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埃塞俄比亚西南部谢科地区试点社区医疗保险计划的家庭满意度及其相关因素。

Household satisfaction with community-based health insurance scheme and associated factors in piloted Sheko district; Southwest Ethiopia.

机构信息

Department of Public Health, College of Health Sciences, Mizan -Tepi University, Mizan-Teferi, Ethiopia.

出版信息

PLoS One. 2019 May 13;14(5):e0216411. doi: 10.1371/journal.pone.0216411. eCollection 2019.

Abstract

BACKGROUND

Community-based health insurance (CBHI) scheme is an emerging strategy for providing financial protection against health-related poverty. It is being piloted in the Sheko district, but community satisfaction with the scheme has not yet studied. Therefore, this study aimed to assess the level of household's satisfaction to CBHI scheme and associated factors in a piloted Sheko district; southwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted in Sheko district from March to April 2018. Data was collected on 528 households by using simple random sampling method. Trained data collectors gathered the data using a pre-tested and structured questionnaire. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. To determine the independent predictors of household's satisfaction to CBHI, a cut point of p values < 0.05 were used.

RESULTS

This study showed that more than half (54.7%) of the households were satisfied with the CBHI scheme. Satisfaction to CBHI was positively associated with adequate knowledge of CBHI benefit packages (AOR = 2.29, 95% CI = 1.55-3.38), type of health facility visit (AOR = 1.93, 95% CI = 1.09-3.39), laboratory service provision (AOR = 2.07, 95% CI = 1.15-373) and length of enrollment (AOR = 1.53, 95% CI = 1.01-2.32).

CONCLUSIONS

Household's satisfaction to CBHI scheme was moderate. Modifiable factors, including adequate knowledge of CBHI benefit packages, type of health facility visit, laboratory service provision, and length of enrollment were independent determinants of satisfaction. In order to augment enrollee's satisfaction to CBHI, efforts should be given to improving their knowledge of CBHI benefit packages through education and information campaigns. Furthermore, due consideration should also be given to improving the quality of health services.

摘要

背景

社区健康保险(CBHI)计划是提供针对与健康相关贫困的财务保障的新兴战略。该计划正在谢科地区试点,但尚未研究社区对该计划的满意度。因此,本研究旨在评估在埃塞俄比亚西南部谢科地区试点的 CBHI 计划中家庭对该计划的满意度水平及其相关因素。

方法

2018 年 3 月至 4 月,在谢科地区进行了一项基于社区的横断面研究。采用简单随机抽样方法,对 528 户家庭进行了数据收集。经过培训的数据收集员使用预先测试和结构化问卷收集数据。采用描述性统计、双变量和多变量逻辑回归分析。为了确定家庭对 CBHI 满意度的独立预测因素,采用了 p 值<0.05 的截断点。

结果

本研究表明,超过一半(54.7%)的家庭对 CBHI 计划表示满意。对 CBHI 的满意度与对 CBHI 福利包的充分了解(AOR=2.29,95%CI=1.55-3.38)、就诊的医疗机构类型(AOR=1.93,95%CI=1.09-3.39)、实验室服务提供(AOR=2.07,95%CI=1.15-373)和入保时间(AOR=1.53,95%CI=1.01-2.32)呈正相关。

结论

家庭对 CBHI 计划的满意度为中等。可改变的因素,包括对 CBHI 福利包的充分了解、医疗机构就诊类型、实验室服务提供和入保时间是满意度的独立决定因素。为了提高参保人的 CBHI 满意度,应通过教育和宣传活动努力提高他们对 CBHI 福利包的了解。此外,还应充分考虑改善卫生服务质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10db/6513074/f53bba63edf0/pone.0216411.g001.jpg

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