EVALUATION OF DATA FOR QUALITY OF HEALTH CARE, COST AND ITS UTILIZATION IN MONITORY OF PATIENTS OUTCOME

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

Health care service delivery in Nigeria falls short of international standards resulting from poor state of health care infrastructure, shortage of medical professionals, threat of re-emerging infectious diseases, and poor sanitation. Over the last five decades post-independence, growth, and development in health care has been very poor. HIV/AIDS has regrettably been a very serious health challenge overtime. About 3.6 million of the populations are HIV positive. More than 300.000 individuals die from AIDS every year (Arikpo, Etor, & Usang, 2007). Another major problem is that of infant mortality. The World Health Organization Report (2008) indicated an infant mortality of 110 per 1000 live births in Nigeria. As a comparison, the infant mortality in Sweden is 2.7 per 1000 live births. Poverty has compounded these problems to give low life-expectancy of 52 years for women and 49 years for men. Recognizable demographic differences exist in Nigeria with consequent disparity in availability of health care facilities across the country (Okeke, 2008; Ouma & Herselman, 2008). Adequate evalution of clinical data of patients like the electronic medical record systems help to improve access to health care in remote suburban areas and ensure improved maintenance of long-term care (Keenan, Nguyen, & Srinivasan, 2006). Onwujekwe (2005) and Ofovwe and Ofili (2005), in separate studies conducted to assess patient and community satisfaction, found discontent with community members who decried the poorly staffed and inadequately equipped Primary Health Centers (PHCs) in their rural settlements compared to hospitals in urban centers. Such demographic disparity in health care accessibility benefits from hospital information technologies and telemedicine to foster collaboration between clinicians in urban areas and those in rural settlements (Ouma & Herselman, 2008). Clinical data evaluation for patients includes strategic decision support systems and clinical documentation systems. Some of the clinical support systems include Laboratory Information Systems (LIS), Radiology Information Systems (RIS), and Computerized Order Entry (COE). Others are pharmacy information systems and personal data analysis systems with important added feature for messaging between providers and staff, and the ability to share data with other medical facilities (Keenan et al., 2006). Telemedicine is a unique application of hospital information technologies. In its simplest form, telemedicine uses audiovisual information and communications apparatus to deliver health care services in a bid to modify socio-economic circumstances of the beneficiaries and improve accessibility to medical care (Yun & Chun, 2008). A paucity of government policy regarding the implementation of clinical data evaluation for patients exists in Nigeria. The lack of strategic government programs has culminated in the poor adoption of hospital information technologies in health care facilities across the country. Okeke (2008) posited that the lack of access to modern medical health care facilities has compelled many Nigerian patients to seek treatment with traditional healers and patent medicine dealers. The more affluent echelon of the society resorts to medical tourism overseas to obtain health care services, resulting in a loss of foreign exchange to Nigeria. According to Okafor-Dike (2008), poor leadership in Nigeria has led to years of economic downturn affecting every aspect of social life. Rather than develop medical services in Nigeria, government officials and wealthy individuals frequently seek medical treatment abroad even for the most basic health care needs.

STATEMENT OF THE PROBLEM

According to Omeruan et al. (2009), the major challenges of Nigeria healthcare system have been largely due to the lack of adequate clinical data of patients. Health services in Nigeria have suffered from decades of neglect, endangering Nigeria health status and national productivity. The healthcare system management is in three tiers; tertiary healthcare- provided by the Federal Government of Nigeria (FGN), mostly coordinated through the university teaching hospitals and federal medical centres. The secondary healthcare provision is by the state governments which manage the General Hospitals. The third tier is the Local Government (774 LGAs) which focuses on primary healthcare services administered in the dispensaries. It is the patients in primary healthcare services that suffer the most neglect and this has resulted to poor monitoring of patients which in extreme cases has led to death. Women, children, and especially the core poor die from avoidable health issues as a result of patients clinical data neglect.

Nigerian patients are being denied quality clinical data quality especially those in the rural areas as a result high profile individuals, especially the political class, continue to fly abroad on regular basis for medical treatment, further widening the inequality in accessing healthcare services which has further deteriorated our health care services leading to avoidable deaths of patients in Nigeria.

AIMS AND OBJECTIVES OF THE STUDY

The major aim of the study is to evaluate clinical data for quality health care cost and utilization in monitoring patients in Nigeria. Other specific objectives of the study include;

1. To examine the need for an effective health care delivery in Nigeria.
2. To determine the importance of health care cost on in Nigeria.
3. To assess the current state of Nigerian health care system in Nigeria.
4. To examine the challenges to effective evaluation of clinical data of patients in the Nigeria health care system.
5. To determine the relationship between evaluation of clinical data of patients and quality health care cost in Nigeria.
6. To recommend ways of improving the evaluation of clinical data of patients so as to enhance quality health care and monitory of patients in Nigeria.

RESEARCH QUESTIONS

1. What is the need for an effective health care delivery in Nigeria?
2. What is the importance of health care cost on in Nigeria?
3. What is the current state of Nigerian health care system in Nigeria?
4. What are the challenges to effective evaluation of clinical data of patients in the Nigeria health care system?
5. What is the relationship between evaluation of clinical data of patients and quality health care cost in Nigeria?
6. What are the ways of improving the evaluation of clinical data of patients so as to enhance quality health care and monitory of patients in Nigeria?

RESEARCH HYPOTHESES

H0: There is significant effect of adequate evaluation of clinical data of patient on quality of health care cost in Nigeria.

H1: There is significant effect of adequate evaluation of clinical data of patient on quality of health care cost in Nigeria.

H0: There is no significant relationship between evaluation of clinical data of patient and quality of health care cost in Nigeria.

H1: There is significant relationship between evaluation of clinical data of patient and quality of health care cost in Nigeria.

SIGNIFICANCE OF THE STUDY

The study would be of importance to the development of the health sector and by extension the development of the economy. The study would also be of immense importance to students, researchers and scholars who are interested in developing further studies on the subject matter by providing relevant literatures for the study.

SCOPE AND LIMITATION OF THE STUDY

The study is restricted to the evaluation of clinical data for quality of health care cost and its utilization in monitoring of patient. using the Lagos university teaching hospital(LUTH).

LIMITATION OF THE STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.