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National health insurance and surgical care for injured people, Ghana
OBJECTIVE: To determine the association between having government health insurance and the timeliness and outcome of care, and catastrophic health expenditure in injured patients requiring surgery at a tertiary hospital in Ghana. METHODS: We reviewed the medical records of injured patients who requi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
World Health Organization
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716100/ https://www.ncbi.nlm.nih.gov/pubmed/33293747 http://dx.doi.org/10.2471/BLT.20.255315 |
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author | Gyedu, Adam Goodman, Stephanie K Katz, Micah Quansah, Robert Stewart, Barclay T Donkor, Peter Mock, Charles |
author_facet | Gyedu, Adam Goodman, Stephanie K Katz, Micah Quansah, Robert Stewart, Barclay T Donkor, Peter Mock, Charles |
author_sort | Gyedu, Adam |
collection | PubMed |
description | OBJECTIVE: To determine the association between having government health insurance and the timeliness and outcome of care, and catastrophic health expenditure in injured patients requiring surgery at a tertiary hospital in Ghana. METHODS: We reviewed the medical records of injured patients who required surgery at Komfo Anokye Teaching Hospital in 2015–2016 and extracted data on sociodemographic and injury characteristics, outcomes and out-of-pocket payments. We defined catastrophic health expenditure as ≥ 10% of the ratio of patients’ out-of-pocket payments to household annual income. We used multivariable regression analyses to assess the association between having insurance through the national health insurance scheme compared with no insurance and time to surgery, in-hospital mortality and experience of catastrophic health expenditure, adjusted for potentially confounding variables. FINDINGS: Of 1396 patients included in our study, 834 (60%) were insured through the national health insurance scheme. Time to surgery and mortality were not statistically different between insured and uninsured patients. Insured patients made smaller median out-of-pocket payments (309 United States dollars, US$) than uninsured patients (US$ 503; P < 0.001). Overall, 45% (443/993) of patients faced catastrophic health expenditure. A smaller proportion of insured patients (33%, 184/558) experienced catastrophic health expenditure than uninsured patients (60%, 259/435; P < 0.001). Insurance through the national health insurance scheme reduced the likelihood of catastrophic health expenditure (adjusted odds ratio: 0.27; 95% confidence interval: 0.20 to 0.35). CONCLUSION: The national health insurance scheme needs strengthening to provide better financial risk protection and improve quality of care for patients presenting with injuries that require surgery. |
format | Online Article Text |
id | pubmed-7716100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | World Health Organization |
record_format | MEDLINE/PubMed |
spelling | pubmed-77161002020-12-07 National health insurance and surgical care for injured people, Ghana Gyedu, Adam Goodman, Stephanie K Katz, Micah Quansah, Robert Stewart, Barclay T Donkor, Peter Mock, Charles Bull World Health Organ Research OBJECTIVE: To determine the association between having government health insurance and the timeliness and outcome of care, and catastrophic health expenditure in injured patients requiring surgery at a tertiary hospital in Ghana. METHODS: We reviewed the medical records of injured patients who required surgery at Komfo Anokye Teaching Hospital in 2015–2016 and extracted data on sociodemographic and injury characteristics, outcomes and out-of-pocket payments. We defined catastrophic health expenditure as ≥ 10% of the ratio of patients’ out-of-pocket payments to household annual income. We used multivariable regression analyses to assess the association between having insurance through the national health insurance scheme compared with no insurance and time to surgery, in-hospital mortality and experience of catastrophic health expenditure, adjusted for potentially confounding variables. FINDINGS: Of 1396 patients included in our study, 834 (60%) were insured through the national health insurance scheme. Time to surgery and mortality were not statistically different between insured and uninsured patients. Insured patients made smaller median out-of-pocket payments (309 United States dollars, US$) than uninsured patients (US$ 503; P < 0.001). Overall, 45% (443/993) of patients faced catastrophic health expenditure. A smaller proportion of insured patients (33%, 184/558) experienced catastrophic health expenditure than uninsured patients (60%, 259/435; P < 0.001). Insurance through the national health insurance scheme reduced the likelihood of catastrophic health expenditure (adjusted odds ratio: 0.27; 95% confidence interval: 0.20 to 0.35). CONCLUSION: The national health insurance scheme needs strengthening to provide better financial risk protection and improve quality of care for patients presenting with injuries that require surgery. World Health Organization 2020-12-01 2020-09-28 /pmc/articles/PMC7716100/ /pubmed/33293747 http://dx.doi.org/10.2471/BLT.20.255315 Text en (c) 2020 The authors; licensee World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. |
spellingShingle | Research Gyedu, Adam Goodman, Stephanie K Katz, Micah Quansah, Robert Stewart, Barclay T Donkor, Peter Mock, Charles National health insurance and surgical care for injured people, Ghana |
title | National health insurance and surgical care for injured people, Ghana |
title_full | National health insurance and surgical care for injured people, Ghana |
title_fullStr | National health insurance and surgical care for injured people, Ghana |
title_full_unstemmed | National health insurance and surgical care for injured people, Ghana |
title_short | National health insurance and surgical care for injured people, Ghana |
title_sort | national health insurance and surgical care for injured people, ghana |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716100/ https://www.ncbi.nlm.nih.gov/pubmed/33293747 http://dx.doi.org/10.2471/BLT.20.255315 |
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