ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2021
Injured and broke: The impacts of the Ghana National Health Insurance Scheme (NHIS) on service delivery and catastrophic health expenditure among seriously injured children.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 21 citations in OpenAlex.
- 'A race against time': a photovoice study on priorities for quality of injury care with patients, health workers and policymakers in four low- and middle-income countries.BMJ global health · 2026Article
- Article
- Estimating the level and determinants of catastrophic expenditure related to hypertension management in the Greater Accra Region of Ghana.Global health action · 2025Article
- Financing surgery in LMICs: building sustainable and equitable systems for universal surgical access - a narrative review.BMC surgery · 2025Review
- Effect of medical insurance policy on child health indicators: an empirical test of difference-in-differences model.Frontiers in public health · 2025Article
- Universal health coverage-Exploring the what, how, and why using realist review.PLOS global public health · 2025Article
- ASSESSING CATASTROPHIC HEALTHCARE EXPENDITURES IN THE EMERGENCY SURGICAL CARE OF CHILDREN WITH INTUSSUSCEPTION: INSIGHTS FROM A TERTIARY HOSPITAL IN NIGERIA.Annals of Ibadan postgraduate medicine · 2024Article
- Impact of Government-Funded Health Insurance on Out-of-Pocket Expenditure and Quality of Hospital-Based Care in Indian States of Madhya Pradesh and Maharashtra.Applied health economics and health policy · 2024Article
- Experiences of injured patients referred to higher levels of care after initial assessment and management at non-tertiary hospitals in Ghana.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Do national health insurance schemes guarantee financial risk protection in the drive towards Universal Health Coverage in West Africa? A systematic review of observational studies.PLOS global public health · 2023Article
- Factors Contributing to and Reducing Delays in the Provision of Adequate Care in Ghana: A Qualitative Study of Trauma Care Providers.World journal of surgery · 2022Article
- Supporting a review of the benefits package of the National Health Insurance Scheme in Ghana.Cost effectiveness and resource allocation : C/E · 2022Article
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGhana implemented a National Health Insurance Scheme (NHIS) in 2003 as a step toward universal health coverage. We aimed to determine the effect of the NHIS on timeliness of care, mortality, and catastrophic health expenditure (CHE) among children with serious injuries at a trauma center in Ghana.
methodsWe performed a retrospective cohort study of injured children aged <18 years who required surgery (i.e., proxy for serious injury) at Komfo Anokye Teaching Hospital from 2015 to 2016. Household income data was obtained from the Ghana Statistical Service. CHE was defined as out-of-pocket payments to annual household income ≥10%. Differences in insured and uninsured children were described. Multivariable regression was used to assess the effect of NHIS on time to surgery, length of stay, in-hospital mortality, out-of-pocket expenditure and CHE.
resultsOf the 263 children who met inclusion criteria, 70% were insured. Mechanism of injury, triage scores and Kampala Trauma Score II were similar in both groups (all
conclusionsNHIS did not improve timeliness of care, length of stay or mortality. Although NHIS did provide some financial risk protection for families, it did not eliminate out-of-pocket payments. The families of most seriously injured children experienced CHE, regardless of insurance status. NHIS and similar financial risk pooling schemes could be strengthened to better provide financial risk protection and promote quality of care for injured children.
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