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Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana

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  • Robert Kaba Alhassan
  • Stephen Opoku Duku
  • Wendy Janssens
  • Edward Nketiah-Amponsah
  • Nicole Spieker
  • Paul van Ostenberg
  • Daniel Kojo Arhinful
  • Menno Pradhan
  • Tobias F Rinke de Wit

Abstract

Background: Quality care in health facilities is critical for a sustainable health insurance system because of its influence on clients’ decisions to participate in health insurance and utilize health services. Exploration of the different dimensions of healthcare quality and their associations will help determine more effective quality improvement interventions and health insurance sustainability strategies, especially in resource constrained countries in Africa where universal access to good quality care remains a challenge. Purpose: To examine the differences in perceptions of clients and health staff on quality healthcare and determine if these perceptions are associated with technical quality proxies in health facilities. Implications of the findings for a sustainable National Health Insurance Scheme (NHIS) in Ghana are also discussed. Methods: This is a cross-sectional study in two southern regions in Ghana involving 64 primary health facilities: 1,903 households and 324 health staff. Data collection lasted from March to June, 2012. A Wilcoxon-Mann-Whitney test was performed to determine differences in client and health staff perceptions of quality healthcare. Spearman’s rank correlation test was used to ascertain associations between perceived and technical quality care proxies in health facilities, and ordered logistic regression employed to predict the determinants of client and staff-perceived quality healthcare. Results: Negative association was found between technical quality and client-perceived quality care (coef. = -0.0991, p

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  • Robert Kaba Alhassan & Stephen Opoku Duku & Wendy Janssens & Edward Nketiah-Amponsah & Nicole Spieker & Paul van Ostenberg & Daniel Kojo Arhinful & Menno Pradhan & Tobias F Rinke de Wit, 2015. "Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities: Implications for a Sustainable National Health Insurance Scheme in Ghana," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-19, October.
    • Handle: RePEc:plo:pone00:0140109
    DOI: 10.1371/journal.pone.0140109
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    References listed on IDEAS

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    2. Philip Dalinjong & Alexander Laar, 2012. "The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana," Health Economics Review, Springer, vol. 2(1), pages 1-13, December.
    3. Roger A. Atinga & Anita A. Baku, 2013. "Determinants of antenatal care quality in Ghana," International Journal of Social Economics, Emerald Group Publishing, vol. 40(11), pages 852-865, August.
    4. Andaleeb, Syed Saad, 2001. "Service quality perceptions and patient satisfaction: a study of hospitals in a developing country," Social Science & Medicine, Elsevier, vol. 52(9), pages 1359-1370, May.
    5. Roger A. Atinga & Anita A. Baku, 2013. "Determinants of antenatal care quality in Ghana," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 40(10), pages 852-865, August.
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    1. Eric Badu & Peter Agyei‐Baffour & Isaac Ofori Acheampong & Maxwell Preprah Opoku & Kwasi Addai‐Donkor, 2019. "Perceived satisfaction with health services under National Health Insurance Scheme: Clients' perspectives," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 964-975, January.
    2. Robert Kaba Alhassan & Edward Nketiah-Amponsah & Daniel Kojo Arhinful, 2016. "A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-16, November.
    3. Robert Kaba Alhassan & Bismark Appiah Adu-Gyamfi & Agbolosu Oliver & Bright Ayensu & Gbekor Awoenam & Owusu Angela & Edward Nketiah-Amponsah & Prudence P. Mwini-Nyaledzigbor, 2018. "Correlates of Patients’ Preference for Therapeutic Injections in a Major Regional Referral Hospital in Ghana: Implications for Policy and Clinical Practice," SAGE Open, , vol. 8(4), pages 21582440188, October.
    4. Robert Kaba Alhassan & Edward Nketiah-Amponsah & Nicole Spieker & Daniel Kojo Arhinful & Tobias F Rinke de Wit, 2016. "Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-19, July.
    5. Stephen Kwasi Opoku Duku & Edward Nketiah‐Amponsah & Christine J. Fenenga & Wendy Janssens & Menno Pradhan, 2022. "The effect of community engagement on healthcare utilization and health insurance enrollment in Ghana: Results from a randomized experiment," Health Economics, John Wiley & Sons, Ltd., vol. 31(10), pages 2120-2141, October.

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