Patient Preference and Reasons for Choice of Healthcare Facilities among Enrollees of the National Health Insurance Scheme. A Case Study of a Teaching Hospital In North-East Nigeria.

Abstract

The National Health Insurance Scheme (NHIS) operational guidelines stipulate that an enrollee has the right to freely choose his/her NHIS accredited primary healthcare facility. Primary care is the bedrock and entry point at which individuals make first contact with health service, and NHIS enrollees have different reasons for their choices. This study assessed factors influencing patient choice of a University Teaching Hospital as a primary care provider under the NHIS. The descriptive cross-sectional study was part of a larger survey conducted among NHIS patients attending the General Outpatient Department at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Borno State, Nigeria. Data were collected from 115 patients selected by systematic random sampling; using anonymous, self-administered, structured questionnaire. Data analysis was done using IBM SPSS Statistics 20.0. Majority (80.9%) of the respondents choose the hospital as their primary care provider because the hospital operates also as a primary care provider despite being a tertiary facility, with the availability of specialist doctors and services. Other influencing factors included; quality services (65.2%), easy accessibility (60.0%) and patient referral (47.9%). The implications of the findings suggest the need for the government to set up/strengthen functional primary care facilities and effective medical referral system between primary, secondary and tertiary centres, enabling patient heath needs to be met in the proper setting; as this will boost patient confidence and influence them to readily make primary healthcare facilities their choice, and be referred if the need arises. The NHIS/HMOs should also continue to carry out continuous quality assurance to ensure qualitative healthcare.