تقييم جودة خدمات التأمين الصحي في السودان دراسة حالة التأمين الصحي- ولاية النيل الأبيض– 2019م

Abstract

The study discussed the issue of evaluation of quality of health insurance services in White Nile State in 2019 considering raised debate about low quality level of that services.  The study aimed at evaluating the level at Health Insurance Fund (NHIF) , the main problem were the lack of its supply as well as its low quality level.  The main study hypothesis was that provision of public and specialist physician services, accuracy of laboratory diagnoses and provision of medicines within NHIF lead to raise the quality of provided service.  Using the descriptive analytical method, a class sample of (133) individuals were taken; a class of (62) beneficiaries of insurance services, (36) laboratory workers, (25) pharmacists and (10) workers in financial Administration.  The study attained some results the most important among that was, the most important of which is that the beneficiaries' assessment to the quality level of health insurance services that provided is good co-in-sided low accuracy of laboratory diagnoses and somewhat long periods of waiting for some services.  The health insurance providers tended to support the inadequacy of the financial reward compared to the work pressures, the failure to keep pace with insurance deductions for the direction of costs and inflation, the high financial burden of recovering the value of the drug and the continued transfer of some diagnoses to external laboratories, despite the existence of equipped laboratory at the NHIF.  The study recommended for the necessity of providing and building the medical and medical assistance capabilities, provision of sophisticated medical equipment, its maintenance, proposing facilities to accelerate provision of health insurance services at lowest waiting periods in order to avoid the waiting period, and so far increasing of health insurance resources.