Effects of Co-payment on Health Care Service at Akuse Government Hospital, Lower Many A-krobo District, Eastern Region

ABSTRACT 

Background: Copayment is a sum of money that a client with health insurance is mandated to pay at each visit to a health facility or when purchasing medicine although under Act 852 Of 2012 it is unacceptable .The study aimed to assess the effects of co-payment on health care at Akuse Government Hospital. The study sought to determine reasons for co-payment, effects of co-payment on health care providers and effects of co-payment on clients. 

Method: The study adopted a mixed method approach using both quantitative and qualitative survey. The study used descriptive and inferential analysis to generalize the findings; the combination provided a better understanding of the research problem. Data was gathered by administering questionnaire which comprised both open and close ended questions. Sample of 400 clients were used for the cross-sectional study and 10 Heads of Departments were purposively selected and interviewed for the qualitative study. The quantitative data was analyzed using Stata Version 14.0 after entering all data into Microsoft Excel and Nvivo were used to analyze themes of in-depth interview for qualitative data. 

Results: Out of the 400 clients studied, 93% admitted that co-payment made access to health care more expensive, impoverished the poor and gave financial and psychological burden on those with chronic diseases and the elderly who often access health care. However, health care providers confirmed that introduction of co-payment had helped the hospital to accrue more funds to meet operational cost and render quality service to clients. 

Conclusion: Co-payment is illegal in Ghana but so far as the NHIA delays reimbursement of funds, the health facilities will also be compelled to practice it to meet operational cost. The ripple effect is then shifted on clients who have to pay more for services and since most of them cannot afford health care may use unorthodox means of health care that will be detrimental to their health and defeat the purpose for which NHIS was established.