Benefit-cost analysis of electronic claims processing under Ghana's National Health Insurance Scheme.

Nonvignon, J; Addo, R; Wang, H; Seddoh, A

Benefit-cost analysis of electronic claims processing under Ghana's National Health Insurance Scheme.

Nonvignon, J Addo, R

Wang, H Seddoh, A

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Publisher:: BMJ
Publication Type:: Journal Article
Citation:: BMJ Open, 2022, 12, (5), pp. e054757
Issue Date:: 2022-05-09

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Field	Value	Language
dc.contributor.author	Nonvignon, J
dc.contributor.author	Addo, R https://orcid.org/0000-0002-5970-1122
dc.contributor.author	Wang, H
dc.contributor.author	Seddoh, A
dc.date.accessioned	2022-07-12T00:23:36Z
dc.date.available	2022-07-12T00:23:36Z
dc.date.issued	2022-05-09
dc.identifier.citation	BMJ Open, 2022, 12, (5), pp. e054757
dc.identifier.issn	2044-6055
dc.identifier.issn	2044-6055
dc.identifier.uri	http://hdl.handle.net/10453/158780
dc.description.abstract	OBJECTIVE: The aim of this study was to evaluate the benefit-cost of E-claims. A benefit-cost analysis was used to evaluate the efficiency of E-claims from the perspective of the providers and the purchaser. DESIGN: A benefit-cost analysis approach was taken for this economic evaluation. Furthermore, we estimated the incremental benefit-cost ratio (IBCR) of the intervention under assessment. PARTICIPANTS: Purchasers and healthcare providers of the National Health Insurance Scheme (NHIS) of Ghana were the study population. RESULTS: The analysis was stratified according to providers and purchaser. Cost incurred in processing claims electronically and manually were estimated by assessing the resource use and their corresponding costs. Sensitivity analysis was conducted to assess the robustness of the results to variations in discount rate and proportions of claims processed under E-claims compared with paper claims. The combined sample of providers and purchaser made incremental gains from processing claims electronically. The IBCR was -19.75, 25.56 and 5.10 for all (sample) providers, purchaser and both providers and purchaser, respectively. When projected for the 330 facilities submitting claims to the NHIS claims processing centre (CPC) as at December 2014, the IBCR were -35.20, 25.56 and 90.06 for all providers, purchaser and both providers and purchaser. The results were sensitive to the discount rate used and proportions of E-claims compared with paper claims. CONCLUSION: Electronic processing of claims is more efficient compared with manual processing, hence provide an economic case for scaling it up to cover many more healthcare facilities and NHIS CPCs in the Ghana.
dc.format	Electronic
dc.language	eng
dc.publisher	BMJ
dc.relation.ispartof	BMJ Open
dc.relation.isbasedon	10.1136/bmjopen-2021-054757
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Electronics
dc.subject.mesh	Ghana
dc.subject.mesh	Health Facilities
dc.subject.mesh	Humans
dc.subject.mesh	Insurance, Health
dc.subject.mesh	National Health Programs
dc.subject.mesh	Humans
dc.subject.mesh	Electronics
dc.subject.mesh	Health Facilities
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Insurance, Health
dc.subject.mesh	National Health Programs
dc.subject.mesh	Ghana
dc.title	Benefit-cost analysis of electronic claims processing under Ghana's National Health Insurance Scheme.
dc.type	Journal Article
utslib.citation.volume	12
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	open_access	*
dc.date.updated	2022-07-12T00:23:34Z
pubs.issue	5
pubs.publication-status	Published online
pubs.volume	12
utslib.citation.issue	5

Abstract:

OBJECTIVE: The aim of this study was to evaluate the benefit-cost of E-claims. A benefit-cost analysis was used to evaluate the efficiency of E-claims from the perspective of the providers and the purchaser. DESIGN: A benefit-cost analysis approach was taken for this economic evaluation. Furthermore, we estimated the incremental benefit-cost ratio (IBCR) of the intervention under assessment. PARTICIPANTS: Purchasers and healthcare providers of the National Health Insurance Scheme (NHIS) of Ghana were the study population. RESULTS: The analysis was stratified according to providers and purchaser. Cost incurred in processing claims electronically and manually were estimated by assessing the resource use and their corresponding costs. Sensitivity analysis was conducted to assess the robustness of the results to variations in discount rate and proportions of claims processed under E-claims compared with paper claims. The combined sample of providers and purchaser made incremental gains from processing claims electronically. The IBCR was -19.75, 25.56 and 5.10 for all (sample) providers, purchaser and both providers and purchaser, respectively. When projected for the 330 facilities submitting claims to the NHIS claims processing centre (CPC) as at December 2014, the IBCR were -35.20, 25.56 and 90.06 for all providers, purchaser and both providers and purchaser. The results were sensitive to the discount rate used and proportions of E-claims compared with paper claims. CONCLUSION: Electronic processing of claims is more efficient compared with manual processing, hence provide an economic case for scaling it up to cover many more healthcare facilities and NHIS CPCs in the Ghana.

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http://hdl.handle.net/10453/158780