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

Bridget Sena Borbor; Bosson-Amedenu Senyefia; Daniel Gbormittah

doi:doi:10.11648/j.sjams.20190703.12

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

Bridget Sena Borbor, Bosson-Amedenu Senyefia, Daniel Gbormittah

Published in Science Journal of Applied Mathematics and Statistics (Volume 7, Issue 3)

Received: 10 July 2019 Accepted: 14 August 2019 Published: 30 August 2019

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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.

Published in	Science Journal of Applied Mathematics and Statistics (Volume 7, Issue 3)
DOI	10.11648/j.sjams.20190703.12
Page(s)	36-44
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Box-Jenkins, NHIS, Cash Carry, Hospital Attendance, Chi-Square

References

[1]	Bannor, F. and Gyan, F (2012). “Modeling Hospital Attendance in Ghana: A case study of Obuasi Government Hospital” Project work, Garden City University College 2019, pp 32.
[2]	Arthur, J. (2013). Application of statistical models to outpatient department (ODP) attendance data in Saltpond Municipal Hospital of the Central Region of Ghana, Thesis, Kwame Nkrumah University of Science and Technology. 2019, pp 68-69.
[3]	Abubakar F. (2012). Time series analysis on membership enrolment of National Health Insurance Scheme: A case study of Savelugu Nanton District Mutual Health Insurance Scheme in Northern Region, Thesis, Kwame Nkrumah University of Science and Technology. 2019, pp 75-76.
[4]	Mensah, J., Oppong, J. R., and Schmidt, C. M. (2006). Ghana’s National Health Insurance Scheme in the context of the health MDGs–an empirical evaluation using propensity score matching. Number 157. Ruhr economic papers.
[5]	PSU (2018d). Chi-square test of independence. retrieved from: https://onlinecourses.science.psu.edu/stat500/node/56/.
[6]	Australian Bureau of Statistics [ABS]. (2008). Retail trade trends. Retrieved on June 2018 from http://.en.wikipedia.org/wiki/Australian_Bureau_of_Statistics.
[7]	Qmul (2018a). Time series. accessed from: http://www.maths.qmul.ac.uk/~bb/TimeSeries/TS_Chapter7.pdf.
[8]	Box, G. E. P., Jenkins, G. M., and Reinsel, G. C. (1994). Time series analysis, forecasting and control (3^rd ed.). New Jersey: Prentice Hall, Englewood Cliffs.
[9]	George Box P. E and Gwilym Jenkins M. (1976). Time series Analysis, Forecasting and control. Holden-Day, Oakland, California, USA, 2^nd edition.
[10]	qmul (2018b). Time series. accessed from: http://www.maths.qmul.ac.uk/~bb/TimeSeries/TS_Chapter6_2_2.pdf.
[11]	PSU (2018b). Applied time series. retrieved from: https://onlinecourses.science.psu.edu/stat510/node/67/.
[12]	PSU (2018c). Applied time series. retrieved from: https://onlinecourses.science.psu.edu/stat510/node/65/.

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APA Style

Bridget Sena Borbor, Bosson-Amedenu Senyefia, Daniel Gbormittah. (2019). Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Science Journal of Applied Mathematics and Statistics, 7(3), 36-44. https://doi.org/10.11648/j.sjams.20190703.12

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ACS Style

Bridget Sena Borbor; Bosson-Amedenu Senyefia; Daniel Gbormittah. Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Sci. J. Appl. Math. Stat. 2019, 7(3), 36-44. doi: 10.11648/j.sjams.20190703.12

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AMA Style

Bridget Sena Borbor, Bosson-Amedenu Senyefia, Daniel Gbormittah. Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Sci J Appl Math Stat. 2019;7(3):36-44. doi: 10.11648/j.sjams.20190703.12

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@article{10.11648/j.sjams.20190703.12,
  author = {Bridget Sena Borbor and Bosson-Amedenu Senyefia and Daniel Gbormittah},
  title = {Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana},
  journal = {Science Journal of Applied Mathematics and Statistics},
  volume = {7},
  number = {3},
  pages = {36-44},
  doi = {10.11648/j.sjams.20190703.12},
  url = {https://doi.org/10.11648/j.sjams.20190703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjams.20190703.12},
  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.},
 year = {2019}
}

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TY  - JOUR
T1  - Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana
AU  - Bridget Sena Borbor
AU  - Bosson-Amedenu Senyefia
AU  - Daniel Gbormittah
Y1  - 2019/08/30
PY  - 2019
N1  - https://doi.org/10.11648/j.sjams.20190703.12
DO  - 10.11648/j.sjams.20190703.12
T2  - Science Journal of Applied Mathematics and Statistics
JF  - Science Journal of Applied Mathematics and Statistics
JO  - Science Journal of Applied Mathematics and Statistics
SP  - 36
EP  - 44
PB  - Science Publishing Group
SN  - 2376-9513
UR  - https://doi.org/10.11648/j.sjams.20190703.12
AB  - 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.
VL  - 7
IS  - 3
ER  -

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Author Information

Bridget Sena Borbor

Department of Mathematical Sciences, University of Mines and Technology, Tarkwa, Ghana
Bosson-Amedenu Senyefia

Department of Mathematics and ICT, Holy Child College of Education, Takoradi, Ghana
Daniel Gbormittah

Department of Mathematics and ICT Education, Komenda College of Education, Komenda, Ghana

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APA Style

Bridget Sena Borbor, Bosson-Amedenu Senyefia, Daniel Gbormittah. (2019). Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Science Journal of Applied Mathematics and Statistics, 7(3), 36-44. https://doi.org/10.11648/j.sjams.20190703.12

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ACS Style

Bridget Sena Borbor; Bosson-Amedenu Senyefia; Daniel Gbormittah. Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Sci. J. Appl. Math. Stat. 2019, 7(3), 36-44. doi: 10.11648/j.sjams.20190703.12

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AMA Style

Bridget Sena Borbor, Bosson-Amedenu Senyefia, Daniel Gbormittah. Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana. Sci J Appl Math Stat. 2019;7(3):36-44. doi: 10.11648/j.sjams.20190703.12

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@article{10.11648/j.sjams.20190703.12,
  author = {Bridget Sena Borbor and Bosson-Amedenu Senyefia and Daniel Gbormittah},
  title = {Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana},
  journal = {Science Journal of Applied Mathematics and Statistics},
  volume = {7},
  number = {3},
  pages = {36-44},
  doi = {10.11648/j.sjams.20190703.12},
  url = {https://doi.org/10.11648/j.sjams.20190703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjams.20190703.12},
  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.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Statistical Analysis of Health Insurance and Cash and Carry Systems in Cape Coast Teaching Hospital of Ghana
AU  - Bridget Sena Borbor
AU  - Bosson-Amedenu Senyefia
AU  - Daniel Gbormittah
Y1  - 2019/08/30
PY  - 2019
N1  - https://doi.org/10.11648/j.sjams.20190703.12
DO  - 10.11648/j.sjams.20190703.12
T2  - Science Journal of Applied Mathematics and Statistics
JF  - Science Journal of Applied Mathematics and Statistics
JO  - Science Journal of Applied Mathematics and Statistics
SP  - 36
EP  - 44
PB  - Science Publishing Group
SN  - 2376-9513
UR  - https://doi.org/10.11648/j.sjams.20190703.12
AB  - 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.
VL  - 7
IS  - 3
ER  -

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