Out-of-Pocket Healthcare Payment for Primary Healthcare in the Era of National Health Insurance: A Five-Year Study of Seven Districts in Northern Ghana

Edmund Kanmiki
Ayaga A. Bawah, University of Ghana
Patrick Opoku Asuming, University of Ghana
John Awoonor-Williams, Ghana Health Service
James F. Phillips, Columbia University
Caesar Agula, University of Ghana, Regional Institute for Population Studies
James Akazili, Navrongo Health Research Centre

This paper examines the trend in out-of-pocket payment for primary health care and assessed the determinants of out-of-pocket payment using a five-year panel data of revenues accruing to public primary health facilities. Descriptive statistics and mean comparison test are employed to examine the trend in out-of-pocket payment vis-à-vis insurance claims for health services, medication, and obstetric care. Furthermore, a linear regression model is fitted to assess the relationship between four explanatory variables and out-of-pocket health payment. Out-of-pocket payment for health services and medications were found to reduce by 63% and 62% respectively between 2010 and 2014. Total insurance claims however increased by 16% within the same period. Factors significantly associated with out-of-pocket payment are population, number of community health facilities and year of observation. The general reduction in revenues accruing from out-of-pocket healthcare payment over the five-year period implies Ghana’s national health insurance program is contributing to reducing out-of-pocket payment.

See extended abstract

 Presented in Session 8. Economy, Labor Force, Education, & Inequality