Health Insurance and Health Seeking Behaviour: A Facility-based Comparative Study between Insured and Uninsured Patients in Northeast, Nigeria

Abstract

Health insurance is gaining more attention worldwide as a means of achieving Universal Health Coverage (UHC) by improving access to health care services and protecting households against the financial burden of out-of-pocket expenditures due to ill health. This facility-based descriptive cross-sectional study used a self-administered questionnaire to collect data on health care seeking behavior of insured and uninsured patients attending the University of Maiduguri Teaching Hospital (UMTH) Maiduguri. The respondents, 115 from each group, were selected by systematic random sampling. Data analysis was done using IBM SPSS Statistics 20.0 software.  A Statistically significant higher proportion of insured patients 97(84.3%), compared to the uninsured 68(59.1%) usually go to the hospital as their first line health-seeking behaviour when sick. Also, the leading cause of delay from seeking hospital care among the respondents was financial constraints; (80.9%) among the uninsured and (31.3%) among the insured. The finding of positive influence of health insurance on health-seeking behaviour is a pointer to the need to scale up of the population coverage of health insurance in Nigeria. Also, challenges relating to quality of care, with the accompanying financial burdens should be addressed so that the main objective of the National Health Insurance Scheme (NHIS), which is to shield people from the financial burden of healthcare access will not be defeated.

Keywords:  Health insurance; Health Seeking Behaviour; Insured; Uninsured; Nigeria.