Implications of chronic disease patient travel to healthcare facilities on the design of national health insurance in South Africa - a preliminary review

Abstract

The South African Human Rights Commission acknowledges that access to healthcare services in South Africa, especially for the poor, is severely constrained by expensive, inadequate or non-existent transport services. This is exacerbated in cases of patients with chronic diseases who require regular travel to healthcare facilities. Therefore, any interventionist programme to improve access to healthcare facilities that does not incorporate transport access requirements reduces the efficacy of such a programme. The paper forms part of a research project aimed at identifying public transport design requirements to support patients with chronic diseases. This paper in particular qualitatively benchmarks the proposed South African National Health Insurance against other similar insurance schemes elsewhere in the world through isolating how the different schemes cover non-emergency patient transport requirements. The paper finds that South Africa’s National Health Insurance is among the many schemes that disregard patient travel requirements. However, subject to further empirical research, the paper identifies options for consideration that could be incorporated in the NHI for chronic patient travel requirements.