The effects of medical insurance on utilization of health services: a case study of Africa Air Rescue (AAR)
In recent times health insurance in Kenya has experienced tremendous changes with an increase in most employers offering health insurance to their employees. Indeed, health care provisions offered by employers determine whether an employee's preference for certain jobs. In an attempt to provide employees with medical insurance, employers have ended up offering the services under corporate coverage. This in effects determines health seeking behaviour of employees. However, employees also develop coping mechanisms in order to access adequate and appropriate health care. This study examined the influence of medical insurance on health seeking behaviour of the insured; it is a case of AAR whose clients are mostly corporate. The study was conducted in Nairobi City. Specifically, the study sought to identify products and services that are preferred by the insured; establish challenges faced by the insured in regard to seeking health services and establish coping mechanisms employed by the insured to overcome health insurance challenges. The study used both qualitative and quantitative methods to collect data. The survey mainly utilized the survey research that adopted the cross-sectional design and a semistructured questionnaire was used to interview 124 respondents. The study also used field research in which key informants were interviewed by used of interview guide. The key informants included four doctors and two employers and two AAR administrators. The quantitative data were analyzed using SPSS (Statistical Package for Social Scientists). It was established that the insured are better off compared to the uninsured in so far as access to health care is concerned. Health insurance offers a promising way to improve access to health care, mitigate the risks of disease and ill health. Significant benefits for the insured are across multiple dimensions of improved access, more timely care, increased availability of preventive care and health education, and reduced risk of catastrophic financial influence. However it was also established that the insured have few choices when it comes to health seeking as they are insured with AAR and have limited choices. The insured seldom have time to present their views and the premiums are already packaged making it hard for them to seek for extra services once covered under specific premium by their employer. The study also identified significant challenges faced by the insured seeking health care and noted that this has resulted in development of coping mechanism with the aim of accessing adequate health care. Given the findings, there is need for medical insurance providers, employers and the insured to increase efforts with the aim of enhancing service delivery to the insured. There are a number of areas in which MIPs and employers can improve including expanding member benefits, developing payment options, improving efficiency to achieve larger scale, and forging collaboration between public and private sectors. Thus, there is need to emphasize awareness, enforcement of policies and collective responsibility of all stakeholders in enhancing health care services to the insured. There is also need for more research to improve the overall understanding of health care services in Kenya.