User satisfaction with national health insurance program and its associated factors in Ilam district.

Thesis Report.

ABSTRACT:

Introduction: To ensure universal health coverage by increasing access to and utilization of quality health service, health insurance program was launched in 2016. It is evident that expansion of insurance coverage alone without improvement in service quality makes it impossible to achieve UHC. Therefore, it is necessary for service provider to systematically measure users’ satisfaction with their service. For which this study aimed to assess the user satisfaction with National Health Insurance Program and its associated factors in Ilam district.

Methods: A cross-sectional mixed method study was conducted among the three hundred forty-seven households of Ilam district with at least one year of enrollment and had utilized the service under NHIP. A multi-stage random sampling method was used. Face to face interview was done in both quantitative and qualitative part using semi-structure questionnaire and interview guideline respectively. Descriptive, bivariate and multivariate analysis was done. Key informant interviews were transcribed, translated and thematic analysis was done.

Results: Overall, 53.6% of the respondents were satisfied with the NHIP. Only 31.1% of the user had comprehensive knowledge about insurance program. Gender, distance to first point of contact, waiting time, availability of diagnostic service, availability of prescribed medicine, perceived quality of service and behavior of service provider were significantly associated with users satisfaction.

Conclusion: The level of satisfaction among the user with NHIP was moderate. The Health insurance board should closely monitor the quality of service delivery from different health facility to robust the health insurance system.

Keywords: Satisfaction, Quality of care, National Health Insurance