国家健康保险计划对尼日利亚西南部二级医疗机构糖尿病护理公平性和质量的影响

IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Journal of Medical and Biomedical Science Pub Date : 2018-06-01 DOI:10.4314/jmbs.v7i1.2
S. Saka, O. T. Fajemirokun
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引用次数: 1

摘要

人们一直担心国家健康保险计划(NHIS)对许多医疗机构糖尿病护理公平性和质量的影响。本研究旨在评估尼日利亚NHIS单因素和糖尿病护理质量的影响。对110名(有保险的n=42,没有保险的=68)同意2型糖尿病患者进行了前瞻性横断面研究。在研究之前,在尼日利亚西南部的两家NHIS认可的公立医院连续选择了服用口服降糖药的糖尿病门诊患者,至少有4次就诊。使用经验证的27项问卷评估患者对DC公平性和质量的感知。糖尿病的医疗护理和药物护理分别使用病历审查和配药药剂师活动的直接观察进行独立评估。卡方检验用于确定变量之间的关联。大多数(61.8%)研究参与者没有保险。女性(50.9%)多于男性(49.1%),40.0%具有中学后学历。参保者和未参保者的平均年龄分别为52.02±11.6岁和58.97±9.3岁。被保险人和未被保险人对药物供应的看法不同(p<0.001)。药剂师的咨询时间(p<001)在不同组之间不同。为糖尿病患者提供的医疗服务质量普遍较低。NHIS没有影响DC的质量,尽管它可能导致了设施中药物护理的不公平。医学与生物医学杂志(2018)7(1),11-21
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The effects of National Health Insurance Scheme on equity and quality of diabetes care in secondary healthcare facilities in SouthWest Nigeria
There have been concerns about the influence of the National Health Insurance Scheme (NHIS) on equity and quality of diabetes care in many healthcare settings. This study aimed to assess the effects of NHIS onequity and quality of diabetes care (DC) in Nigeria. A prospective cross-sectional study was carried out among 110 (insured n=42, uninsured=68) consenting type 2-diabetics. Diabetic outpatients on oral hypoglycemic drugs, with at least 4 clinic visits prior to the time of the study were consecutively selected at two NHIS accredited public hospitals in Southwest, Nigeria. Patients’ perceptions of equity and quality of DC were assessed using a validated 27 items questionnaire. The medical care and pharmaceutical care in diabetes were independently assessed using medical chart review and a direct observation of dispensing pharmacists’ activities respectively. Chi-squared test was used to determine associations between variables. Majority (61.8%) of the study participants were uninsured. Females (50.9%) were more than the males (49.1%), 40.0% had post-secondary qualifications. The mean ages for the insured and uninsured were 52.02±11.6 and 58.97± 9.3years respectively. The insured and the uninsured differ in their perceptions of drug availability (p<0.001). The pharmacists’ counselling time (p<0.001) differs between the groups. The quality of medical care provided to the diabetics was generally low. The NHIS did not influence the quality of DC, though it may have engendered inequity in pharmaceutical care in the facilities.Journal of Medical and Biomedical Sciences (2018) 7(1), 11 - 21
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