ArticleInternational health2021
The bypassing of healthcare facilities among National Health Insurance Scheme enrollees in Ibadan, Nigeria.
Article in International health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement.African journal of primary health care & family medicine · 2022Pooled it
- An assessment of primary health care costs and resource requirements in Kaduna and Kano, Nigeria.Frontiers in public health · 2023Article
- Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa.BMC health services research · 2022Article
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Authors and funding
3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundBypassing occurs when patients knowingly visit a health facility other than the one they live nearest to. In Ibadan, southwest Nigeria, the majority of enrollees in the National Health Insurance Scheme (NHIS) receive medical care in just 12% of the available NHIS-accredited facilities. Given that enrollees access healthcare services at highly subsidized rates under the scheme, this study aimed to determine the factors responsible for the observed distribution of enrollees across these health facilities.
methodsThe study was a descriptive cross-sectional survey conducted among NHIS enrollees receiving care at outpatient departments of five randomly selected accredited health facilities in Ibadan. A total of 311 NHIS enrollees were consecutively recruited and a semistructured, pretested, interviewer-administered questionnaire was used to elicit information from respondents. Descriptive and inferential statistics were used to present results at 5% level of significance. Distance traveled by patients from their residence to the facilities was measured using Google maps.
resultsThe mean age of respondents was 37.1±16.1 y. There were 167 (53.7%) males and 224 (72.3%) were married. The bypassing rate was 174 (55.3%). More than a third of enrollees, 127 (41.0%), reported that their hospital choice was made based on physician referral, 130 (41.8%) based on personal choice, 26 (8.4%) based upon the recommendation of the Health Management Organization (HMO), while 27 (8.7%) were influenced by friends/family/colleagues. Bypassing was positively associated with educational status (X2 = 13.147, p=0.004). Respondents who bypassed expended additional time and money traveling to the farther away hospitals, 35.1 (±34.66) min and 389.51 (±545.21) naira per visit, respectively.
conclusionThe level of bypassing among enrollees was fairly high. Enrollees should be properly guided regarding the need to access healthcare in facilities closer to them by their HMOs and physicians in the case of referrals. This will reduce bypassing and the cost of travel leading to better outcomes among enrollees.
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