Financial Exploitation and Client Satisfaction among Enrollees of the National Health Insurance Scheme (NHIS) in Makurdi LGA, Benue State

Abstract

This study examined the effect of financial exploitation on client satisfaction among enrollees of the National Health Insurance Scheme (NHIS) in Makurdi Local Government Area, Benue State, Nigeria. The study adopted a descriptive survey research design. A sample size of 400 respondents was determined using the Taro Yamane formula, out of which 380 valid questionnaires were retrieved and analyzed. Data were analyzed using descriptive statistics, including frequencies, percentages, mean scores, and standard deviations, while simple linear regression was employed to test the hypotheses at the 0.05 level of significance. The study was anchored on the Theory of Equity in Health Care Utilization, which emphasizes fairness in healthcare financing and access as determinants of patient satisfaction. The findings revealed that perceived cost fairness significantly predicted client satisfaction positively (R = 0.642, R² = 0.412, β = 0.642, t = 6.812, p < 0.05), while out-of-pocket payments significantly predicted client satisfaction negatively (R = 0.668, R² = 0.446, β = -0.668, t = -6.955, p < 0.05). Billing transparency also had a significant positive effect on client satisfaction (R = 0.691, R² = 0.477, β = 0.691, t = 7.143, p < 0.05), whereas financial exploitation significantly reduced client satisfaction (R = 0.715, R² = 0.511, β = -0.715, t = -7.300, p < 0.05). The study concluded that equitable healthcare financing, transparent billing practices, and the elimination of unauthorized charges are essential for improving client satisfaction among NHIS enrollees. The study recommended stronger NHIA oversight, improved provider accountability, regular billing audits, and stricter enforcement of NHIS operational guidelines to safeguard beneficiaries and strengthen confidence in the scheme.