TAILIEUCHUNG - Amporfu Health Economics Review 2011, 1:13

Amporfu Health Economics Review 2011, 1:13 RESEARCH Open Access Private hospital accreditation and inducement of care under the Ghanaian National Insurance Scheme Eugenia Amporfu Abstract The Ghanaian National Health Insurance Scheme pays providers according to the fee for service payment scheme, a method of payment that is likely to encourage inducement of care. The goal of this paper is to test for the presence of supplier induced demand among patients who received care in private, for profit, hospitals accredited to provide care to insured patients. An instrumental variable Poisson estimation was used to compare the demand curves for health care by insured outpatients in. | Amporfu Health Economics Review 2011 1 13 http content 1 1 13 o Health Economics Review a SpringerOpen Journal RESEARCH Open Access Private hospital accreditation and inducement of care under the Ghanaian National Insurance Scheme Eugenia Amporfu Abstract The Ghanaian National Health Insurance Scheme pays providers according to the fee for service payment scheme a method of payment that is likely to encourage inducement of care. The goal of this paper is to test for the presence of supplier induced demand among patients who received care in private for profit hospitals accredited to provide care to insured patients. An instrumental variable Poisson estimation was used to compare the demand curves for health care by insured outpatients in the public and private hospitals. The results showed that supplier induced demand existed in the private sector among patients within the ages 18 and 60 years. Impact on cost of care and patients welfare is discussed. 1. Introduction The introduction of the National Health Insurance Scheme NHIS in Ghana has allowed registered members to seek care at zero cost at the point of purchase and hence improved access to health care. The scheme covers about ninety five percent of common diseases in the population and patients are free to choose their own providers. The resulting increase in utilization of care caused over-crowding in public health facilities. This necessitated the accreditation of private health facilities to ease the over-crowding in the public health facilities. The government has also used demand side cost sharing measures to curb utilization rates due to moral hazard1. Patients of the NHIS were given attendant cards which were supposed to be filled by health facilities during each visit. The inconvenience of going to the NHIS office for new cards when those given were full was supposed to deter patients from making unnecessary visits. These measures are now being reexamined. Thus policy to

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