This study examines the relationships between National Health Insurance Scheme (NHIS) enrollment and the frequency and 'timing' of health services utilisation among community-dwelling older Ghanaians. It also investigates whether the NHIS policy has improved equity in access to healthcare in later life.
Cross-sectional data were derived from an Ageing, Health, Psychological Wellbeing and Health-seeking Behaviour Study collected between August 2016 and January 2017 (N = 1200). Descriptive and bivariate analyses described the sample. Generalised Poisson and logit regression models respectively estimated the predictors of frequency of health services utilisation and time from onset of illness to health facility use and during last illness episode.
Older persons with active NHIS membership frequently used health facilities (β = 0.237, SE = 0.0957, p ˂ 0.005), but the association was largely a function of health-related factors. The NHIS enrollees were more likely to attend health facility earlier (β = 1.347, SE = 0.3437, p ˂ 0.001) compared with non-enrollees, after adjusting for theoretically relevant covariates. Moreover, given the NHIS enrollment, the rich (eβ = 2.149, SE = 0.240, p ˂ 0.005), social support recipients (eβ = 1.366, SE = 0.162, p ˂ 0.05) and those living with relevant others (eβ = 2.699, SE = 0.175, p ˂ 0.001) were more likely to consume health services.
Ghana's NHIS policy generally increases health services utilisation but at present lacks the capability to improve equitable access to healthcare, especially between poor and non-poor older adults. This may hamper the progress towards universal health coverage (UHC), indicating the need for further refinements in the policy including ways to improve the health status of older persons.
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 August 2018.
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#4,502,364
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Outputs from Journals of Gerontology Series B: Psychological Sciences & Social Sciences
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#16
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Altmetric has tracked 34,040,673 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,667 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.2. This one has gotten more attention than average, scoring higher than 69% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 372,103 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
