Assessing the effects of capitation payment system of National Health Insurance Scheme (NHIS) and health care delivery in Ashanti Region

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JUNE 2015
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Health invariable is an essential component for nation building because health is wealth, however, the question is, what is the best means to pay for health care services? In order to ensure equitable access to health care, quality and affordable health care and efficient economic leverage aiming at sustaining our health service sector. Service providers and pressure groups claimed that, the system would motivate service providers to under-supply services, and reduce quality hence, adverse effects on patients’ health status, as has been supported by many studies. This research sought to assess the Effects of Capitation payment system on health care delivery in Ashanti Region. The study was conducted with a quantitative method. Statistical Package of Social Sciences (SPSS) and Microsoft Excel were used to analyze data obtained from field research. A total of 250 respondents were selected randomly from NHIS staff, patients and service providers. The finding shows that the main ingredients of capitation system are Package of primary care services, Base per capital rate of 0.99 GH₵ in January and increased to 1.30 per member per month in April 2012 (15.60 GH₵ PMPA), enrollment of clients to Preferred Primary Providers (PPP), general and financial management and reporting systems (Common management Arrangement) as well as quality monitoring system. The study went further to reveal that; majority representing 90% of the respondents said they were not satisfied with the healthcare delivery under capitation and that significant majority do not see any improvement and effectiveness in healthcare delivery in Ashanti region. Lastly, policy makers should streamline the Capitation payment system to avert patient dumping and under-provision, and better provider relations to improve quality of care.
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A thesis submitted to College of Humanities and Social Science, Kwame Nkrumah University of Science and Technology, in partial fulfillment of the requirements for the degree of Master of Business Administration.
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