退出医疗保险计划的原因:尼泊尔卢宾尼省的一个经验
Devaraj Acharya1, Krishna Bahadur Thapa2, Bhagawoti Sharma3
1Bhairahawa Multiple Campus [TU], Siddharthanagar, Rupandehi, Lumbini Province, Nepal.
Dialogues in health
|March 22, 2024
概括
尼泊尔医疗保险计划 (HIP) 的低招生率和高退学率源于服务质量差,程序性问题和缺乏知识等因素. 解决这些问题对于程序改进至关重要.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 质量健康研究 质量健康研究
- 卫生政策分析 卫生政策分析
背景情况:
- 尼泊尔的健康保险计划 (HIP) 面临着严重的挑战,招生率低,学率高.
- 在HIP中,这些入学和学问题的根本原因在很大程度上仍未被探索.
研究的目的:
- 调查和确定尼泊尔医疗保险计划中高退学率背后的主要原因.
- 从个人和机构的角度了解促成因素.
主要方法:
- 使用了一种探索性定性研究设计.
- 通过16次深入采访,4次关键信息人采访和4次重点小组讨论收集数据.
- 应用了主题分析来分析来自Palpa和Bardia地区的定性数据.
主要成果:
- 确定了两个主要主题和九个与学相关的子主题.
- 关键的退学因素包括感知缺乏必要性,更新疏忽,无法支付缴费,机构/人际合作问题,覆盖范围有限,服务访问刚性,医疗保健提供者的行为,服务质量差以及信息不足.
- 个人/个人和机构/政策相关的因素都会导致计划的消耗.
结论:
- 漫长的程序,不满意的服务质量,对保险流程的知识不足以及健康专业人员的负面互动是学的主要驱动因素.
- 加强信息,教育和沟通 (IEC) 策略对于改善对HIP的理解和熟悉至关重要.
- 政策制定者应该考虑这些已识别的因素,制定旨在减少低入学率和高退学率的干预措施.
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