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The association between health insurance status and utilization of health services in rural Northern Ghana: evidence from the introduction of the National Health Insurance Scheme

Overview of attention for article published in Journal of Health, Population, & Nutrition, December 2017
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1 tweeter

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Title
The association between health insurance status and utilization of health services in rural Northern Ghana: evidence from the introduction of the National Health Insurance Scheme
Published in
Journal of Health, Population, & Nutrition, December 2017
DOI 10.1186/s41043-017-0128-7
Pubmed ID
Authors

Philip Ayizem Dalinjong, Paul Welaga, James Akazili, Anthony Kwarteng, Martin Bangha, Abraham Oduro, Osman Sankoh, Jane Goudge

Abstract

Many households in low- and middle-income countries face financial hardships due to payments for health care, while others are pushed into poverty. Risk pooling and prepayment mechanisms help to lessen the impact of the costs of care as well as assisting to achieve universal health coverage (UHC). Ghana implemented the National Health Insurance Scheme (NHIS) for the promotion of access to health services for all Ghanaians. In this paper, we examined the association between health insurance status and utilization of outpatient and inpatient health services in rural poor communities. The study was a cross-sectional household survey conducted in the Kassena-Nankana districts of Northern Ghana. We conducted interviews in 11,175 households and collected data on 55,992 household members. Multiple logistic regression models were used to identify factors associated with the utilization of outpatient and inpatient health services. The dependent variables were the utilization of outpatient and inpatient health services. We adjusted for several potential socio-demographic factors associated with utilization and health insurance status. Significantly, the insured had 2.51 (95% CI 2.3-2.8) and 2.78 (95% CI 2.2-3.6) increased odds of utilizing outpatient and inpatient health services respectively. Respondents with a history of recent illness or injury [32.4 (95% CI 29.4-35.8) and 5.72 (95% CI 4.6-7.1)] and poor or very poor self-reported health status [2.08 (95% CI 1.7-2.5) and 2.52 (95% CI 1.9-3.4)] and those on chronic medication [2.79 (95% CI 2.2-3.5) and 3.48 (95% CI 2.5-4.8)] also had increased odds of utilizing both outpatient and inpatient health services respectively. Among the insured, the poorest use the Community-based Health Planning and Services (CHPS) compounds, while the least poor use private clinics and public hospitals for outpatient health services. The uninsured predominately use pharmacies or licensed chemical shops (LCSs). For inpatient health services, the insured largely use public hospitals, with the uninsured using private clinics or public health centres. The findings suggest that being insured with the NHIS is associated with increased utilization of outpatient and inpatient health services in the study area. Overall, the NHIS can be an effective tool for achieving UHC and hence pragmatic efforts should be made to sustain it.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 129 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 129 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 33 26%
Student > Ph. D. Student 17 13%
Student > Bachelor 9 7%
Researcher 9 7%
Student > Doctoral Student 8 6%
Other 22 17%
Unknown 31 24%
Readers by discipline Count As %
Medicine and Dentistry 27 21%
Nursing and Health Professions 24 19%
Social Sciences 16 12%
Business, Management and Accounting 6 5%
Economics, Econometrics and Finance 3 2%
Other 15 12%
Unknown 38 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 19 December 2017.
All research outputs
#10,916,785
of 12,319,220 outputs
Outputs from Journal of Health, Population, & Nutrition
#217
of 272 outputs
Outputs of similar age
#287,121
of 346,263 outputs
Outputs of similar age from Journal of Health, Population, & Nutrition
#11
of 13 outputs
Altmetric has tracked 12,319,220 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 272 research outputs from this source. They receive a mean Attention Score of 4.0. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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 346,263 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 13 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.