PDF(Pubmed)
Abstract：
UNASSIGNED: The activities of Health maintenance organizations (HMO) are central to the achievement of universal health coverage. This study sought to examine the number of HMOs actively operating in the FCT and to determine whether the HMOs are promoting or inhibiting universal coverage and proffer recommendations for the overall progress of the scheme.
UNASSIGNED: A descriptive prospective cross-sectional study design was used and mixed (qualitative and quantitative) methods A pre-tested interviewer-administered questionnaire make was used to collect quantitative data while qualitative data were collected through a review of literature and in-depth interviews to examine the roles of HMOs from stakeholders\' points of view. A total of 250 participants comprised predominantly 230 enrollees into three major programs of the NHIS that is the formal sector social insurance program (FS-SHIP), tertiary institution social health insurance program (TI-SHIP), and community-based social health insurance program (CB-SHIP). The remaining 20 (twenty) enrollees comprised NHIA desk officers, HMO managers, community-based representatives, and healthcare providers.
UNASSIGNED: The majority of the respondents (64.8%) reported a high level of awareness of the knowledge of NHIS, while fewer than 19% indicated a lack of awareness as compared to 17% who did not respond to the question. Similarly, most of the respondents (62.2%) reported having satisfactory knowledge of the structure-function modalities of HMOs, while 20.4% were not aware of the mode of operation of HMOs.Contrasting contributions of HMOs to NHIS implementation, approximately half of the respondents (50%) reported dissatisfaction. Likewise, about 50% of the study subjects were of the view that HMOs are not putting the desired commitment towards achieving this goal of universal health coverage. The report from the in-depth interview reiterated that the enrollees were not well satisfied due to the perceived poor and inadequate operational mechanisms of both the HMOs and NHIS.
UNASSIGNED: The study revealed a high level of awareness of the knowledge of NHIS and good working knowledge of the structure and function of the HMOs. However, this study demonstrated a low understanding of the working interactions between the NHIS and HMO, among the respondents. Understanding HMOs and how they work is critical for choosing a health plan during open enrollment, hence, there is a need for more client enlightenment.
UNASSIGNED: A descriptive prospective cross-sectional study design was used and mixed (qualitative and quantitative) methods A pre-tested interviewer-administered questionnaire make was used to collect quantitative data while qualitative data were collected through a review of literature and in-depth interviews to examine the roles of HMOs from stakeholders\' points of view. A total of 250 participants comprised predominantly 230 enrollees into three major programs of the NHIS that is the formal sector social insurance program (FS-SHIP), tertiary institution social health insurance program (TI-SHIP), and community-based social health insurance program (CB-SHIP). The remaining 20 (twenty) enrollees comprised NHIA desk officers, HMO managers, community-based representatives, and healthcare providers.
UNASSIGNED: The majority of the respondents (64.8%) reported a high level of awareness of the knowledge of NHIS, while fewer than 19% indicated a lack of awareness as compared to 17% who did not respond to the question. Similarly, most of the respondents (62.2%) reported having satisfactory knowledge of the structure-function modalities of HMOs, while 20.4% were not aware of the mode of operation of HMOs.Contrasting contributions of HMOs to NHIS implementation, approximately half of the respondents (50%) reported dissatisfaction. Likewise, about 50% of the study subjects were of the view that HMOs are not putting the desired commitment towards achieving this goal of universal health coverage. The report from the in-depth interview reiterated that the enrollees were not well satisfied due to the perceived poor and inadequate operational mechanisms of both the HMOs and NHIS.
UNASSIGNED: The study revealed a high level of awareness of the knowledge of NHIS and good working knowledge of the structure and function of the HMOs. However, this study demonstrated a low understanding of the working interactions between the NHIS and HMO, among the respondents. Understanding HMOs and how they work is critical for choosing a health plan during open enrollment, hence, there is a need for more client enlightenment.
摘要：
健康维护组织（HMO）的活动对于实现全民健康覆盖至关重要。这项研究旨在研究在FCT中积极运作的HMO数量，并确定HMO是否在促进或抑制全民覆盖，并为该计划的总体进展提供建议。
■使用描述性前瞻性横断面研究设计和混合（定性和定量）方法预先测试的面试官管理的问卷制作用于收集定量数据，而定性数据则通过文献回顾和深入访谈收集，以从利益相关者的角度检查HMO的作用。共有250名参与者，主要是230名参与者参加了NHIS的三个主要计划，即正式部门社会保险计划（FS-SHIP），高等教育机构社会健康保险计划(TI-SHIP)，以及基于社区的社会健康保险计划（CB-SHIP）。其余20（20）名注册人员包括NHIA主管官员，HMO经理，社区代表,和医疗保健提供者。
■大多数受访者（64.8％）表示对NHIS知识的认识很高，而不到19%的人表示缺乏意识，相比之下，17%的人没有回答这个问题。同样，大多数受访者(62.2%)报告对HMO的结构-功能模式有令人满意的了解，而20.4%的人不知道HMO的操作方式。对比HMO对NHIS实施的贡献，大约一半的受访者(50%)表示不满意.同样，约50%的研究对象认为,HMO没有为实现全民健康覆盖这一目标投入预期的承诺.深入访谈的报告重申，由于HMO和NHIS的运作机制不佳和不足，注册人员并不满意。
■该研究揭示了对NHIS知识的高度认识以及对HMO结构和功能的良好工作知识。然而,这项研究表明，对NHIS和HMO之间的工作相互作用的理解很低，在受访者中。了解HMO及其工作方式对于在公开注册期间选择健康计划至关重要，因此，需要更多的客户启蒙。
■使用描述性前瞻性横断面研究设计和混合（定性和定量）方法预先测试的面试官管理的问卷制作用于收集定量数据，而定性数据则通过文献回顾和深入访谈收集，以从利益相关者的角度检查HMO的作用。共有250名参与者，主要是230名参与者参加了NHIS的三个主要计划，即正式部门社会保险计划（FS-SHIP），高等教育机构社会健康保险计划(TI-SHIP)，以及基于社区的社会健康保险计划（CB-SHIP）。其余20（20）名注册人员包括NHIA主管官员，HMO经理，社区代表,和医疗保健提供者。
■大多数受访者（64.8％）表示对NHIS知识的认识很高，而不到19%的人表示缺乏意识，相比之下，17%的人没有回答这个问题。同样，大多数受访者(62.2%)报告对HMO的结构-功能模式有令人满意的了解，而20.4%的人不知道HMO的操作方式。对比HMO对NHIS实施的贡献，大约一半的受访者(50%)表示不满意.同样，约50%的研究对象认为,HMO没有为实现全民健康覆盖这一目标投入预期的承诺.深入访谈的报告重申，由于HMO和NHIS的运作机制不佳和不足，注册人员并不满意。
■该研究揭示了对NHIS知识的高度认识以及对HMO结构和功能的良好工作知识。然而,这项研究表明，对NHIS和HMO之间的工作相互作用的理解很低，在受访者中。了解HMO及其工作方式对于在公开注册期间选择健康计划至关重要，因此，需要更多的客户启蒙。
