The interaction of healthcare service quality and community-based health insurance in Ethiopia

Autor: Subrata Routh, Aynalem Hailemichael, Bamikale Feyisetan, Zewditu Kebede, Yordanos B. Molla, Gebeyehu Abelti, Tarekegn Abate, Mengistu Asnake Kibret, Binyam Fekadu Desta, Abdulmumin Saad, Hailu Zelelew, Elizabeth Futrell, Girma T. Kassie, Bekele Belayihun Tefera
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Economics
media_common.quotation_subject
Science
Social Sciences
Qualitative property
Interpersonal communication
Medical Services
Geographical Locations
Health Economics
Environmental health
Surveys and Questionnaires
Medicine and Health Sciences
Humans
Quality (business)
Drug Interactions
Community-Based Health Insurance
Community Health Services
Health Systems Strengthening
media_common
Quality of Health Care
Pharmacology
Service quality
Family Characteristics
Multidisciplinary
Health economics
Health Care Policy
Insurance
Health
Models
Theoretical
Health Care
Socioeconomic Factors
Health Care Facilities
People and Places
Africa
Medicine
Customer satisfaction
Business
Ethiopia
Composite index
Thematic analysis
Health Expenditures
Delivery of Health Care
Finance
Research Article
Health Insurance
Zdroj: PLoS ONE, Vol 16, Iss 8, p e0256132 (2021)
PLoS ONE
ISSN: 1932-6203
Popis: Community-based health insurance (CBHI) as a demand-side intervention is presumed to drive improvements in health services quality, and the quality of health services is an important supple-side factor in motivating CBHI enrollment and retention. There is, however, limited evidence on this interaction. This study examined the interaction between quality of health services and CBHI enrollment and renewal. A mixed-method comparative study was conducted in four agrarian regions of Ethiopia. The study followed the Donabedian model to compare quality of health services in health centers located in woredas/districts that implemented CBHI with those that did not. Data was collected through facility assessments, client-exit interviews, and key informant interviews. In addition to manual thematic analysis of qualitative data, quantitative descriptive and inferential analyses were done using SPSS vs 25. The process related (composite index including provider-client interpersonal communication) and outcome related (client satisfaction) measures of service quality in CBHI woreda/districts differed significantly from non-CBHI woredas/districts, but there were no significant differences in overall measures of structural quality between the two. The study found better diagnostic test capacity, availability of tracer drugs, provider interpersonal communication, and service quality standards in CBHI woredas. A higher proportion of clients at CBHI health centers gave high ratings of overall satisfaction with services. Individual and household factors including family size, age, household health care-related expenditures, and educational status, played a more significant role in CBHI enrollment and renewal decisions than health service quality. Key-informants reported in interviews that participation in the scheme increased accountability of health facilities in CBHI woredas/districts, because they promised to provide quality services using the CBHI premium collected at the beginning of the year from all enrolled households. This study indicates a need for follow-up research to understand the nuanced linkages between quality of care and CBHI enrollment.
Databáze: OpenAIRE
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