Assessment of the financial management and financial sustainability of the capitation system of The National Health Insurance Scheme in the Ashanti Region, Ghana

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AUGUST, 2015
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The importance of Capitation in reducing financial waste and abuse of resources as well as improving the efficiency of health delivery cannot be overemphasized. The purpose of this research was to examine the financial sustainability of the NHIS capitation in the Ashanti region. Using questionnaire for a sample population of 152 people, various data relating to financial management under capitation the capitation, clients understanding of the capitation, satisfaction received during health care services, type of services received etc. were gathered and used for the analysis. The study showed that Capitation system is financially sustainable due to its inherent control mechanism that eliminates fraud in provider claims under the NHIS. However lack of proper and adequate education on the Capitation has led to many misconception and confusion about scheme. This has consequently affected clients‟ level of access and reduction in healthcare utilization under the scheme. The study further showed that about 75% of patients who visited the hospital were satisfied at the healthcare services they received. This phenomenon is consonance with earlier argument that Capitation is likely to improve health care delivery because hospitals in attempt to win more clients to their hospitals under the capitation will offer more efficient healthcare services. In this way, capitation, apart from reducing financial malpractice in the NHIS also led to improved services. However challenges still remain with achieving universal health coverage since most prospective clients do not fully understand how the capitation system works.
Thesis submitted to the department of accounting and finance, Kwame Nkrumah University of Science and technology in partial fulfillment of the requirement for the degree of Master of Business Administration (finance option),