- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT03604458
Evaluating the Impact of the National Health Insurance Scheme of Ghana on Surgical Care
Evaluating the Impact of Health Insurance on Financial Risk Protection for Surgical Care: an Analysis of Ghana' Insurance Scheme at Korlebu Teaching Hospital
Panoramica dello studio
Stato
Condizioni
Descrizione dettagliata
It is estimated that 11%-33% of the global burden of disease is attribute to surgical conditions. Yet, globally 3.7 billion people face financial catastrophe if surgical care is needed. Ghana, a country of 27 million people has a 14-year experience with a national health insurance scheme (NHIS) that provides coverage for 95% of the health conditions afflicting Ghanaians and includes access to surgical care. Despite much progress in providing Universal Health Coverage through NHIS, prior work shows that up to 18% of insured households make catastrophic health payments for routine care which is largely unaffordable for the poor. Particularly in Ghana where 1 out of 4 individuals live on less than 1.25 dollars per day. More importantly in 2015, the Lancet Commission on Global Surgery called for national surgical plans that provide 100% coverage against catastrophic health expenditures as a result of seeking surgical care.
The premise of Dr. Okoroh's GloCal project is to describe the surgical conditions that are included in the health insurance scheme and to evaluate whether insurance protect surgical patients against catastrophic health payments through a single institutional review at Korle-bu Teaching Hospital. With this work she hopes to develop a set of recommendations to the ministry of health and the national health insurance authority on how to improve health-care financing for surgical care in Ghana.
Early results of our study show that NHIS provides coverage for most common surgical conditions including symptomatic hernia, breast cancer, and appendicitis. 70% of the total cost of surgical care was covered by NHIS, yet 56% of insured individuals made catastrophic payments for surgical care. Surgery is unaffordable as on average insured individuals spent close to 40% of their annual income on surgical care. Particularly the coverage of medicines, supplies, imaging, and other ancillary services are sparse which are necessary to the provision of surgical care. Our recommendations include; NHIS increasing the proportion of the total cost of surgical care covered for the poor and addressing the gaps in coverage of ancillary services. Further work includes understanding how households economically cope with making payments and the contribution of borrowing and other financing mechanisms in reducing the burden of cost. Our new study characterizes the cost of trauma care which is a major source of disability and injury for young adults in Ghana. Efforts are being made to engage policymakers on healthcare reform in Ghana.
Tipo di studio
Iscrizione (Effettivo)
Contatti e Sedi
Luoghi di studio
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Accra, Ghana
- Korle-Bu Teaching Hospital
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- All adult patients admitted to the general surgery ward between February 1st and October 1st 2017.
Exclusion Criteria:
- Patients treated on the subspecialty wards
- Individuals less than 18 years of age.
- If unable to provide informed consent
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Out of Pocket Expenditure for Surgical Care
Lasso di tempo: During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)
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Out of pocket expenditure for surgical care is defined as all of the direct and indirect expenses incurred by an individual seeking surgical care at Korlebu Teaching Hospital during the study time period.
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During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Catastrophic Health Expenditure for Surgical Care
Lasso di tempo: During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)
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Catastrophic Health Expenditure for Surgical Care is defined as out of pocket expenditures which exceed 20% of the individual's income, 10% of the household expenditures, or 40% of net food expenditures
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During the hospitalization or episode of surgical care (respondents are interviewed prior to discharge from the hospital, on average less than two weeks)
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Collaboratori e investigatori
Collaboratori
Investigatori
- Investigatore principale: Juliet Okoroh, MD, University of California, San Francisco
Pubblicazioni e link utili
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Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Altri numeri di identificazione dello studio
- D43TW009343 (Sovvenzione/contratto NIH degli Stati Uniti)
Piano per i dati dei singoli partecipanti (IPD)
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Informazioni su farmaci e dispositivi, documenti di studio
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Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .