Satisfaction of Enrolees and Non-Enrolees of National Health Insurance Scheme with Health Care Services: A Comparative Study at a Tertiary Hospital in Southeast Nigeria

Abstract

In the era of value-based care, patients satisfaction is paramount to quality health care delivery. Patients satisfaction is a humanistic outcome measure and a benchmark in quality assessment of patients care services. The study assessed enrollee’s and non-enrollees satisfaction with health care services in the hospital. The study was a descriptive and comparative cross sectional survey using pretested structured questionnaire on national health insurance scheme (NHIS) and non- NHIS enrollees who attended the hospital between January 2014 and June 2016. Data were analyzed using descriptive and inferential statistics at P< 0.05 confidence interval. The mean age of NHIS and non-NHIS were 38.98±5.1 and 34.68±3.6 years. The NHIS patients average satisfaction scores with accessibility was 2.89 against 2.55 for non-NHIS. Satisfaction with hospital environment was 2.62 for NHIS enrollees and 2.38 for non-enrollees, while the hospital bureaucracy score for NHIS was 2.44 against 1.97 for non-NHIS patients. However, the average satisfaction score of non-NHIS patients for cost of care in the entire domain was higher than that of NHIS patients while the relative difference was not significant except for laboratory fees where NHIS had 2.70 against 2.48 for non-NHIS. Accessibility and patient waiting time were ranked for NHIS 2.89 and 2.81 for non-NHIS patients. Patients staff communication was 2.39 for NHIS and 2.25 for non-NHIS. The NHIS respondent’s satisfaction scores with patient’s provider relationship were higher than that of Non-NHIS respondents in all the selected domains of care. Majority of NHIS patients had better satisfaction to services compared to the non-NHIS enrollees. Consolidation on the domains, which improved patient’s satisfaction, and improvement on the domains that led to dissatisfaction could be a way of improving the value of care to patients. NHIS patients’ satisfaction with the services provided was significantly higher than that of non-NHIS patients.