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Educationist condemns "physician inducement" in private hospitals

31 August 2009 | Health

Accra , Aug 31, GNA - An educationist has called for a better and fixed payment system to motivate doctors in private hospitals operating the National Health Insurance Scheme (NHIS) to discourage "physician inducement".

Dr Eugenia Amporfu, Senior Lecturer at the Kwame Nkrumah University of Science and Technology (KNUST), told the Ghana News Agency on Monday that "physician inducement" occurred when a medical doctor influenced a patient to consume more healthcare than required.

Dr Amporfu, who is also a member of the Governing Council of the Association of Certified Chartered Economists, said doctors in private hospitals that operated under the NHIS system, were more likely to influence patients to consume more health care services than they needed, since they received income based on the number of patients they could care for.

"With many private hospitals getting accredited for the NHIS, the number of patients that each hospital would receive gets reduced. As a result, many physicians influence consumption of healthcare service in a way so as to prevent a decrease in their income since they are paid on fees-for-service basis."

She said the situation was worrying since the healthcare provider had a lot of influence on how much the patient could consume unlike other commodities where the situation called for consumers deciding on their own the quantity they would need.

Dr Amporfu said the probability of occurrence of physician inducement in public hospitals was remote since there was no relationship between the outputs of doctors in such hospitals with the income they received.

She said a research she conducted in four private and public hospitals in Kumasi , on the topic "Private Hospital Accreditation and Inducement of Care under the NHIS," indicated that demand care for some patients within the active range of 18 to 60 years in private hospitals was more than that of the public hospitals.

"I focused on patients suffering from mild malaria in the research and it was revealed that people in private hospitals consumed more healthcare services for the same kind of treatment than their public hospital counterparts did. This may be costly to the NHIS," she said.

Dr Amporfu said her research did not ascertain how much cost this imposed on the NHIS but called for further research in the future to clarify matters.

"It is not clear as to whether the phenomenon imposes any cost to the NHIS because respondents outside the active range received less healthcare in private than in public hospitals and that could neutralize such increased demand," she said.

Dr Amporfu called on donor partners interested in the NHIS to give financial support to the scheme in order to sustain it.


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