Factors Influencing Utilization of Health Insurance in a Tertiary Hospital in Southeast Nigeria

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Published: 2024-04-03

Page: 11-17

Arodiwe Ijeoma O.

Department of Paediatrics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Esom EA

Anatomy Department, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Shu EN

Department of Paediatrics, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

Okoronkwo IL

Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria.

*Author to whom correspondence should be addressed.


Aims: Sixteen years after the formal sector social health insurance program (FSSHIP) was introduced for the federal civil service in Nigeria. However, there is the paucity of information on how this has affected the level of utilization and satisfaction of the enrollees in Southeast Nigeria.

To evaluate the health services utilization among enrollees and their satisfaction with the scheme. 

Methods: Data were analyzed using SPSS version 25. Descriptive statistics-logit models were used to investigate the factors influencing the satisfaction and utilization of health insurance in a tertiary hospital.

Results: The mean age of respondents was 34.0±13.4 years. The program improved the utilization of health insurance services for 60.0% of respondents. However, they have low satisfaction at 36.6% with health service delivery. Factors responsible were long waiting time (80.6%), and payment of extra cost (61.0%), with 36.0% having catastrophic health expenditure. The chi-square value of 29.3, p = 0.02, df = 4 showed a significant association between these variables and poor utilization. Logistic regression showed, females and the married, were more likely to use health services (AOR 2.21, p = 0.02, 95% CI 1.03-2.17 and AOR 4.18, p=0.02, 95% CI; 0.11- 4.60 respectively).   

Conclusion: FSSHIP had some positive effects in increasing the utilization of health care. However, the low level of satisfaction in the scheme is a cause for attention for both the HMO’s and the NHIS regulators. The variables causing this should be mitigated. The operators can leverage these factors that increase utilization through public enlightenment.

Keywords: Health insurance, utilization, satisfaction, out-of pocket payments, coverage of care, Nigeria

How to Cite

Arodiwe Ijeoma O., Esom EA, Shu EN, & Okoronkwo IL. (2024). Factors Influencing Utilization of Health Insurance in a Tertiary Hospital in Southeast Nigeria. Asian Journal of Research in Medicine and Medical Science, 6(1), 11–17. Retrieved from https://globalpresshub.com/index.php/AJRMMS/article/view/1990


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