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The SHINE project also documented insured client out of pocket payments.
Making it even more difficult to conclude on supplier-induced demand as a major reason for the increased numbers of encounters per insured client is that our key informant interviews with frontline providers suggested that the G-DRG is leading to some shifting of cases in the form of referral.
Online coverage protects not only against assaults, he said, but for accidents or mistakes on the part of an insured client.
This was what an insured client said: We come to the hospital early in the morning and leave only in the evening for home.
An insured client said:..after my complaints, the doctor just wrote some drugs for me, he did not touch any part of my body (FGD, insured women-Builsa).
The exit interview data confirmed the failure to supply all medicines prescribed in the facility dispensary and also showed insured client discontent with this failure.
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Systematic random sampling was used to recruit insured clients at the health facilities for the survey.
However, most insured clients reported verbal abuse, long waiting times, not being physically examined and discrimination in favor of the uninsured and the rich.
For instance, it was reported by the Ghana News Agency that the Ho Municipal Hospital (in the Volta region, Ghana) had turned away insured clients unless they were ready to pay for the services [26].
The finding runs contrary to that of Bassili et al. Their study in Egypt, found insured clients to have had a significantly higher frequency of physical examination, laboratory investigations and diabetes education compared to their uninsured colleagues [29].
They reported that they had seen insured clients accessing health care services without any payment, even with free feeding for those hospitalized: The insurance helps in the sense that when you are admitted in the hospital it is free, you get everything for free; even the food and the bed free (FGD, uninsured men-Bolgatanga).
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com