Patients Satisfaction with Health Services Under National Health Insurance Scheme (NHIS)In Nigeria

Abstract

Patients satisfaction has come to stay as a measure of health systems’ performances all over the world, the world health organization recommend periodic patient satisfaction surveys as a measurement and evaluation tool with the aim of improving the functioning of health systems. In Nigeria, the NHIS was established to improve health seeking behavior, access to healthcare and to reduce out of pocket spending; it is compulsory for all federal level civil servant. This study was conducted with the primary aim of measuring how happy these federal civil servants are with the health services they receive from health facilities; it also sought to know whether workers are willing to continue or whether they will opt out of the scheme if given a chance. A 24 point Likert scale questionnaire was administered to federal civil servants working in Bauchi and Gombe states targeting them in their work places and homes rather than in the health facilities. Results indicate that there is a significant level of satisfaction with attitudes, medical care and treatment. Although satisfaction level ranged from 28% to 72% on attitude, dissatisfaction ranged from 20% to 27%; in medical care received, responses show that majority (56%) are satisfied with the idea of health insurance, over 70% do not have a problem with the percentage cost they have to bear for accessing drugs, and 48% have access to medical specialist while 51% get care whenever it is needed. On the other hand, 61% think that doctors have too many patients beyond their capacity and 49% think the waiting time is too long, another 47% think it is difficult to get appointments with doctors to access treatment. On treatment they receive, 63% have no doubt on the ability of the doctor to treat them, and 50% are satisfied with prescriptions. Despite the divergent views expressed, 59% still want to remain on health insurance because of the benefits that have enjoyed, 30% want their pay so they can access health care at their own convenience. While 11% are indifferent about continuing on health insurance scheme. however, a significant percentage expressed dissatisfaction with all the points made. some of the areas of dissatisfaction are waiting time, non-availability of prescribed drugs, difficulty in booking appointments. A major recommendation is that the activities of HMOs, and Health Facilities needs to be properly monitored to ensure that the grey areas identified in the study as areas of dissatisfaction are addressed. Table of Content 

- 7 -  Title Page --------------------------------------------------------------------------------------i

Declaration -----------------------------------------------------------------------------------ii

Certification ---------------------------------------------------------------------------------iii

Approval -------------------------------------------------------------------------------------iv

Dedication-------------------------------------------------------------------------------------v

Acknowledgement---------------------------------------------------------------------------vi

Table of content-----------------------------------------------------------------------------vii

Abstract---------------------------------------------------------------------------------------xi

Abbreviations -------------------------------------------------------------------------------xii

CHAPTER ONE GENERAL INTRODUCTION

Background to the study --------------------------------------------------------------------1

Statement of Research Problem -----------------------------------------------------------5

Aim and Objectives of the study ----------------------------------------------------------6

Scope and Limitations of the study -------------------------------------------------------6

Significance of the Study-------------------------------------------------------------------7

Outline of the study -------------------------------------------------------------------------8

CHAPTER TWO LITERATURE REVIEW Introduction--------------------------------------------------------------------------9 

- 8 -  Theoretical Literature --------------------------------------------------------------9

Empirical Literature----------------------------------------------------------------26

CHAPTER THREE METHODOLOGY Introduction----------------------------------------------------------------------------34 Description of the Study Area-------------------------------------------------------34

Gombe State----------------------------------------------------------------------------34

Bauchi State----------------------------------------------------------------------------35

Population and Sampling-------------------------------------------------------------37

Inclusion and Exclusion criteria -----------------------------------------------------37

Instrument of Data Collection -------------------------------------------------------38

Method of Analysis--------------------------------------------------------------------38

CHAPTER FOUR PRESENTATION AND INTERPRETATION OF FINDINGS

Introduction----------------------------------------------------------------------------39

Presentations and Analysis of Data ------------------------------------------------39

Characteristics of Respondents------------------------------------------------------39

Interpretation of Patient’s Satisfaction with Attitudes of Health Workers ----39

Interpretation of Patient’s Satisfaction with Medical Care ----------------------42

Interpretation of Patient’s Satisfaction with Treatment ------------------------------44 

- 9 -   CHAPTER FIVE SUMMARY OF FINDINGS AND RECOMMENDATIONS

Introduction ---------------------------------------------------------------------------------47

Summary of Findings ----------------------------------------------------------------------47

Conclusion-----------------------------------------------------------------------------------50

Recommendations---------------------------------------------------------------------------52

Areas of Further Study ---------------------------------------------------------------------54

References -----------------------------------------------------------------------------------55 

Appendices 

Appendix 1:

Questionnaire --------------------------------------------------------------57