Evaluation of National Health Insurance Scheme(NHIS) enrollees' satisfaction with the medical care provided in a Tertiary Hospital in North Central Nigeria

Abstract

Background: The National Health Insurance Scheme (NHIS) was designed to provide good and affordable healthcare to all Nigerians. The scheme has additional responsibility to maintain continuous quality assurance. This is the first attempt to evaluate patient satisfaction of NHIS enrollees in the study site in 15 years. The study determined the enrollees' satisfaction with NHIS services, it also assessed the patient and operational factors associated with satisfaction.

Methods: Using a cross sectional study, we recruited 306 NHIS enrollees from five outpatient clinics of the study institution and assessed their level of satisfaction in six domains, namely: General Satisfaction, Technical Quality, Interpersonal Manner,  Communication, Financial Aspects, Time Spent with Doctor, Accessibility and Convenience, using the Patient Satisfaction  Questionnaire - Short Form (PSQ-18). We analysed the data using the  SPSS version 21. A P-value of < 0.05 was considered as  statistically significant.

Results: General Satisfaction with services was 50.25%. Satisfaction from the six domains ranged from 53.55% to 81.25%. The  highest level of  satisfaction was from Communication (81.25%) and the lowest was from the Financial Aspects (53.55%). Enrollees  who were new, male or non-staff  of the health institution had higher satisfaction levels. HMO type was associated with satisfaction  level, while enrollee age, referral status,  occupation, level of education, marital status and number of children had no association with  satisfaction.

Conclusion: We found an average General Satisfaction level. The finding that NHIS enrollees were least satisfied with Accessibility and Financial Aspects of their care is of concern because protecting enrollees from financial burden and ensuring accessibility to good healthcare are the core mandates of NHIS.