Influence of Health Insurance on Clinical Decision Making Among Kenyan Doctors in Emergency Care

Abstract

Majority of Kenyans lack health insurance and therefore find it difficult to raise money for health expenditure. Studies elsewhere have shown disadvantage to uninsured individuals in terms of health care accorded to them when compared to those insured, even in provision of lifesaving medical care. The objective was to examine the extent that clinical decisions on emergency medical care by doctors in Kenya changed given the health insurance status of a patient. An online self-administered survey was sent to Kenyan doctors. Alongside demographics of the doctors and the modality of payment of their patients, respondents estimated frequency of decision change in emergency medical cases. The results were compared to the payment modality of their patients. The completed responses were 20 % of total surveyed. Regarding decision change in delivery of emergency health care, no difference was found between the doctors who attended to uninsured patients and those who attended to insured patients (p=0.4). While clinical decision making of Kenyan doctors is influenced by health insurance, delivery of emergency health care is not influenced by health insurance.