variables and the odds of awareness on the NHI. Conclusions The majority of participants involved in this study were not aware and they were not equipped to be involved in the NHI policy process. Most of the participants were not provided with suitable opportunities for them to be involved in the NHI policy process, despite public involvement in such a process being constitutional requirement.

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Performance and Attitude of Dental Poly Officers with Patient Satisfaction on JKN Era in Panembahan Hospital Bantul Yogyakarta

Jurnal Kesehatan Gigi ◽

10.31983/jkg.v6i2.5492 ◽

2019 ◽

Vol 6 (2) ◽

pp. 141-146

Author(s):

Naufal Rachmanda ◽

Edi Sumarwanto ◽

Ayu Kristin Rakhmawati

Keyword(s):

Patient Satisfaction ◽

Health Insurance ◽

Health Services ◽

National Health Insurance ◽

National Health ◽

P Value ◽

Cross Sectional ◽

A Value ◽

Quality Of Health Services

Panembahan Senopati Hospital is a referral hospital. In the government program in the form of the National Health Insurance (JKN), most people who seek treatment at Panembahan Senopati District Hospital have health insurance. The ineffectiveness of the referral system in Indonesia has an impact on the accumulation of patients in advanced health facilities, resulting in a decline in the quality of health services provided. The main indicator of knowing hospital standards is patient satisfaction with services from the hospital. Various facts show that there are serious problems in the quality of health services in Indonesia. This is due to the absence of the best quality control system that can be applied. To determine the level of satisfaction of National Health Insurance (JKN) patients with the quality of health services provided by dental clinic officers at Panembahan Senopati Hospital. Descriptive analytic observational with a cross sectional study design. The population in this study were patients who received dental and oral health services. Samples were taken using 86 accidental sampling techniques. Data was collected using a questionnaire consisting of 14 structured question items based on the performance and attitude of dental clinicians. Data analysis using the Chi-Square test followed by logistic regression test. From the results of multivariate analysis, the P value of 0.035 performance is significant and has a greater chance of 10,588 times compared to performance that is not appropriate. P value of 0.023 attitude is significant and has a 4.315 times the opportunity compared to attitudes that do not include 3 components. Factors related to satisfaction include intelligence, skills. emotional stability, a person's characteristics include attitudes, personal traits, physical traits, desires and motivation. There is a relationship between the performance and attitude of dental clinicians that performance is a variable X which is more influential with a value of P = 0.035 compared with attitude with a value of P = 0.023 to the variable Y about patient satisfaction of dental dentists.

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Relationship between Quality of Health Services and Satisfaction of National Health Insurance Participant in the District Hospital of North Buton in 2018

MEDULA ◽

10.46496/medula.v6i3.9645 ◽

2019 ◽

Vol 6 (3) ◽

Author(s):

Asmarani Dian Pratiwi ◽

Nina Indriyani N ◽

Erik Astrada ◽

Rhenislawaty Rhenislawaty

Keyword(s):

Health Insurance ◽

Health Services ◽

National Health Insurance ◽

National Health ◽

District Hospital ◽

P Value ◽

Cross Sectional ◽

Spearman Rank ◽

Quality Of Health Services

ABSTRACTLatar Belakang: Kualitas layanan kesehatan merupakan upaya yang dilakukan oleh petugas kesehatan, dokter, perawat, dan paramedis lainnya dalam hal memenuhi kebutuhan dan keinginan pelanggan dan penyediaan pengiriman untuk mengimbangi harapan pelanggan. Kualitas layanan kesehatan yang diberikan terdiri dari aspek bukti fisik, keandalan, daya tanggap, jaminan danempati. Tujuan Penelitian: Tujuan penelitian ini adalah untuk mengetahui hubungan kualitas pelayanan kesehatan dengan kepuasan peserta Asuransi Kesehatan Nasional di RSUD Buton Utara. Metode Penelitian: Penelitian ini menggunakan metode analitik-observasional dengan pendekatan cross sectional. Populasi penelitian ini adalah pasien yang berpartisipasi dalam Asuransi Kesehatan Nasional di Rumah Sakit Kabupaten Buton Utara dari Agustus hingga September 2018 dengan populasi 64. Dengan sampel 55 sampel diambil menggunakan metode accidental sampling. Data tentang kualitas layanan dan kepuasan pasien diperoleh melalui kuesioner. Analisis data menggunakan metode uji korelasi Spearman rank dan dianggap signifikan jika p <0,05. Hasil Penelitian: Hasil penelitian menunjukkan bahwa ada hubungan yang signifikan antara kualitas layanan dan kepuasan pasien. Hal ini dapat dilihat dari dimensi reliabilitas, yaitu p -value 0,000 (<0,05), dari dimensi responsi yaitu p-value 0,000 (<0,05), dimensi jaminan adalah p-value 0,000 (<0,05)), dan dari dimensi empati itu adalah nilai p-value 0,000 (<0,05) sedangkan pada dimensi buktifisik yang diperoleh p-value adalah 0,000 (<0,05). Dalam penelitian ini diperoleh responden yang menyatakan puas dengan pelayanan kesehatan dengan persentase 80,0% sedangkan mereka yang menyatakan ketidakpuasannya dengan persentase 20,0%. Simpulan: simpulan dari penelitian ini, terdapat hubungan antara kualitas pelayanan dan kepuasan peserta Asuransi Kesehatan Nasional di RSUD Buton Utara. Kata Kunci: bukti fisik, jaminan, keandalan, kepuasan pasien, pasien JKN

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Patient’s Satisfaction With Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria

Journal of Patient Experience ◽

10.1177/2374373520981471 ◽

2021 ◽

Vol 8 ◽

pp. 237437352098147

Author(s):

Temitope Esther Olamuyiwa ◽

Foluke Olukemi Adeniji

Keyword(s):

Health Care ◽

Patient Satisfaction ◽

Quality Of Care ◽

Health Insurance ◽

National Health Insurance ◽

National Health ◽

Bivariate Analysis ◽

P Value ◽

Tertiary Center

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients’ satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility. Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Bivariate analysis was performed using Pearson χ2 with a P value set at ≤ .05. Results: The study found out that about half (193, 50.9%) of the respondents were satisfied with the availability of structure. Patients were not satisfied with waiting time in the medical records, account, laboratory, and pharmacy sections. Overall, 286 (75.5%) of the respondents were satisfied with the outcome of health care provided at the NHIS clinic. A statistically significant association ( P = .00) was observed between treatment outcome and patient satisfaction. Conclusion: There is a need to address structural deficiencies and time management at the clinic.

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