Tilahun Hiwot, Atnafu Desta Debalkie, Asrade Geta, Minyihun Amare, Alemu Yihun Mulugeta
Curative and Rehabilitative Core Process, Amhara Regional Health Bureau, Bahir Dar City, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia.
Health Econ Rev. 2018 Aug 22;8(1):15. doi: 10.1186/s13561-018-0200-z.
To identify factors for healthcare utilization and to describe effect of Mutual Health Insurance on health service utilization in rural community in South Achefer, North West Ethiopia.
Across-sectional study was conducted. A total of 652 households consented to participate in the study (326 insured and 326 uninsured households). Propensity score matching was used to explain possible differences in the baseline variables between enrolled and un-enrolled households. Logistic regression analysis was used to identify factors for healthcare utilization.
Healthcare utilization among insured households was 50.5% (95% CI: 44.8%, 56.2%). Whilst among uninsured households, healthcare utilization was 29.3% (95% CI: 24.11, 34.47). In general, the overall healthcare utilization was 39.89% (95% CI: 35.7, 43.8). The overall increase in patient-attendance given illness among insured households was 25.2% higher compared with uninsured (t = 4.94, 95% CI: 0.145, 0.359). Educated (primary and above) (AOR = 1.84; 95% CI: 1.14, 2.98), chronic patient (AOR = 1.86; 95% CI: 1.13, 3.06), first choice was health facilities at the point of illness (AOR = 6.33; 95% CI: 2.97-13.51), rich (AOR = 2.1; 95%CI: 1.29, 3.43), and insured (AOR = 2.16; 95% CI: 1.45, 3.23) were independently associated with increased healthcare utilization.
Enrolment to mutual health insurance increases healthcare utilization. Presence of illness in the households, household earnings, educational status, first choice of treatment at point of illness, and membership to Mutual Health Insurance scheme should be targeted during escalating of healthcare utilization.
确定影响医疗保健利用的因素，并描述相互健康保险对埃塞俄比亚西北部阿切费尔南部农村社区卫生服务利用的影响。
开展了一项横断面研究。共有652户家庭同意参与研究（326户参保家庭和326户未参保家庭）。倾向得分匹配用于解释已登记和未登记家庭基线变量的可能差异。逻辑回归分析用于确定医疗保健利用的因素。
参保家庭的医疗保健利用率为50.5%（95%置信区间：44.8%，56.2%）。而在未参保家庭中，医疗保健利用率为29.3%（95%置信区间：24.11，34.47）。总体而言，总体医疗保健利用率为39.89%（95%置信区间：35.7，43.8）。与未参保家庭相比，参保家庭因病就诊的总体增加率高25.2%（t = 4.94，95%置信区间：0.145，0.359）。受过教育（小学及以上）（比值比=1.84；95%置信区间：1.14，2.98）、慢性病患者（比值比=1.86；95%置信区间：1.13，3.06）、患病时首选医疗机构（比值比=6.33；95%置信区间：2.97 - 13.51）、富裕家庭（比值比=2.1；95%置信区间：1.29，3.43）和参保家庭（比值比=2.16；95%置信区间：1.45，3.23）与医疗保健利用率增加独立相关。
参加相互健康保险可提高医疗保健利用率。在提高医疗保健利用率时，应针对家庭中是否患病、家庭收入、教育状况、患病时的首选治疗方式以及相互健康保险计划的参保情况。
