Disparities between Explanatory Models of Health Clients, Healthcare Providers and Health Insurer  

作　　者：Christine J. Fenenga Robert Kaba Alhassan Stephen Duku Wendy Janssens Daniel Arhinful Inge Hutter 

机构地区：[1]Population Research Centre, Department of Demography, Faculty of Spatial Sciences, University of Groningen and at the Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands [2]Noguchi Memorial Institute for Medical Research, University of Ghana and the University of Amsterdam, The Netherlands [3]Noguchi Memorial Institute for Medical Research, University of Ghana and the Free University of Amsterdam, The Netherlands [4]Free University of Amsterdam, The Netherlands [5]Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana [6]International Institute for Social Studies, The Hague, The Netherlands

出　　处：《Journal of Health Science》2016年第3期143-154,共12页健康科学（英文版）

摘　　要：We present qualitative data from a study in Ghana （2011）, where the National Health Insurance Scheme （NHIS） was introduced to improve access to health care. In 2011 membership enrolment and retention in the scheme was stalling. To obtain better insights into socio-cultural factors that influence utilization of healthcare services and the NHIS this study compared Explanatory Models of healthcare clients with those of primary healthcare providers and the NHIS regarding illness, the need for, the quality of, and the control over heaithcare and health insurance services. We found critical disparities in socio-cultural beliefs and perceptions of healthcare and health insurance between these three stakeholder groups, such as the clients＇ holistic view on illness versus healthcare providers＇ bio-medical view; the clients＇ inter-relational focus in perceiving quality of services versus the providers＇ medical technical focus. These differences are leading to misconceptions, blame practice, poor services, non-adherence and low trust. The findings increase our understanding of clients＇ behavior and that of their service providers. We conclude with key messages for policy leaders and operational managers that can guide them in improving services and facilitating client trust and interest to participate in health insurance and utilize healthcare services.

关 键 词：Explanatory Models COMMUNICATION TRUST health insurance Ghana. 

分 类 号：Q[生物学]