The Effects of Delays in Reimbursement of Claims by National Health Insurance Authority on Financial Management of Health Care Facilities in Brong Ahafo Region of Ghana

2020 ◽  
pp. 103-114
Author(s):  
Nestor Naabulee Nasage
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Financial Management ◽  
Health Care Facilities ◽  
Care Facilities ◽  
Brong Ahafo Region ◽  
Brong Ahafo

scholarly journals Targeting and Impact of National Health Insurance Program in Indonesia

2020 ◽  
Vol 9 (4) ◽  
pp. 468-481
Author(s):  
Galih Putri Yunistria
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Health Care Facilities ◽  
National Health Insurance System ◽  
Care Facilities

National Health Insurance System (NHIS) program in Indonesia has been launched since 2014,and government spending to support the program has allocated nearly 40% of MoH budget,especially for the NHIS subsidies. This study examined the distribution of NHIS subsidizedbeneficiaries which associated with the household income distribution, and also studied about theutilization rate of health care facilities among the residents since the NHIS program has introducedto change citizens’ health seeking behaviour from traditional services to health facilities. Using the2016 Susenas data, this study employed the benefit incidence analysis method to measure thedistribution of NHIS-subsidized group, and logistic regression analysis to determine the health careseeking behavior. The result shows that households in higher income (quantile III-V) get benefitfrom government subsidy on NHIS program. It indicated there was a leakage on governmentbudget that not belong to the target (quantile I and II). Then, logistic regression analysis found thatpeople with higher income and having health insurance tend to visit health care facilities morefrequently than lower income group and uninsured people. This can be concluded that healthinsurance ownership is one of the important factors to influence people visiting health carefacilities.

scholarly journals Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study (Preprint)

2019 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Health Care Facilities ◽  
Health Record ◽  
National Medical ◽  
Referral Service ◽  
Care Facilities ◽  
Access Logs ◽  
Medical Referral

BACKGROUND Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. OBJECTIVE To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. METHODS We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. RESULTS The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. CONCLUSIONS This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.

scholarly journals Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study

10.2196/13563 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e13563 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Health Care Facilities ◽  
Health Record ◽  
National Medical ◽  
Referral Service ◽  
Care Facilities ◽  
Access Logs ◽  
Medical Referral

Background Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. Objective To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. Methods We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. Results The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. Conclusions This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.

scholarly journals Factors Affecting Utilization of the National Health Insurance Scheme by Federal Civil Servants in Rivers State, Nigeria

2021 ◽  
Vol 58 ◽  
pp. 004695802110176
Author(s):  
Obelebra Adebiyi ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Workers ◽  
Civil Servants ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Rivers State

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires. Data were collated and analyzed using SPSS version 21.0. A Chi-square test was carried out. The level of Confidence was set at 95%, and the P-value ≤ .05. Out of a total of 334 respondents, 280 (83.8%) were enrolled for NHIS, 203 (72.5%) utilized the services of the scheme. Most 181 (82.1%) of the respondents who utilized visited the facility at least once in the preceding year. Although, 123 (43.9%) of the respondents made payments at a point of access to health care services, overall there was a reduction in out of pocket payment. Possession of NHIS card, the attitude of health workers, and patients’ satisfaction were found to significantly affect utilization P ≤ .05. Regression analysis shows age and income to be a predictor of utilization of the NHIS. Though utilization is high, effort should be made to remove payment at the point of access and improving the harsh attitude of some of the health workers.

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

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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