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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/9919

Title: Evaluating the effects of capitation as an alternate payment method for the National Health Insurance Scheme as against diagnostic related groupings: case study of Ahafo - Ano South District of Ghana
Authors: Domoh, Prosper Banagbal
Issue Date: 18-Jan-2017
Abstract: Health insurance is a method of pre-financing the services of health used by subscribers belonging to a health insurance scheme. The method implored for the transfer of funds from the health insurance organization which is the purchaser of the health care service to the providers of that service is known as Provider Payment Method. In this study, we seek to evaluate the effects of Capitation as an additional payment method of the National Health Insurance Scheme in the Ahafo - Ano South District of Ghana as compared to Diagnostic Related Groupings. Secondary data of purposely chosen health facilities were collected from the scheme and compared with data obtained from these health care providers to ensure consistency. The results from the analysis conducted revealed that there was a statistically significant increase (p < 0005) in the overall cost of claims paid to providers from the period before the introduction of Capitation to period after it was introduced. On the other hand, the paired samples t-test conducted to evaluate the impact of Capitation on health facility attendance within the district revealed that there was no statistically significant difference in the rate of attendance, t (30) = -0.11, p= 0.991], the Eta squared statistic (0.0004) indicated that the implementation of the Capitation as an alternate payment method has had very small or no effect (insignificant) on the rate of attendance at health facilities within the study area. Finally, the paired samples t-test conducted to evaluate the impact of the Capitation payment method on membership revealed a statistically significant increase in the total number of members registered with the scheme from the period before Capitation (M (Average cost of claims) = 28, 900, SD= 3, 898.21) to period after Capitation [M= 37, 100, SD= 2, 675.19), t (24) = -6.514, p= 0.000]. The Eta squared statistic (0.65) indicated a large effect with a substantial difference in the rate at which clients registered and joined the scheme in the district before and after the introduction of Capitation. The study conducted suggests that the introduction of Capitation for the two-year period (2012 and 2013) showed a significant increase in the cost of claims but maintained the rate of attendance to health facilities as there was no statistically significant increase. However, the membership increased substantially in 2012 to 2013, the period of implementation as compared to the period before the introduction of Capitation (2010 to 2011) when it was only the Ghana Diagnostic Related Groupings.  
Description: A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Master of Science in Health Informatics, 2016
URI: http://hdl.handle.net/123456789/9919
Appears in Collections:College of Science

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