What Factors Explain Low Adoption of Digital Technologies for Health Financing in an Insurance Setting? Novel Evidence From a Quantitative Panel Study on IMIS in Tanzania

Background  Digital information management systems for health financing are implemented on the assumption that digitalization, among other things, enables strategic purchasing. However, little is known about the extent to which these systems are adopted as planned to achieve desired results. This study assesses the levels of, and the factors associated with the adoption of the Insurance Management Information System (IMIS) by healthcare providers in Tanzania.Methods  Combining multiple data sources, we estimated IMIS adoption levels for ۳۶۵ first-line health facilities in ۲۰۱۷ by comparing IMIS claim data (verified claims) with the number of expected claims. We defined adoption as a binary outcome capturing underreporting (verifiedTanzania may be sub-optimal and far from policy-makers’ expectations, limiting its capacity to provide the necessary information to enhance strategic purchasing in the health sector. Countries and agencies adopting digital interventions such as openIMIS to foster health financing reform are advised to closely track their implementation efforts to make sure the data they rely on is accurate. Further, our study suggests organizational and infrastructural barriers beyond the software itself hamper effective adoption.

Keywords:

Health Financing , Health Insurance , Strategic Purchasing , Tanzania , Digital Health Intervention , Adoption