The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.
In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.
Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium.
Gustave
G
Karara
Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium.
Frank
F
Verbeke
Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium.
Marc
M
Nyssen
D003362:Cost-Benefit Analysis / Q000191:economics; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006751:Hospital Information Systems / Q000191:economics* / Q000706:statistics & numerical data; D012432:Rwanda; D019472:Universal Health Insurance / Q000191:economics* / Q000706:statistics & numerical data*