Enrollees’ knowledge and satisfaction with national health insurance scheme service delivery in a tertiary hospital, southwest Nigeria

Abstract

Background: Social health insurance scheme provides a platform for mobilizing revenue for health and enhances universal health‑care coverage. In addition, knowledge about patients’ satisfaction with health care under the scheme will help in identifying gaps and provides evidence toward strengthening the scheme. This study assessed enrollees’ knowledge about the National Health Insurance Scheme (NHIS) and satisfaction with health services provided under the scheme. Materials and Methods: The study was a descriptive cross‑sectional survey conducted among the NHIS enrollees accessing health‑care services in the University College Hospital, Ibadan. A total of 373 individuals were consecutively recruited for the study, and a semi‑structured, pretested interviewer‑administered questionnaire was used to obtain information from respondents. Descriptive statistics was used to present results, and Chi‑square test was used to test for the association between categorical variables. The level of significance was set at P < 005. Results: The mean age was 42.5 ± 10.0 years. Of the respondents, 209 (56.0%) were male and 359 (96.2%) were married. About two‑thirds, 227  (60.9%), had good knowledge about the NHIS. Majority of the respondents 303 (81.2%) reported paying for some of the costs of service (drugs, laboratory tests, consultation fees, and X‑ray) through out‑of‑pocket and of these, 218 (71.9%) reported that such payments were occasional. Overall, slightly more than half, 197 (52.8%), of the respondents were satisfied
with service delivery under the scheme. Female respondents were significantly more satisfied with health‑care services (χ² = 3.894, P = 0.048). Conclusion: There was good knowledge of NHIS, but the level of satisfaction with service delivery was not outstandingly appreciable. There is an urgent need to improve on all areas of quality of service to improve satisfaction with care among enrollees in the scheme.