Health Insurance and Healthcare Quality: A Comparative Study between Insured and Uninsured Patients at a Teaching Hospital in Northeast Nigeria

Objective: Patients’ perception of the quality of care is essential in assessing health services and feedbacks from patient satisfaction surveys are useful in healthcare quality improvements.

Methods: A descriptive cross-sectional study was done to evaluate satisfaction with the quality of care among insured patients under the National Health Insurance Scheme (NHIS) and uninsured (Out-of-Pocket paying) patients at University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Borno State, Nigeria. Data were collected from 115 respondents from each group selected by systematic random sampling; using self-administered questionnaires. Analysis was done using IBM SPSS Statistics 20.0.

Results: The overall mean satisfaction for the uninsured group (73.1 ± 7.2) was higher than that of the insured group (71.2 ± 7.5). However, the difference was not statistically significant, p = 0.063. The observed satisfaction levels in the various areas of services accessed among the insured and uninsured group in this study are comparable, except for the significant differences observed in satisfaction with hospital facilities and the availability of prescribed drugs, suggesting the need for the improvement of hospital facilities and availability of drugs.

Conclusion: Despite complaints about the NHIS, it is still generally preferred to out-of-pocket payment by both groups. Therefore, more efforts should be made to expand the population coverage of health insurance to allow the inclusion of more people, while the need for continuous improvement of quality health services cannot also be overemphasized.