A comparative study of the effectiveness of different health insurance models: A study of hospitals in Kaduna State
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Background of the study
Health insurance is a critical component of healthcare financing that helps in improving access to healthcare services while reducing the financial burden on individuals and healthcare institutions (Adewale et al., 2024). In Nigeria, there are various health insurance models, including the National Health Insurance Scheme (NHIS), private health insurance, and employer-sponsored health plans, each with unique benefits and challenges (Alhassan & Ibrahim, 2023). Kaduna State, one of Nigeria’s diverse states, has a mixed healthcare system where both public and private hospitals utilize different insurance schemes to fund healthcare delivery.
The NHIS was established to provide affordable healthcare to Nigerians, but its implementation has faced challenges such as limited coverage, administrative inefficiencies, and inadequate funding (Abubakar & Salim, 2024). Private health insurance models, although growing in popularity, often struggle with high premiums and limited access to healthcare providers, especially in rural areas (Onyema et al., 2025). Understanding the comparative effectiveness of these models is critical to improving healthcare financing strategies, optimizing resource allocation, and ensuring that more Nigerians, especially in Kaduna State, have access to quality health services.
This study will focus on comparing the effectiveness of different health insurance models in Kaduna State by examining their impact on hospital revenue, healthcare access, and patient outcomes.
Statement of the problem
Despite the availability of multiple health insurance models in Nigeria, there is limited research comparing their effectiveness, particularly in Kaduna State, where the healthcare system faces significant challenges. Hospitals in the region, both public and private, struggle with providing quality care while managing the financial risks associated with these insurance models. This study aims to fill the gap by critically evaluating the effectiveness of various health insurance models in improving healthcare delivery, patient outcomes, and financial sustainability in hospitals in Kaduna State.
Objectives of the study
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To compare the effectiveness of different health insurance models used by hospitals in Kaduna State.
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To assess the impact of health insurance models on hospital revenue and financial sustainability.
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To explore the effect of health insurance models on access to and quality of healthcare services.
Research questions
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What are the key differences in the effectiveness of various health insurance models used by hospitals in Kaduna State?
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How do health insurance models affect the financial sustainability and revenue generation of hospitals in Kaduna State?
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What impact do health insurance models have on patient access to healthcare and the quality of services in hospitals in Kaduna State?
Research hypotheses
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There is a significant difference in the effectiveness of various health insurance models used by hospitals in Kaduna State.
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Health insurance models that cover a broader range of services significantly improve hospital revenue and financial sustainability.
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Health insurance models with higher patient coverage lead to improved access to healthcare and better patient outcomes in hospitals in Kaduna State.
Scope and limitations of the study
This study will focus on hospitals in Kaduna State that utilize different health insurance models, including the NHIS, private insurance, and employer-sponsored plans. The research will examine hospitals' revenue, healthcare delivery, and patient outcomes. Limitations include potential biases in self-reporting by hospital administrators and the lack of data on certain models that may not be widely implemented.
Definitions of terms
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Health Insurance Models: The various systems and schemes used to fund healthcare services, such as the NHIS, private health insurance, and employer-sponsored plans.
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Healthcare Access: The ability of individuals to obtain necessary healthcare services, based on availability, affordability, and proximity.
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Financial Sustainability: The ability of hospitals to maintain stable financial operations while providing quality healthcare services.
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