Magnitude and Factors Affecting Out-of-Pocket Medical Expenditure among Outpatients in ST.Paul Hospital Millennium College, Addis Ababa, Ethiopia

Abstract

The Objectives of the study is to assess the magnitude and factor that affect out-of pocket medical expenditure among outpatients department in St Paul's hospital Millennium College, Addis Ababa, Ethiopia. An Institution-based crosssectional study in quantitative method was conducted among outpatient services. The required sample size is determined by single population and double population proportion formula. The final sample size was 422. A descriptive statistical analysis, binary and multivariable logistic regression model was used to describe the findings. Gender, marital status, educational status, occupation, family size, total income was statistically associated with TOOPME at Sig< 0.2. Statistically associated with TOOPME In multivariate analysis were marital status (B=.197; CI 95%190.2-585; sig .000), Occupation status (B=-.174; CI 95%-180-39.6; sig .002), family size (B=.229; CI 95%58-150; sig .000), and total income (B=.305; CI 95%10Table: 1 9-227; sig .000). The financing system of health care should be based on the principle of cost sharing so that there will be resource pooling among the poor and the rich. The financing mechanism should also move into prepayment schemes or insurance to protect the poor from unanticipated health care costs.

Are Ethiopian diabetic patients protected from financial hardship?

“…monthly diabetic care expenditure is 505 ETB (17.92 USD). It is lower than that of a study done on catastrophic health care expenditure in Ethiopia (610ETB) [24]. The possible explanation for this difference might be due to the fact that the previous study incorporated catastrophic health care expenditure as results of all diseases while the current study was conducted on catastrophic expenditure for diabetic care.…”

The burden of household out-of-pocket healthcare expenditures in Ethiopia: a systematic review and meta-analysis

“…et.al (2018) [ 39 ] Amhara Cross-sectional 454 households 5 Low risk Fitsum S. et al (2018) [ 40 ] Amhara Cross-sectional 346 patients 8 Low risk Abyot A. et al (2018) [ 34 ] South Longitudinal 735 patients 7 Low risk Hailemichael Y. et.al (2019) [ 35 ] South Comparative cross-sectional 579 households 7 Low risk Hailemichael Y. et.al. (2019) [ 36 ] South Comparative ross-sectional 257 households 7 Low risk Biniam G. et al (2019) [ 37 ] South Cross-sectional 812 women 7 Low risk Amelewerk A. et al (2019) [ 46 ] Addis Ababa Cross-sectional 422 patients 7 Low risk Miljeteig I. et al (2019) [ 54 ] National Survey/ Cross-sectional 647 physicians 8 Low risk Obse AG. et.al.…”

“…The pooled analysis of three studies revealed that marital status was associated with the burden of household Out-Of-Pocket / catastrophic healthcare expenditures (AOR 10.25, 95% CI: 0.92, 114.21) (Table 8 ). Marital status was associated total Out-Of-Pocket healthcare expenditures (AOR 0.20, 95%CI: 0.19, 0.20) [ 46 ]. However, being unmarried was found to be associated with higher median total cost (AOR 1.17, 95%CI: 0.02, 55.40) [ 40 , 46 ].…”

“…Marital status was associated total Out-Of-Pocket healthcare expenditures (AOR 0.20, 95%CI: 0.19, 0.20) [ 46 ]. However, being unmarried was found to be associated with higher median total cost (AOR 1.17, 95%CI: 0.02, 55.40) [ 40 , 46 ].…”

“…The pooled effects of three studies showed that occupation was associated with the burden of household Out-Of-Pocket / catastrophic healthcare expenditures (AOR 0.53, 95% CI: 0.28, 1.03) (Table 9 ). Type of occupation of the patients was associated with total Out-Of-Pocket healthcare expenditures (AOR 0.84, 95%CI: 0.83, 0.85) [ 46 ]. For example, households that had a member of working adults were 68% (AOR = 0.32; 95% CI: 0.16, 0.63) times less likely to face catastrophic healthcare expenditures compared to households who had no working adults [ 51 ].…”