Perceived quality of primary healthcare post-National Health Insurance pilot implementation.
outpatient department
primary healthcare
self-referral rate
universal health coverage
Journal
Health SA = SA Gesondheid
ISSN: 2071-9736
Titre abrégé: Health SA
Pays: South Africa
ID NLM: 101213385
Informations de publication
Date de publication:
2021
2021
Historique:
received:
28
11
2020
accepted:
02
04
2021
entrez:
30
6
2021
pubmed:
1
7
2021
medline:
1
7
2021
Statut:
epublish
Résumé
Contracting private medical practitioners for the National Health Insurance pilot project in 2012 by the National Department of Health in South Africa was envisaged to reduce workload at referral district hospitals by reducing self-referral by clients as the perceived quality of care at the primary healthcare level improves. To describe the effect of contracting private medical practitioners at primary healthcare facilities on the self-referral rate of clients at district hospitals as a proxy for perceived quality of care in a National Health Insurance pilot district. The study was set in Tshwane National Health Insurance pilot district compared to Ekurhuleni district. We compared findings before and after implementing the National Health Insurance private medical practitioners contracting between a pilot and a non-pilot district. A quasi-experimental ecological study design was used to compare district hospital outpatient department indicators of clients follow-up, self-referral, self-referral rate and referred in the two districts from June 2012 to May 2014 using single and controlled interrupted time-series analyses. Controlled interrupted time series analysis found decreases in self-referral rate (-1.8 [-2.2, -1.1] [ We concluded that the implementation of contracting private medical practitioners in primary healthcare facilities might have resulted in an improved perceived quality of care at primary health care facilities. However, the higher number of outpatient department headcounts for follow-up and the increase in referred cases in the pilot district would need to be investigated.
Sections du résumé
BACKGROUND
BACKGROUND
Contracting private medical practitioners for the National Health Insurance pilot project in 2012 by the National Department of Health in South Africa was envisaged to reduce workload at referral district hospitals by reducing self-referral by clients as the perceived quality of care at the primary healthcare level improves.
AIM
OBJECTIVE
To describe the effect of contracting private medical practitioners at primary healthcare facilities on the self-referral rate of clients at district hospitals as a proxy for perceived quality of care in a National Health Insurance pilot district.
SETTING
METHODS
The study was set in Tshwane National Health Insurance pilot district compared to Ekurhuleni district.
METHODS
METHODS
We compared findings before and after implementing the National Health Insurance private medical practitioners contracting between a pilot and a non-pilot district. A quasi-experimental ecological study design was used to compare district hospital outpatient department indicators of clients follow-up, self-referral, self-referral rate and referred in the two districts from June 2012 to May 2014 using single and controlled interrupted time-series analyses.
RESULTS
RESULTS
Controlled interrupted time series analysis found decreases in self-referral rate (-1.8 [-2.2, -1.1] [
CONCLUSION
CONCLUSIONS
We concluded that the implementation of contracting private medical practitioners in primary healthcare facilities might have resulted in an improved perceived quality of care at primary health care facilities. However, the higher number of outpatient department headcounts for follow-up and the increase in referred cases in the pilot district would need to be investigated.
Identifiants
pubmed: 34192067
doi: 10.4102/hsag.v26i0.1580
pii: HSAG-26-1580
pmc: PMC8182563
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1580Informations de copyright
© 2021. The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
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