Health Services Utilization Patterns among Enrollees of the National Health Insurance Scheme at a Tertiary Health Facility in Federal Capital Territory (FCT) – Abuja, Nigeria

Abstract

Background: The National Health Insurance Scheme (NHIS) was established to provide accessible, affordable and quality healthcare to the Nigerian population and the enrollees utilize healthcare services at the various NHIS accredited healthcare facilities. Objective: This study assessed the types and patterns of health services utilization and perception of patients towards the NHIS in a tertiary hospital in FCT-Abuja, Nigeria. Methodology: A cross-sectional study of 305 NHIS enrollees selected by systematic random sampling was done at the General Outpatient Clinic, University of Abuja Teaching Hospital, Gwagwalada, FCT-Abuja, Nigeria. Participants’ sociodemographic variables, reasons for hospital choice, utilization and perceptions about NHIS services were assessed. Data were analyzed with IBM SPSS Statistics 20.0. Results: Majority 204 (66.9%) of the respondents were principal enrollees, 93 (30.5) were spouses and 8(2.6%) were extra-dependants, 157 (51.5%) had been enrolled for more than 5 years, and availability of specialist doctors was the main reason most patients 198 (64.9%) chose to access care at the hospital. An average of 4 services were utilized by the respondents, with outpatient care and laboratory services being the most utilized services. Majority 208 (68.2%) stated that health insurance positively influences prompt health seeking behaviour, while 182 (59.7%) felt that NHIS gives access to quality health services. Conclusion: The study revealed the types of healthcare services utilized and the perception of NHIS beneficiaries towards the scheme. While continuous advocacy and sustained efforts towards improved services and coverage expansion should be intensified, further studies considering patients and healthcare providers’ perspectives and other associated factors are recommended.