Addise Teketel, Alemayehu Tadesse, Assefa Nega, Erkalo Desta
Anilemo District Health Office, Hadiya Zone, Southern Ethiopia.
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Risk Manag Healthc Policy. 2021 Jan 13;14:145-154. doi: 10.2147/RMHP.S290671. eCollection 2021.
Community-based health insurance (CBHI) schemes are an emerging strategy for providing financial protection against healthcare-related poverty. In Ethiopia, CBHI is being piloted in 13 districts, but community experience and satisfaction with the scheme have yet to be studied.
To assess the magnitude of satisfaction and associated factors among household heads who visited health facilities with community-based health insurance schemes in the Anilemo district Hadiya Zone Southern Ethiopia.
A community-based cross-sectional study design was conducted for 627 household heads in the Anilemo district, from March 1-30, 2020. Study participants were selected using stratified random sampling for kebeles and systematic sampling for study households. Data were collected by trained data collectors using a pre-tested structured questionnaire. Descriptive statistics, bivariate, and multivariate logistic regression analyses were performed. P values less than 0.05 with 95% confidence intervals were used to determine associations between independent and dependent variables.
The magnitude of household heads' satisfaction was 54.1%. Household heads age [AOR=1.70;95% CI 1.09-2.67], households income [AOR=0.19; 95% CI 0.11-0.35], knowledge of CBHI benefit packages [AOR=3.15; 95% CI 1.97-5.03], agreement with laboratory services [AOR=2.25; 95% CI 1.40-3.62], and got and agreed with prescribed drugs [AOR=2.69; 95% CI 1.66-4.37] were significantly associated with the magnitude of household heads satisfaction with community-based health insurance.
About half of the household heads who visited health facilities with CBHIS were satisfied. Age, household's income, knowledge of CBHI benefit packages, agreement with laboratory service provision, availability and agreement with prescribed drugs were significant predictors of satisfaction with CBHI. Therefore, much effort could be required to increase the magnitude of the household head's satisfaction with the scheme.
基于社区的健康保险(CBHI)计划是一种新兴的策略,旨在为防范与医疗保健相关的贫困提供经济保障。在埃塞俄比亚,CBHI正在13个地区进行试点,但社区对该计划的体验和满意度尚未得到研究。
评估埃塞俄比亚南部哈迪亚地区阿尼莱莫区使用基于社区的健康保险计划前往医疗机构就诊的户主的满意度及其相关因素。
2020年3月1日至30日,在阿尼莱莫区对627户户主进行了基于社区的横断面研究设计。研究参与者通过对行政区进行分层随机抽样和对研究家庭进行系统抽样来选取。由经过培训的数据收集员使用预先测试的结构化问卷收集数据。进行了描述性统计、双变量和多变量逻辑回归分析。使用P值小于0.05且置信区间为95%来确定自变量和因变量之间的关联。
户主的满意度为54.1%。户主年龄[AOR=1.70;95% CI 1.09 - 2.67]、家庭收入[AOR=0.19;95% CI 0.11 - 0.35]、对CBHI福利套餐的了解[AOR=3.15;95% CI 1.97 - 5.03]、对实验室服务的认可[AOR=2.25;95% CI 1.40 - 3.62]以及获得并认可处方药[AOR=2.69;95% CI 1.66 - 4.37]与户主对基于社区的健康保险的满意度显著相关。
约一半使用CBHIS前往医疗机构就诊的户主感到满意。年龄、家庭收入、对CBHI福利套餐的了解、对实验室服务提供的认可、处方药的可得性和认可程度是对CBHI满意度的重要预测因素。因此,可能需要付出很大努力来提高户主对该计划的满意度。