Abadi Teamir, Mebratie Anagaw Derseh
Health Bureau Health Care Financing Reform Case Team, Tigray Regional Health Bureau, Mekelle, Ethiopia.
School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Risk Manag Healthc Policy. 2021 Jan 8;14:87-95. doi: 10.2147/RMHP.S285793. eCollection 2021.
The government of Ethiopia introduced an exemption policy that guarantees free maternal healthcare services from public providers. This policy aims to ensure financial protection and enhance utilization of services especially for low-income people. However, patients in most cases incur health expenditure when seeking health care. This paper aims to assess direct and indirect medical costs of treating maternal complications and associated factors at a public hospital in Northern Ethiopia.
An institution-based cross-sectional study design was carried on 267 mothers with complications. A multivariate linear regression model at 5% level of significance was used to analyze factors driving the outcome.
The median cost was more than seven times the monthly minimum wage, and this may cause severe financial consequences for the poor. Direct medical costs accounted for the major share (68%) of total cost, and this was mainly driven by lack of diagnostic services at public facilities and paying for private providers. Expenditure for treatment of maternal complications is positively associated with income, absence from work, travel time to the facility and being diagnosed at a private facility.
The overall evidence in this study poses a concern about the context in which fee exemption reforms are being implemented.
埃塞俄比亚政府推行了一项豁免政策，确保公立医疗机构提供免费的孕产妇医疗服务。该政策旨在确保经济保障，提高服务利用率，尤其是针对低收入人群。然而，在大多数情况下，患者在寻求医疗服务时仍需承担医疗费用。本文旨在评估埃塞俄比亚北部一家公立医院治疗孕产妇并发症的直接和间接医疗成本及相关因素。
对267名患有并发症的母亲进行了基于机构的横断面研究设计。采用显著性水平为5%的多元线性回归模型分析影响结果的因素。
中位数成本超过月最低工资的七倍，这可能给贫困人口带来严重的经济后果。直接医疗成本占总成本的主要部分（68%），这主要是由于公共设施缺乏诊断服务以及向私立医疗机构付费所致。孕产妇并发症治疗费用与收入、缺勤、前往医疗机构的时间以及在私立医疗机构确诊呈正相关。
本研究的总体证据引发了对正在实施的费用豁免改革背景的关注。
