Preferred Primary Healthcare Provider Choice Among Insured Persons in Ashanti Region, Ghana

Abstract

Background: In early 2012, National Health Insurance Scheme (NHIS) members in Ashanti Region were allowed to choose their own primary healthcare providers. This paper investigates the factors that enrolees in the Ashanti Region considered in choosing preferred primary healthcare providers (PPPs) and direction of association of such factors with the choice of PPP. Methods: Using a cross-sectional study design, the study sampled 600 NHIS enrolees in Kumasi Metro area and Kwabre East district. The sampling methods were a combination of simple random and systematic sampling techniques at different stages. Descriptive statistics were used to analyse demographic information and the criteria for selecting PPP. Multinomial logistic regression technique was used to ascertain the direction of association of the factors and the choice of PPP using mission PPPs as the base outcome. Results: Out of the 600 questionnaires administered, 496 were retained for further analysis. The results show that availability of essential drugs (53.63%) and doctors (39.92%), distance or proximity (49.60%), provider reputation (39.52%), waiting time (39.92), additional charges (37.10%), and recommendations (48.79%) were the main criteria adopted by enrolees in selecting PPPs. In the regression, income (-0.0027), availability of doctors (-1.82), additional charges (-2.14) and reputation (-2.09) were statistically significant at 1% in influencing the choice of government PPPs. On the part of private PPPs, availability of drugs (2.59), waiting time (1.45), residence (-2.62), gender (-2.89), and reputation (-2.69) were statistically significant at 1% level. Presence of additional charges (-1.29) was statistically significant at 5% level. Conclusion: Enrolees select their PPPs based on such factors as availability of doctors and essential drugs, reputation, waiting time, income, and their residence. Based on these findings, there is the need for healthcare providers to improve on their quality levels by ensuring constant availability of essential drugs, doctors, and shorter waiting time. However, individual enrolees may value each criterion differently. Thus, not all enrolees may be motivated by same concerns. This requires providers to be circumspect regarding the factors that may attract enrolees. The National Health Insurance Authority (NHIA) should also ensure timely release of funds to help providers procure the necessary medical supplies to ensure quality service.

Utilisation of outpatient healthcare services among elderly people with Hypertension in Ghana

“…Following Grossman [16], Amaghionyeodiwe [27], and Boachie [20], we assume that the utility of a hypertensive patient depends on the consumption of two goods: good health (H); and consumption of all other goods and services (X). S represents the social and economic characteristics of the patient.…”

“…The study employs descriptive and inferential statistics to analyze the data. As in Dou et al [3] and Boachie [20], percentages are used to obtain the differences in responses and background information. To ascertain the effect of socio-economic and demographic variables on outpatient healthcare utilization, we employed logistic regression model.…”

“…Similar to Dou et al [3] and Boachie [20], we made use of logistic regression model to find the direction of association of the socio-economic factors with outpatient healthcare utilization, and their magnitudes. The results of the logistic regression are presented in Table 3.…”

“…In estimating the demand for healthcare, the price of healthcare has been found to be a significant determinant of the choice of healthcare provider. Thus, where the sick person seeks treatment is significantly affected by price, whether user fee or co-payment [20,21].…”

What factors influence the choice of first healthcare provider for childhood fever or cough in Ghana?

“…Amaghionyeodiwe (2008) revealed among other findings that, monetary prices and distance from the facility decreased the choice of using modern healthcare providers in Nigeria. Specifically on Ghana, Boachie (2016) in the Kumasi metropolis and Kwabre East District of Ghana found additional charges, income, age, clean environment, reputation, availability of drugs, waiting time, availability of doctors, residence and gender to influence the choice of preferred health care providers for enrolees under the Ghana National Health Insurance scheme. Fenny, Asante, Enemark and Hansen (2015) in three Districts of Ghana among other findings, revealed that having a health insurance increased the choice of formal care over informal healthcare.…”