Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana

Abstract

The passage of National Health Insurance Scheme to replace the old system (called cash and carry) in Ghana seems to have raised many questions as to whether it has increased the rate at which people attend hospital and abolished cash and carry system. The data collected were hospital attendance for both health insurance and cash and carry system on monthly basis across age groups and gender for 2008-2017, obtained from Cape Coast Teaching Hospital. Chi-Square tests and the Box-Jenkins's methodology of time series analysis were employed to analyse the data. From the findings, the autocorrelation function (ACF) and partial autocorrelation function (PACF) plot suggested an AR process with order 1. Candidate models were obtained using the minimum AIC criteria to select adequate models and appropriate models were obtained as SARIMA (1,0,0) (0,1,0) 12 model for insured (NHIS) and SARIMA (1,1,1) (2,0,1) 12 model for uninsured (Cash and Carry system). Model diagnostics tests were performed using Ljung-Box test. The Chi-square tests inferred dependence in hospital attendance between insured and non-insured patients on gender and the years, In conclusion, insured patients will be increasing throughout the age groups and non-insured patients will be increasing for specific age groups 0-28 days to 15-17 years for the next 24 months. This research recommended among others that education should be given to the general public about the importance of health insurance, it registration and operations especially age group 0-28days to 15-17 years because they seem to continue the use of Cash and Carry System in seeking healthcare regardless of the introduction of NHIS.