Evaluating the Impact of the National Health Insurance Scheme of Ghana on Surgical Care

NCT03604458 | Completed

• 1 other identifier: D43TW009343
• Study Type: observational
• Target: 203
• Locations: 1 country
• Sites: 1

Brief Summary

Ghana, a Low-Middle Income Country (LMIC) situated in the heart of West Africa started a national health insurance scheme in 2003.The scheme was designed to provide a comprehensive benefit package inclusive of surgical care and to protect against the need to pay out of pocket at the point of service. As of 2013, close to 40% of the population of Ghana was actively enrolled and ongoing plans to expand coverage by the government. This study tests the extent to which the national health insurance scheme of Ghana provides financial risk protection against catastrophic payments as a result of access to surgical care.

Conditions

General Surgery, Costs and Cost Analysis

Keywords

Universal Health Coverage, Surgery in resource limited settings

Outcome Measures

Primary Outcomes (1)

• Out of Pocket Expenditure for Surgical Care

  Out of pocket expenditure for surgical care is defined as all of the direct and indirect expenses incurred by an individual seeking surgical care at Korlebu Teaching Hospital during the study time period.

  During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)

Secondary Outcomes (1)

• Catastrophic Health Expenditure for Surgical Care

  During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study was conducted in the Korle Bu teaching hospital, which is situated in the southwestern part of Accra, the capital of Ghana. The hospital receives and treats patients referred from other centers all over Ghana and also patients referred from other neighboring West African countries. The population of Accra, which is largely cosmopolitan, has inhabitants who are natives and a large population who have migrated from other parts of the country on account of economic reason as well as educational pursuit. It is also home to a significant population who are nationals of neighboring West African countries and a small proportion of the population being from Europe, Asia and North America. Inhabitants are therefore mostly urban or suburban with a small proportion of rural and slum dwellers. The Department of Surgery at the Korle Bu hospital has four general surgical units and sees a variety of cases in general surgery encompasses colorectal, hepatobilary, and oncology

You may qualify if:

• All adult patients admitted to the general surgery ward between February 1st and October 1st 2017.

You may not qualify if:

• Patients treated on the subspecialty wards
• Individuals less than 18 years of age.
• If unable to provide informed consent

Sponsors & Collaborators

• University of California, San Francisco: lead
• Office of Research on Women's Health (ORWH): collaborator
• Fogarty International Center of the National Institute of Health: collaborator
• University of California Global Health Institute - UCGloCal Program: collaborator
• Brigham and Womens' Hospital, Center for Surgery and Public Health: collaborator
• UC Global Health Institute: collaborator

Study Sites (1)

Korle-Bu Teaching Hospital

Accra, Ghana

Location

Related Publications (1)

• Okoroh J, Sarpong DO, Essoun S, Riviello R, Harris H, Weissman JS. Does insurance protect individuals from catastrophic payments for surgical care? An analysis of Ghana's National Health Insurance Scheme at Korle-Bu teaching Hospital. BMC Health Serv Res. 2020 Jan 17;20(1):45. doi: 10.1186/s12913-020-4887-2.

  PMID: 31952520 DERIVED

Study Officials

• Juliet Okoroh, MD

  University of California, San Francisco

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 26, 2018
• First Posted: July 27, 2018
• Study Start: February 1, 2017
• Primary Completion: October 1, 2017
• Study Completion: November 12, 2017
• Last Updated: July 27, 2018

Record last verified: 2018-07

Data Sharing

• IPD Sharing: Will not share

Locations

GH (1)