A Web-Based Management Information System for National Health Insurance Scheme
CHAPTER ONE
Objectives of the Study
The objective of this project is to develop a web based information Management system for National Health Insurance Scheme. The new system will be able to do the following:
- Provide Online Registration Processing for the
- Do an on-Line accreditation of Health Maintenance Organizations (HMOs)
- Also do an on-Line Publication of HMOs List
- Provide an on – Line listing of Health care
- Provide an on-Line access to change of health service providers to another
- Builda database of all the HMOs and Health providers
- Builda database for the ministries that are registered for the scheme
- Maintain a database security for theNational Health Insurance Scheme (NHIS)
CHAPTER TWO
LITERATURE REVIEW
Review of Health Insurance Scheme
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care and health system expenses, among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is available to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity. According to the Health Insurance Association of America, health insurance is defined as “coverage that provides for the payments of benefits as a result of sickness or injury. Includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment” (Gary Caxton, 2007).
The Commonwealth Fund, in its annual survey, “Mirror, Mirror on the Wall”, compares the performance of the health care systems in Australia, New Zealand, the United Kingdom, Germany, Canada and the U.S. Its 2007 study found that, although the U.S. system is the most expensive, it consistently under-performs compared to the other countries. One difference between the U.S. and the other countries in the study is that the U.S. is the only country without universal health insurance coverage. (Schoen C et al, 2010).
The Commonwealth Fund completed its thirteenth annual health policy survey in 2010. A study of the survey “found significant differences in access, cost burdens, and problems with health insurance that are associated with insurance design”. Of the countries surveyed, the results indicated that people in the United States had more out-of-pocket expenses, more disputes with insurance companies than other countries, and more insurance payments denied; paperwork was also higher although Germany had similarly high levels of paperwork. (Schoen C et al, 2010).
History and Evolution of Health Insurance
“By late 19th century, “accident insurance” began to be available, which operated much like modern disability insurance” (Microsoft Encarta, 2009) This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance.
Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the U.S. by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the U.S. effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911 (Health Insurance Association of America, 1997).
Before the development of medical expense insurance, patients were expected to pay health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle-to-late 20th century, traditional disability insurance evolved into modern health insurance programs. One major obstacle to this development was that early forms of comprehensive health insurance were enjoined by courts for violating the traditional ban on corporate practice of the professions by for-profit corporations. State legislatures had to intervene and expressly legalize health insurance as an exception to that traditional rule. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs (but this is not always the case).
Hospital and medical expense policies were introduced during the first half of the 20th century. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations. The predecessors of today’s Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II (Thomas P. O’Hare, 2000)
CHAPTER THREE
SYSTEM ANALYSIS AND METHODOLOGY
INTRODUCTION
Research Methodology is a procedure and approach adopted by a researcher for sourcing facts used in the research work. In academic research, there are two main approaches that are widely used. These are the Quantitative and the Qualitative approaches.
While the emphasis of Quantitative research is on collecting and analyzing numerical data; it concentrates on measuring the scale, range, frequency etc. of phenomena, the Qualitative research is more subjective in nature than Quantitative research and involves examining and reflecting on the less tangible aspects of a research subject, e.g. values, attitudes, perceptions. (Flick, U., 2007).
The quantitative (practical) method would be adopted in this project research, in which case all the data use for analysis will be directly observed values from experimental result. This work intends to develop a prototype that demonstrates the working model of the project. Tools like Dreamweaver and hypertext Processor (php) scripting language will be used.
Fact Finding Methods
In order to create rhetorically effective and engaging pieces, one must be able to find appropriate and diverse sources and to evaluate those sources for usefulness and credibility. This section discusses the method employed. These sources gave rise to references cited within this work. Finding good sources and using them effectively helps you to create a message and a persona which your readers are more likely to accept, believe, and be interested in than if unsuitable and unreliable sources are used. This chapter covers the various kinds of research sources available to writers. It discusses how to find, evaluate, and use primary and secondary sources, printed and online ones. The three basic methods of research were effectively employed in this project. These are briefly discussed below.
CHAPTER FOUR
IMPLEMENTATION OF THE NEW SYSTEM
This chapter is dedicated to the implementation of the National Health Insurance Scheme Registration Portal. The information presented here will cover the requirement specifications, system implementation and description of tools used.
CHAPTER FIVE
SUMMARY, RECOMMENDATION AND CONCLUSION
Summary
This Project design has identified numerous need of web based application in administering, collection and management of information especially in health care delivery.
Having surveyed the operation of NHIS in different nations as well as seen the interesting features of using Information and Communication Technology in medical information management, it became expedient to develop a web-based registration portal for the National Insurance health Scheme in Nigeria to enable patients to do an online registration from their respective locations without having to trace or locate the office of the NHIS for manual registration, which will normally waste a lot of time and money. In such a case the financial risk which the scheme seeks to prevent will be ached a great deal. I have achieved using php and Mysql to implement it
Achievements
The following were achieved at the end of the work:
- Enrollees were successfully registered using the system
- Administrator can easily register Health Service providers
- Listof Accredited HMOs could be displayed
- Listof Registered Ministries were displayed
- Usercan at any time change their Health Service Provider
Problems Encountered
Achieving success at such enormous work as this is not without few challenges. These challenges were both technical and non technical. Some of the technical issues that constituted problems were as follows:
Developing interfaces for each module and managing a huge database was a priority concern. The process of developing the system started with building simple assessment modules. Later, complicated forms are designed and integrated. After the system was tested, many modifications suggested by the testers were also taken into consideration. At certain times this involved modifying interfaces as well as the database design. Scripts were written to share data between different forms to avoid users requiring entering data more than once.
Recommendations
First, this web base information management system is recommended for the National Health Insurance Scheme for effective management of the scheme and membership information. The system will cut down cost, save time and securely protect the data and information generated.
For further researchers an online accreditation of HMOs is recommended such that the administrator can conduct an online accreditation on the spot when given all the necessary information.
Conclusion
Computerization is one of the fastest growing activities. Virtually every facet of the human society is pursuing after computerization. With the hug growth in business activities in this present time, organizations need to upgrade not only to computer versions of their operations but also upgrade to online solution to their business solutions.
The test results obtained from this research has shown that a web based information system for NHIS will help the scheme to achieve its goal of reaching the expected range of the society. With this state of the art information system, the scheme is not only sure of security of its data, but also has such data readily available whenever and wherever.
REFERENCES
- Aderoumi A.O, “National Health Insurance scheme in Nigeria”, (www.oauife.edu.ng)
- Connecting for health: Global vision, local insight Report for the World Summit on the Information Society. Country profiles, 2006 (http:/!www.who.int/kms/resources/wsis report/en!).
- Dzenowagis J. World Health Organization, Geneva. 2006 (http://www.who.int/kms/resources/wsis report/en!).
- Dr Dotun Adesina, News Item: THE NATIONAL HEALTH INSURANCE SCHEME, NigerianPhysician.com, April, 2009.
- (http:/!thenigeriandoctor.org/news.php?extend.850).
- “Encarta: Health Insurance”. Archived from the original on 31st October, 2009.
- EoinOFiachain,(www.owenfeehan.com/teachin2/ct216/pdf/ct2l6 tutoriat3), January 20th 2014, 6:27 am).
- Health Insurance Association of America, Fundamentals of Health Insurance: Part A, 1997.
- Flick, U. The Sage Qualitative Research Kit. London: Sage, 2007. Gary Caxton, Institution for Health Care Research and Policy,
- Georgetown University, on behalf of the Henry J. Kaiser Family Foundation., 2008.