Financing health care service delivery in public universities in Ghana: case study of UG, KNUST, and UCC

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Financing healthcare service delivery in Ghanaian Universities has been a major concern in recent times. At the end of 2005 the University authorities at KNUST alone were in arrears of over 3 billion as outstanding refunds to be paid to staff and students on mainly drugs and other medical expenses. This money is not readily available. This study investigates and analyses the financing of health care service delivery in public Universities in Ghana using the University of Ghana, Kwame Nkrumah University of Science and Technology and the University of Cape Coast as case studies. Analysis of data collected from the Universities over the period (1999/2000-2003) led to a number of findings, recommendations and conclusions regarding the state and number of health facilities, costs and revenue, hospital attendance, types of services rendered as well as sustainability of healthcare delivery in the Universities. The study revealed that out-patient attendance increased consistently from 1 l5, 014 in 2000 to 144,042 in 2003, representing an increase of 25% over the period under study. Attendance by staff and their dependants accounted for the bulk of attendance, constituting on the average 45%, followed by Non-University persons which was 37% and then students (18%) over the 4-year period. Revenue from students and Non- university persons was ¢2.3 billion in 2000 as against total expenditure of ¢6.3 billion: ¢7.7 billion in 2003 compared with a total of ¢24 billion, leaving a gap of approximately ¢17billon for the Universities to deal with. It is recommended among others that the Universities should take advantage of the National Health Insurance Scheme by establishing their own health insurance schemes. Other measures recommended in remedying the problem of quality and unsustainable health financing and delivery include increasing the user charges to reflect cost of services rendered, increase in government subvention to the Universities among others.
A thesis submitted to the KNUST School of Business,in partial fulfilment of the requirements for the award of the degree of MBA, 2008