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Households Sociodemographic Profile as Predictors of Health Insurance Uptake and Service Utilization: A Cross-Sectional Study in a Municipality of Ghana

机译:家庭社会人口学特征作为健康保险吸收和服务利用的预测指标:加纳市的跨部门研究

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Introduction. Attempts to use health insurance in Low and Middle Income Countries (LMICs) are recognized as a powerful tool in achieving Universal Health Coverage (UHC). However, continuous enrolment onto health insurance schemes and utilization of healthcare in these countries remain problematic due to varying factors. Empirical evidence on the influence of household sociodemographic factors on enrolment and subsequent utilization of healthcare is rare. This paper sought to examine how household profile influences the National Health Insurance Scheme (NHIS) status and use of healthcare in a municipality of Ghana. Methods. A cross-sectional design with quantitative methods was conducted among a total of 380 respondents, selected through a multistage cluster sampling. Data were collected using a semistructured questionnaire. Data were analysed using descriptive and multiple logistics regression at 95% CI using STATA 14. Results. Overall, 57.9% of respondents were males, and average age was 34 years. Households’ profiles such as age, gender, education, marital status, ethnicity, and religion were key predictors of NHIS active membership. Compared with other age groups, 38–47 years (AOR 0.06) and 58 years and above (AOR = 0.01), widow, divorced families, Muslims, and minority ethnic groups were less likely to have NHIS active membership. However, females (AOR = 3.92), married couples (AOR = 48.9), and people educated at tertiary level consistently had their NHIS active. Proximate factors such as education, marital status, place of residence, and NHIS status were predictors of healthcare utilization. Conclusion. The study concludes that households’ proximate factors influence the uptake of NHIS policy and subsequent utilization of healthcare. Vulnerable population such as elderly, minority ethnic, and religious groups were less likely to renew their NHIS policy. The NHIS policy should revise the exemption bracket to wholly cover vulnerable groups such as minority ethnic and religious groups and elderly people at retiring age of 60 years.
机译:介绍。在中低收入国家(LMIC)中尝试使用健康保险被认为是实现全民健康覆盖(UHC)的有力工具。然而,由于各种因素,在这些国家中持续加入健康保险计划和利用医疗保健仍然存在问题。很少有关于家庭社会人口统计学因素对入学率和随后利用医疗保健影响的经验证据。本文试图研究家庭状况如何影响加纳市国民健康保险计划(NHIS)的地位和医疗保健的使用。方法。通过多阶段整群抽样选择了总共380名受访者,采用定量方法进行了横断面设计。使用半结构化问卷收集数据。使用STATA 14,在95%CI处使用描述性和多元物流回归分析数据。结果。总体而言,57.9%的受访者是男性,平均年龄为34岁。家庭的个人资料,例如年龄,性别,教育程度,婚姻状况,种族和宗教信仰,是NHIS活跃会员资格的主要预测指标。与其他年龄段相比,38-47岁(AOR 0.06)和58岁及以上(AOR = 0.01),寡妇,离婚家庭,穆斯林和少数民族不太可能拥有NHIS活跃会员资格。但是,女性(AOR = 3.92),已婚夫妇(AOR = 48.9)和受过高等教育的人始终具有活跃的NHIS。受教育程度,婚姻状况,居住地和NHIS状况等邻近因素是医疗保健利用率的预测指标。结论。研究得出的结论是,家庭的附近因素会影响NHIS政策的采用和随后的医疗保健利用。老年人,少数民族和宗教团体等弱势群体不太可能更新其NHIS政策。 NHIS政策应修改豁免范围,以完全涵盖弱势群体,例如少数民族和宗教团体以及60岁退休的老年人。

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