Critical Determinants of Demand for Services in the Nigeria Formal Sector Social Health Insurance Programme
Obi Ikechukwu Vincent,
Okoronkwo Ijeoma Lewechi,
Iloh Gabriel Uche Pascal,
Nwonwu Elizabeth Uzoamaka,
Ogbu Kenneth,
Yakubu Adole Agada-Amade
Issue:
Volume 5, Issue 1, March 2020
Pages:
1-8
Received:
29 January 2020
Accepted:
18 February 2020
Published:
26 February 2020
Abstract: Introduction: Social health insurance programme was initiated in Nigeria with one of the aims being to improve the demand for quality healthcare services with a resultant reduction in catastrophic spending among the citizenry. Unfortunately, in this programme, healthcare providers who offer quality healthcare services still witness poor enrollee demand for services which has led to inability of the programme to achieve its set out objectives. Hence, the need to study the effects of selected critical determinants on demand for health insurance services and how much these determinants can collectively account for the demand for services in the programme. Design/Methodology: The study adopted a cross sectional design with a quantitative approach. The sample size was calculated using G - Power 3.1 software and the determined sample for the study was one thousand four hundred and thirty five (1435). Multistage sampling method was adopted. Data was analyzed using descriptive statistics and linear regression method with the aid of SPSS version 11. Result: The critical determinants of provider ownership, distance to healthcare provider, enrollee educational level have significant positive effect on the demand for health insurance services (<0.05) but the effect of enrollee income was positively insignificant (>0.05). Similarly, 75% of the changes in demand for health insurance services can be accounted for by the predictor variables in this study. Conclusion: The inability of the programme to address these selected critical determinants significantly will lead to out of pocket spending for healthcare services with a resultant catastrophic effect on families’ finances. Therefore, there is a need to take into account the effects of these determinants duringpolicy formulation, reviews and process implementation in the programme.
Abstract: Introduction: Social health insurance programme was initiated in Nigeria with one of the aims being to improve the demand for quality healthcare services with a resultant reduction in catastrophic spending among the citizenry. Unfortunately, in this programme, healthcare providers who offer quality healthcare services still witness poor enrollee de...
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Treatment of Spinal Deformities - The Appearance of a Conflict of Interest
Issue:
Volume 5, Issue 1, March 2020
Pages:
9-14
Received:
11 April 2020
Accepted:
24 April 2020
Published:
28 May 2020
Abstract: The majority of patients with spinal deformities need some type of treatment. Typically, physiotherapy and bracing are sufficient and a minority of cases require surgical treatment. However, in many international papers on spinal deformities surgical issues are investigated while conservative management of spinal deformities is definitively underrepresented. The purpose of this survey is to look more deeply into the implications of the surgical societies and spine surgeons lobbyism on the payroll of industry and how these groups influence payments (reimbursement) made by national health services or health insurance systems worldwide for the treatments of patients with spinal deformities. Materials and methods: An international network of specialists for the conservative treatment of spinal deformities have performed a survey analyzing the cost of spinal surgery for spinal deformities (scoliosis), the cost of a brace and whether insurance/the NHS reimbursement applies with surgery or bracing. Results: In most countries surgery is paid without co-payments by the patient. In Japan, China and Ukraine co-payments are necessary for surgery. There are more restrictions when looking at payments for braces. In some countries, braces are not covered by the health care systems or insurance companies at all (China, Indonesia) in others the amount covered is only minimal (Turkey, Ukraine). Conclusions: Evidence in scientific literature is not reflected in the political decision making in parliaments. Evidence based treatment approaches for patients with spinal deformities are not necessarily reimbursed by local health care systems while surgery without scientific evidence is reimbursed more easily although it is more expensive. The most economic approach would be to pay for high quality conservative treatment in order to largely prevent the need for surgery. Surgical indications should be approved by an independent non-surgical specialist for spinal deformites.
Abstract: The majority of patients with spinal deformities need some type of treatment. Typically, physiotherapy and bracing are sufficient and a minority of cases require surgical treatment. However, in many international papers on spinal deformities surgical issues are investigated while conservative management of spinal deformities is definitively underre...
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