A Comparative Assessment of Manual and Digital Registration Systems and Their Effects on Healthcare Delivery in Tertiary Hospitals in Kogi State, Nigeria.

Abstract:

The effectiveness of patient registration systems is increasingly recognized as a key factor influencing healthcare delivery. In Nigeria, many tertiary hospitals operate both manual and digital registration systems without clear evidence of their comparative performance, despite ongoing health information system reforms. This study therefore assesses the comparative effects of manual and digital registration systems on healthcare delivery in tertiary hospitals in Kogi State, Nigeria. The study was a facility-based cross-sectional study conducted among healthcare workers in two tertiary hospitals in Kogi State. A total of 452 respondents were selected using stratified random sampling to ensure adequate representation of relevant professional categories. Data were collected through structured questionnaires and analyzed using descriptive and inferential statistical techniques. Differences between manual and digital systems were examined using independent t-tests. Structural Equation Modeling was further applied to evaluate direct and indirect relationships among study variables. Statistical significance was set at p < 0.05. The results show that 30.31% of respondents were aged 25–29 years, 67.70% were female, 57.08% held a bachelor’s degree, and 23.01% had ≥20 years of professional experience. The findings show that respondents using digital registration systems recorded the highest mean outcome score of 2.78 ±0.26 (CI: 2.73 – 2.83), while those using manual registration systems recorded a lower mean score of 2.55 ±0.42 (CI: 2.49 – 2.62) with a significant mean difference (p < 0.001). Furthermore, digital registration is positively associated with perceived data quality (β = 0.239, 95% CI: 0.148–0.329, p < 0.001) and patient satisfaction (β = 0.421, 95% CI: 0.309–0.533, p < 0.001). The study demonstrates that while digital registration systems are associated with measurable improvements in efficiency, and patient processing compared with manual approaches. Addressing infrastructural gaps, strengthening staff capacity, and ensuring consistent technical support are critical for maximizing the benefits of digital registration and advancing health system performance in Nigeria