| dc.description.abstract | Cost sharing financing schemes are seen as an option for extending insurance coverage in low-income countries, particularly among rural and informal sectors of society. Over the years other community financing mechanisms have been added including introduction of prepaid insurance like schemes such as National Hospital Insurance Fund (NHIF), Community Health Funds (CHF), National Social Security Fund (NSSF) and National Social Health Insurance Schemes. The main purpose of this study was to determine the best Cost sharing practices being implemented by Public Hospitals in Kenya.
The study adopted the descriptive research design. A descriptive survey is a process of collecting data from the members of a population in order to determine the current status of the sample under study with respect to one or more variables.The study population consisted of all the seven Provincial General Hospitals and three Referral Hospitals registered in Kenya by December,2010. A Sample of two referral hospitals was randomly selected from the population and all the seven provincial hospitals were studied. The data analysis for this study was based on quantitative approach using descriptive and inferential statistics. The data was analyzed with the help of statistical package for Social Sciences (SPSS) version. Percentages, frequencies, pie charts, tables and graphs were used where applicable to facilitate easy understanding. Multiple regression analysis was used to evaluate the statistical relationship between the variables.
The findings of the study revealed that the best cost sharing practices are practices where: the Government promptly finances lost revenues due to exemptions and waivers given by hospitals, there is transparency and accountability in collecting and spending cost sharing funds, funds are regularly audited, health management boards are properly inducted to their duties, monitor and verify collection and expenditure, collection registers exist, health care staff are involved in decision making regarding use of collected funds, health care protection policy exist such that no one is denied health care services due to inability to pay and that citizens are aware of it, there is legal and political framework where political commitment and top management support exist, revenue generated should be an addition to hospital budget allocation and Government budget allocation to hospitals should not reduce with introduction of cost sharing and an accounting information system exist to enhance cost sharing revenue collection and usage.
The respondents cited challenges in the implementation of cost sharing practices and from the findings the challenges included: Poverty in communities that increases waivers, difficulty in determining the patients who qualify' for waivers, inadequate budget allocation by the government, failure by the government to promptly reimburse the hospitals for costs forfeited through protection policy, inadequate staff to run the funds and that board members are not well trained on financial management and accounting.
It was recommended that the government should promptly fund the exemptions and waivers to reduce the constraints experienced by tli~ public hospitals, the board members should be well trained on financial management and accounting for them to be more competent, budget allocation should be increased, the village elders and the provincial administration officers should be involved in determining the patients who qualify for waiver and more staff should be hired. The government should employ qualified personnel and train existing ones to raise their capacities in order to affirm efficiency and proper utilization of resources and revenue maximization. | en_US |
