Date of Conferral

2020

Degree

Ph.D.

School

Health Services

Advisor

John W. Oswald

Abstract

The purpose of this study was to understand the effects of access to health insurance on the healthcare-seeking behavior of the population in four suburban communities in Rivers State, Nigeria. The conceptual framework of the study is based on Anderson's behavioral model of health services use. The study looked at how access to health insurance affects the healthcare seeking behavior and the preventive care seeking behavior of the study population. Two-hundred and seventy participants were surveyed using the Health Care Access and Utilization Survey (HCAUS) questionnaire. Data were analyzed using descriptive statistics (frequencies and percentages) and bivariate logistic regression. Respondents with health insurance had a higher statistically significant proportion for having access to health care compared to respondents without health insurance (38.18% vs. 11.16%; p=0.001). Respondents with health insurance were 4.92 times more likely to have access to health care compared to respondents without health insurance (OR=4.92; p=0.001; 95% CI: 2.47-9.80). Respondents with access to health insurance had a higher statistically significant proportion for seeking of preventive care compared to respondents without access to health insurance (23.64% vs. 12.09%; p=0.05). The analysis showed that respondents who currently have access to health insurance were 2.25 times more likely to seek preventive care compared to respondents without access to health insurance (OR=2.25; p=0.05; 95% CI: 1.06-4.74). The findings in this study may help health policy advocates, formulators, and implementers design effective, universal, and affordable health insurance programs for poor and vulnerable communities where finance is still a major barrier to healthcare access.

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