Examining the responsiveness of the National Health Insurance Fund to people living with hypertension and diabetes in Kenya: a qualitative study.
Examining the responsiveness of the National Health Insurance Fund to people living with hypertension and diabetes in Kenya: a qualitative study.
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检查国家健康保险基金对肯尼亚高血压和糖尿病患者的反应能力：一项定性研究。
DOI：
10.1136/bmjopen-2022-069330
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发表时间：
2023-07-04
期刊：
影响因子：
2.9
通讯作者：
中科院分区：
文献类型：
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作者：
评估国家健康保险基金（NHIF）Supa Cover福利计划对肯尼亚糖尿病和高血压患者需求的反应。我们进行了定性研究，并收集了数据，使用关键线人访谈（n=39）和焦点小组讨论（n=4）在两个有目的地选择在肯尼亚西部的县。研究参与者来自NHIF官员，县政府官员，卫生设施管理人员，医疗保健工作者以及参加NHIF的高血压和糖尿病患者。我们使用主题方法分析数据。研究参与者报告说，NHIF Supa Cover福利包扩大了高血压和糖尿病患者获得服务的机会。然而，NHIF成员和医护人员对NHIF服务权利的认识不足。NHIF福利计划没有充分涵盖高血压和糖尿病患者所需的服务范围，并且福利计划没有优先考虑预防和促进服务。有时候，病人受到医疗服务提供者的歧视，他们更喜欢现金支付的病人，一些国家卫生保险基金配备的卫生设施没有足够的结构投入，这对护理质量至关重要。研究参与者认为，一般计划的NHIF保费是负担不起的，NHIF成员面临额外的自付费用，因为没有提供或覆盖的服务的额外付款。虽然NHIF减少了高血压和糖尿病患者的财务障碍，但为了提高对患者需求的响应能力，NHIF应实施机制，提高成员和提供者对福利计划的认识。此外，应将预防和促进服务纳入国家保健基金的一揽子惠益，并应加强监测和追究合同提供者责任的机制。
To assess the responsiveness of the National Health Insurance Fund (NHIF) Supa Cover benefit package to the needs of individuals with diabetes and hypertension in Kenya. We carried out a qualitative study and collected data using key informant interviews (n=39) and focus group discussions (n=4) in two purposively selected counties in Western Kenya. Study participants were drawn from NHIF officials, county government officials, health facility managers, healthcare workers and individuals with hypertension and diabetes who were enrolled in NHIF. We analysed data using a thematic approach. Study participants reported that the NHIF Supa Cover benefit package expanded access to services for people living with hypertension and diabetes. However, the NHIF members and healthcare workers had inadequate awareness of the NHIF service entitlements. The NHIF benefit package inadequately covered the range of services needed by people living with hypertension and diabetes and the benefits package did not prioritise preventive and promotive services. Sometimes patients were discriminated against by healthcare providers who preferred cash-paying patients, and some NHIF-empanelled health facilities had inadequate structural inputs essential for quality of care. Study participants felt that the NHIF premium for the general scheme was unaffordable, and NHIF members faced additional out-of-pocket costs because of additional payments for services not available or covered. Whereas NHIF has reduced financial barriers for hypertension and diabetes patients, to enhance its responsiveness to patient needs, NHIF should implement mechanisms to increase benefit package awareness among members and providers. In addition, preventive and promotive services should be included in NHIF’s benefits package and mechanisms to monitor and hold contracted providers accountable should be strengthened.
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影响因子：
4.8
作者：
Chuma, Jane;Musimbi, Janet;Molyneux, Catherine
通讯作者：
Molyneux, Catherine
影响因子：
2.8
作者：
Agyepong IA;Abankwah DN;Abroso A;Chun C;Dodoo JN;Lee S;Mensah SA;Musah M;Twum A;Oh J;Park J;Yang D;Yoon K;Otoo N;Asenso-Boadi F
通讯作者：
Asenso-Boadi F
影响因子：
8.1
作者：
Barasa, Edwine;Nguhiu, Peter;McIntyre, Di
通讯作者：
McIntyre, Di
影响因子：
--
作者：
Barasa, Edwine W;Mwaura, Njeri;Andrawes, Ledia
通讯作者：
Andrawes, Ledia
影响因子：
34.3
作者：
Gouda, Hebe N.;Charlson, Fiona;Whiteford, Harvey
通讯作者：
Whiteford, Harvey