Health insurance and hospitalisation duration: empirical evidence from Ghana’s national health insurance scheme

Abstract

AbstractThe study aims to explore the causal effect of Ghana’s National Health Insurance Scheme (NHIS) on hospitalisation duration. The analysis was based on the Ghana Socioeconomic Panel Survey datasets, comprising the second wave (2014/2015) and the third wave (2018/2019). The study employed the endogenous switching regression model for count data (ESRC) to control selection bias and unobserved heterogeneity. The ESRC estimates reveal that NHIS membership significantly reduces the length of stay in the hospital, indicating that health insurance has a negative association with hospitalisation. On average, insured people spend nearly five fewer days in the hospital than their uninsured counterparts. The findings further revealed common and heterogeneous determinants of hospitalisation care for both insured and uninsured individuals. Age, household expenditure, and self-assessed health were the main predictors of hospitalisation duration for insured and uninsured persons. Heterogeneously, gender, education, and physical inactivity are significant determinants of NHIS members’ hospitalisation care, while chronic illness affects the length of stay in the hospital of the uninsured. The paper concludes with a discussion of the policy options for increasing NHIS enrolment to reduce the length of stay in the hospital and improve individuals’ well-being.

Keywords

• Endogenous switching regression model
• health insurance
• hospitalisation
• Ghana
• Joe Thomas, Institute of Health and Management, Australia
• Economics and Development