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Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana

BACKGROUND: Ghana introduced capitation payment method in 2012 but was faced with resistance from provider groups and civil society organizations for its perceived negative effects on quality care delivery. This study seeks to explore the views of providers to understand their preferred payment meth...

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Autores principales: Andoh-Adjei, Francis-Xavier, Nsiah-Boateng, Eric, Asante, Felix Ankomah, van der Velden, Koos, Spaan, Ernst
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709917/
https://www.ncbi.nlm.nih.gov/pubmed/31449530
http://dx.doi.org/10.1371/journal.pone.0221195
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author Andoh-Adjei, Francis-Xavier
Nsiah-Boateng, Eric
Asante, Felix Ankomah
van der Velden, Koos
Spaan, Ernst
author_facet Andoh-Adjei, Francis-Xavier
Nsiah-Boateng, Eric
Asante, Felix Ankomah
van der Velden, Koos
Spaan, Ernst
author_sort Andoh-Adjei, Francis-Xavier
collection PubMed
description BACKGROUND: Ghana introduced capitation payment method in 2012 but was faced with resistance from provider groups and civil society organizations for its perceived negative effects on quality care delivery. This study seeks to explore the views of providers to understand their preferred payment method for the various types of services they provide in order to inform the discussion and negotiations during this period of reform. Findings will not only aid the National Health Insurance Authority (NHIA) to improve the implementation arrangements but also provide useful inputs for other low and middle-income countries (LMICs) in their quest to reform their provider payment systems. MATERIALS AND METHODS: We conducted a cross-sectional survey of 200 credentialed health care providers’ in the three regions of Ghana on providers’ preference for payment method. We administered closed-ended questionnaires employing 5-point Likert scales for measurement of payment method preference. Descriptive and regression analysis were performed to examine healthcare providers’ background characteristics and their association with preferred payment method for primary care. RESULTS: In general, health care providers prefer the Ghana-Diagnosis-Related Grouping (G-DRG) payment method to fee-for-service and capitation payment methods. Result of bivariate analyses showed that healthcare providers’ preference for payment method for primary outpatient services differed significantly by their region of residence (p<0.001). The multinomial logic model showed that being a female (p = 0.013) or healthcare provider in the Volta region (p = 0.008) was significantly associated with health provider preference for G-DRG payment method relative to fee-for-service. Similarly, being a healthcare provider in the Volta region (p = 0.026) or Medical Assistant (p = 0.032) was significantly associated with capitation relative to fee-for-service payment method. CONCLUSION: We conclude that the most preferred payment method across all regions is the G-DRG. However, whereas providers in the Volta region are not willing to accept capitation as payment method, this was not the case in Ashanti and Central regions. Capitation payment method as an option for primary care services in Ghana should, therefore, not be ruled out of the discussion.
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spelling pubmed-67099172019-09-10 Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana Andoh-Adjei, Francis-Xavier Nsiah-Boateng, Eric Asante, Felix Ankomah van der Velden, Koos Spaan, Ernst PLoS One Research Article BACKGROUND: Ghana introduced capitation payment method in 2012 but was faced with resistance from provider groups and civil society organizations for its perceived negative effects on quality care delivery. This study seeks to explore the views of providers to understand their preferred payment method for the various types of services they provide in order to inform the discussion and negotiations during this period of reform. Findings will not only aid the National Health Insurance Authority (NHIA) to improve the implementation arrangements but also provide useful inputs for other low and middle-income countries (LMICs) in their quest to reform their provider payment systems. MATERIALS AND METHODS: We conducted a cross-sectional survey of 200 credentialed health care providers’ in the three regions of Ghana on providers’ preference for payment method. We administered closed-ended questionnaires employing 5-point Likert scales for measurement of payment method preference. Descriptive and regression analysis were performed to examine healthcare providers’ background characteristics and their association with preferred payment method for primary care. RESULTS: In general, health care providers prefer the Ghana-Diagnosis-Related Grouping (G-DRG) payment method to fee-for-service and capitation payment methods. Result of bivariate analyses showed that healthcare providers’ preference for payment method for primary outpatient services differed significantly by their region of residence (p<0.001). The multinomial logic model showed that being a female (p = 0.013) or healthcare provider in the Volta region (p = 0.008) was significantly associated with health provider preference for G-DRG payment method relative to fee-for-service. Similarly, being a healthcare provider in the Volta region (p = 0.026) or Medical Assistant (p = 0.032) was significantly associated with capitation relative to fee-for-service payment method. CONCLUSION: We conclude that the most preferred payment method across all regions is the G-DRG. However, whereas providers in the Volta region are not willing to accept capitation as payment method, this was not the case in Ashanti and Central regions. Capitation payment method as an option for primary care services in Ghana should, therefore, not be ruled out of the discussion. Public Library of Science 2019-08-26 /pmc/articles/PMC6709917/ /pubmed/31449530 http://dx.doi.org/10.1371/journal.pone.0221195 Text en © 2019 Andoh-Adjei et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Andoh-Adjei, Francis-Xavier
Nsiah-Boateng, Eric
Asante, Felix Ankomah
van der Velden, Koos
Spaan, Ernst
Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title_full Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title_fullStr Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title_full_unstemmed Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title_short Provider preference for payment method under a national health insurance scheme: A survey of health insurance-credentialed health care providers in Ghana
title_sort provider preference for payment method under a national health insurance scheme: a survey of health insurance-credentialed health care providers in ghana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709917/
https://www.ncbi.nlm.nih.gov/pubmed/31449530
http://dx.doi.org/10.1371/journal.pone.0221195
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