IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v38y2023i2p398-415.html
   My bibliography  Save this article

Exploring physicians′ experiences under the national health insurance scheme in Southeastern Nigeria

Author

Listed:
  • Nene Okunna
  • Nkiru Nwamaka Ezeama
  • Chukwuemeka Okwudili Ezeama
  • Leso Munala

Abstract

Background A number of low‐and middle‐income countries have implemented National Health Insurance Schemes (NHIS) as part of efforts to increase access to quality healthcare and financial protection from regressive out‐of‐pocket payments. This study explored physicians' experiences under the Nigerian (NHIS) to identify factors that may influence efficient health care delivery. Methods A convenient sample of 85 physicians residing in South‐East Nigeria who had active contracts with the NHIS were surveyed via self‐administered questionnaire for this study. Descriptive statistics were used to summarize the data while Kruskal‐Wallis tests were used to determine if there were statistically significant associations between physician professional characteristics and their responses to key statements that assessed their experiences and behavior. Also, thematic analysis was used to assess additional qualitative data provided by study participants. Results Provider experiences were affected by the perceived inadequacy of reimbursement rates, delays in payment and services not covered by the NHIS. Participants' responses to statements on inadequacy of reimbursement was significantly associated with location using Kruskal‐Wallis test (χ2 (1) = 7.24, p = 0.027) while billing patients for services not covered under the NHIS was significantly associated with length of years of practice (χ2 (1) = 15.5, p = 0.001) and place of employment (χ2 (1) = 5.82, p = 0.054). Conclusion Physician experiences and challenges they face under the NHIS program in Nigeria have unintended effects on the delivery of health care services. It is imperative that these issues are addressed to improve health service delivery.

Suggested Citation

  • Nene Okunna & Nkiru Nwamaka Ezeama & Chukwuemeka Okwudili Ezeama & Leso Munala, 2023. "Exploring physicians′ experiences under the national health insurance scheme in Southeastern Nigeria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 38(2), pages 398-415, March.
    • Handle: RePEc:bla:ijhplm:v:38:y:2023:i:2:p:398-415
    DOI: 10.1002/hpm.3591
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3591
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hpm.3591?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. John C. Langenbrunner & Cheryl Cashin & Sheila O’Dougherty, 2009. "Designing and Implementing Health Care Provider Payment Systems : How-To Manuals," World Bank Publications - Books, The World Bank Group, number 13806.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fourie, Carina & Biller-Andorno, Nikola & Wild, Verina, 2014. "Systematically evaluating the impact of diagnosis-related groups (DRGs) on health care delivery: A matrix of ethical implications," Health Policy, Elsevier, vol. 115(2), pages 157-164.
    2. Omelyanovsky, Vitaly (Омельяновский, Виталий) & Avxentieva, Maria (Авксентьева, Мария) & Zheleznyakova, Inna (Железнякова, Инна) & Ignatyeva, Victoria (Игнатьева, Виктория) & Tyurina, Irina (Тюрина, И, 2018. "Improving of the Systems of Organization and Payment of Ambulatory Medical Care [Совершенствование Систем Организации И Оплаты Амбулаторной Медицинской Помощи]," Working Papers 031807, Russian Presidential Academy of National Economy and Public Administration.
    3. Chen, Chun & Dong, Weizhen & Shen, Jay J. & Cochran, Christopher & Wang, Ying & Hao, Mo, 2014. "Is the prescribing behavior of Chinese physicians driven by financial incentives?," Social Science & Medicine, Elsevier, vol. 120(C), pages 40-48.
    4. Jayendra Sharma, 2016. "An assessment of fiscal space for health in Bhutan," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 296-308, July.
    5. Shirin Nosratnejad & Reza Esmaeili & Jafar Sadegh Tabrizi & Alireza Mahboub‐Ahari, 2019. "Development of age‐sex adjusted capitation payment: The experience of Iranian public health complexes," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 183-193, January.
    6. Stefan Meyer, 2015. "Payment schemes and cost efficiency: evidence from Swiss public hospitals," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 73-97, March.
    7. Melvin Obadha & Edwine Barasa & Jacob Kazungu & Gilbert Abotisem Abiiro & Jane Chuma, 2019. "Attribute development and level selection for a discrete choice experiment to elicit the preferences of health care providers for capitation payment mechanism in Kenya," Health Economics Review, Springer, vol. 9(1), pages 1-19, December.
    8. Cavalieri, M. & Guccio, C. & Lisi, D. & Pignataro, G., 2015. "Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 15/29, HEDG, c/o Department of Economics, University of York.
    9. Víctor Giménez & Jorge R. Keith & Diego Prior, 2019. "Do healthcare financing systems influence hospital efficiency? A metafrontier approach for the case of Mexico," Health Care Management Science, Springer, vol. 22(3), pages 549-559, September.
    10. Camilleri, Carl & Jofre-Bonet, Mireia & Serra-Sastre, Victoria, 2018. "The suitability of a DRG casemix system in the Maltese hospital setting," Health Policy, Elsevier, vol. 122(11), pages 1183-1189.
    11. Hong Wang & Kimberly Switlick & Christine Ortiz & Beatriz Zurita & Catherine Connor, 2012. "Health Insurance Handbook : How to Make It Work," World Bank Publications - Books, The World Bank Group, number 5913.
    12. Saheed O. Olayiwola & Francis O. Adeyemi, 2022. "Strategic Health Purchasing and Health System Performance in Nigeria," International Journal of Research and Innovation in Social Science, International Journal of Research and Innovation in Social Science (IJRISS), vol. 6(7), pages 238-245, July.
    13. Joint Learning Network & Mongolia Ministry of Health & World Bank & World Health Organization, 2015. "Assessment of Systems for Paying Health Care Providers in Mongolia," World Bank Publications - Reports 22812, The World Bank Group.
    14. Zakieh Ostad-Ahmadi & Miriam Nkangu & Mahmood Nekoei-Moghadam & Mohammad Heidarzadeh & Reza Goudarzi & Vahid Yazdi-Feyzabadi, 2024. "Fragmentation of payment systems: an in-depth qualitative study of stakeholders’ experiences with the neonatal intensive care payment system in Iran," Health Economics Review, Springer, vol. 14(1), pages 1-14, December.
    15. Ali Mofleh Alshahrani & Mona Y. Alsheikh, 2021. "Community Pharmacists’ Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services," IJERPH, MDPI, vol. 18(20), pages 1-11, October.
    16. Patrick Opiyo Owili & Miriam Adoyo Muga & Ya-Ting Yang & Yi-Hsin Elsa Hsu, 2019. "Perceived Impact of Taiwan’s National Health Insurance Allocation Strategy: Health Professionals’ Perspective," IJERPH, MDPI, vol. 16(3), pages 1-12, February.
    17. World Bank, 2013. "Lessons from 11 Country Case Studies : A Global Synthesis Report for the Global Conference on Universal Health Coverage for Inclusive and Sustainable Growth," World Bank Publications - Reports 17003, The World Bank Group.
    18. World Bank, 2010. "Tajikistan - Feasibility Study for Results-Based Financing (RBF) In the Health Sector," World Bank Publications - Reports 2838, The World Bank Group.
    19. Melvin Obadha & Jane Chuma & Jacob Kazungu & Edwine Barasa, 2019. "Health care purchasing in Kenya: Experiences of health care providers with capitation and fee‐for‐service provider payment mechanisms," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 917-933, January.
    20. World Bank, 2015. "Understanding and Monitoring Service Delivery in a Decentralizing Environment in Mongolia," World Bank Publications - Reports 24055, The World Bank Group.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:38:y:2023:i:2:p:398-415. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.