Service Utilization and Client Satisfaction with Quality of Healthcare among Enrollees of Health Insurance Attending a Tertiary Hospital in South-Western Nigeria

Abstract

Background: The establishment of National Health Insurance Scheme (NHIS) in Nigeria was the national strategy of combating the appalling health indices and rising cost of healthcare in the country. However, this vision remains a shadow of itself after over a decade of implementation of the scheme. This study sought to assess the level of service utilization and client satisfaction with quality of healthcare among enrollees attending NHIS Clinic of Lagos University Teaching Hospital (LUTH). Methods: This is a cross-sectional study among enrollees of NHIS Clinic of LUTH. An interviewer-administered questionnaire was used to collect data from respondents over a period of eight weeks. A close-ended questionnaire was used to assess service utilization while SERVQUAL questionnaire was used to assess client satisfaction with quality of healthcare services. The data was collected from 377 participants using systematic sampling technique and analyzed with Statistical Package for Social Sciences (SPSS). In determining an association, a P-value of ≤0.05 was considered statistically significant in the study. Results: Among the respondents, 88.1% asserted that NHIS enhanced their utilization of health facility and 93.9% were able to access clinic anytime they wanted. The assessment of client satisfaction showed that 73.7% of the respondents were satisfied with the perceived quality of care while 13.3% of the respondents were dissatisfied. Age, marital status, employment status and average monthly income of respondents were statistically significant factors affecting service utilization. Conclusion: The study shows that NHIS enrolment enhanced service utilization by 88.1% without compromising the quality of healthcare services.