Clients' Satisfaction with Quality of Care among Health-Insured and Non-Insured Diabetic Patients in Kaduna State, Northwest Nigeria.

Background: Access to affordable and quality care is critical to reducing suffering and mortality from diabetes given the huge economic challenge it poses. Health insurance aims to, among other things, improve the quality of health care services provided to patients.

Objectives: To assess and compare client satisfaction with quality of care among health-insured and non-insured diabetic patients in Kaduna State.

Methods: A comparative cross-sectional study was conducted using a two-stage sampling technique and 500 respondents, comprising 250 (50%) insured and 250 (50%) uninsured patients. Data was collected with a pretested, semi-structured, interviewer-administered questionnaire. Data was analysed using IBM SPSS version 25. A p-value < 0.05 was considered statistically significant, and results were presented using tables.

Results: The mean satisfaction scores of the health-insured and noninsured patients were found to be 106.6 and 109.5 respectively. The noninsured patients were more satisfied with the Health workers' interpersonal approach (p = 0.022) and communication (p = 0.026), while the health-insured patients were more satisfied with the financial aspect of care (p = 0.040). However, there is no statistically significant difference in the composite satisfaction between the health-insured and non-insured patients. Religion, duration of diabetes and educational status were found to be predictors of client satisfaction.

Conclusions: The study found that although there was no significant difference in total satisfaction with the quality of care, the noninsured patients were more satisfied with the Health workers' interpersonal approach and communication. It was recommended that the NHIA through accredited health facilities should improve interpersonal relationships and communication with health-insured diabetic patients.