PERFORMANCE OF THE NATIONAL HEALTH INSURANCE SCHEME IN THE HO MUNICIPALITY

ABSTRACT

This study focused on assessing the performance of the Ho Mutual Health Insurance Scheme and considered factors including; availability of administrative structures and logistical support, quality of care, attitude of hospital staff towards insured persons, claim processing, etc. There have been some concerns over the quality of treatment under the health reform compared to cash and carry system hitherto, practiced. For instance, questions have been raised about the attitude of hospital staff towards insured persons as well as the quality of treatment expected. The study used a sample size of 380 respondents, obtained through appropriate statistical instruments. About 96% of the respondents were accessed though quota sampling from the three health felicities and the general public and only 4% of employees of the mutual health insurance scheme were interviewed. A triangulation of quantitative and qualitative methodologies and analysis of results were employed to explore perceptions of research participants on the performance of the scheme. The perception of the insured persons accessed was that, the health reform was a good intervention but was not functioning too well, for instance, the quality of care was satisfactory and claim processing was manually done delaying government reimbursement to the healthcare providers. It suggested, for example, that revenue sources should be diversified to sustain the scheme and also, claim processing by the scheme computerised for high level performance.