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Record W4402389539 · doi:10.1007/s44250-024-00147-w

Risk management and insurance failures: the case of Ghana’s National Health Insurance Scheme

2024· article· en· W4402389539 on OpenAlexaff
Nelson Dzupire, Solomon Aboagye, Samuel Asante Gyamerah, Prince Blackson Dennis Chirwa

Bibliographic record

VenueDiscover Health Systems · 2024
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicInsurance and Financial Risk Management
Canadian institutionsUniversity of Waterloo
Fundersnot available
KeywordsBusinessActuarial scienceScheme (mathematics)Risk managementNational health insuranceIncome protection insuranceHealth insuranceInsurance policyRisk analysis (engineering)Environmental healthGeneral insuranceFinanceEconomicsEconomic growthMedicineHealth care

Abstract

fetched live from OpenAlex

Since its inception, Ghana’s National Health Insurance Scheme (NHIS) has brought about notable improvements in healthcare access and health outcomes. However, challenges have arisen, threatening its intended function. This study aims to investigate the challenges encountered by NHIS participants and their risk management practices in response to insurance failures. Convenience and purposeful sampling techniques were employed to gather data from 45 Quality Insurance Company (QIC) employees residing in the Greater Accra area of Ghana who are NHIS members. A quantitative approach was utilized, and a questionnaire was administered to collect data. The study employed Cronbach’s alpha to assess the reliability and validity of the data. Additionally, Regression analysis, correlation, and descriptive statistics were utilized to achieve the study's objectives. The study revealed several challenges facing the NHIS, including a shortage of medical specialists, medications, and hospital beds, as well as high patient out-of-pocket expenses. Despite these challenges, the NHIS has not yet failed. However, the majority of NHIS cardholders (62.20%) would be adversely affected in the event of system failure, as they primarily rely on NHIS for risk management. Conversely, a minority of participants (37.80%) are less likely to experience the effects of failure due to alternative insurance plans and personal savings. Therefore, understanding these dynamics is crucial for policymakers and stakeholders to strengthen the NHIS and ensure sustainable healthcare access for all Ghanaians.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.009
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.045
Threshold uncertainty score0.089

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0040.009
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0070.004
Scholarly communication0.0040.003
Open science0.0010.003
Research integrity0.0030.003
Insufficient payload (model declined to judge)0.0050.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.026
GPT teacher head0.272
Teacher spread0.246 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2024
Admission routes1
Has abstractyes

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