Utilization of health services and associated factors among fee waiver beneficiaries in Dawunt district, North Wollo zone, Ethiopia

Jemal, J.; Hagos, Tesfaye; Fentie, Melkitu; Zenebe, Getachew Assefa

doi:10.1016/j.puhe.2022.01.039

Cited by 3 publications

(6 citation statements)

References 9 publications

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“…Our study showed that all of the study participants (100%) visited public health facilities. But it is in line with the studies conducted in Northwest Ethiopia (61.8%) and Northeast Ethiopia (60.98%) [ 13 , 14 ]. This could be due to similarities in the implementation of the fee waiver system; both study areas are found in the same region.…”

Section: Discussionsupporting

confidence: 91%

“…Being an urban resident was also positively related to health service consumption, which is consistent with a study conducted in Northeast Ethiopia and Serbia [ 14 , 17 ]. This could be because urban residents have easier access to medical information and health services.…”

Section: Discussionsupporting

confidence: 90%

“…The fee waiver system still lacks financial security for the poor and exposes them to OOP expenses in Ethiopia [ 6 ]. According to studies conducted in different parts of Ethiopia, the highest level of health service utilization among fee waiver beneficiaries was in Gondar town (61.8%) [ 13 ], Daunt (60.98%) [ 14 ], Gamo Gofa (59.6%) [ 15 ], and Tigray (51.5%) [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…According to a study conducted in South Africa and Serbia; age, wealth status, the absence of drugs and supplies, the lack of information about waivers, the difficulty in identifying beneficiaries, and the inadequate operating structure were significant factors in health service utilization, but occupation, education, and income level were not [ 9 , 17 ]. Besides studies done in Ethiopia, sex, residence, occupation status, family size, perceived health status, travel time, perceived distance, earning more than the poverty line, perceived severity of illness, shortage of drugs and procedures, and perceived transport costs were significantly associated with utilization of health services [ 14 , 15 , 18 ]. Additionally, studies revealed that marital status, educational status, income level, presence of a disability health problem, presence of under-five children in the household, presence of elders in the household, insurance status, the nearest health institution, the presence of chronic illness in the household, the time taken to reach the health institution, and attitude were significantly associated with the utilization of health services [ 16 , 19 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Health services utilization and associated factors among fee waiver beneficiaries’ in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

Tadesse

Feleke

Chanie

et al. 2022

BMC Health Serv Res

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Background The fee waiver system is one of the components of the 2004 health care financing reform in Ethiopia. It is a system for granting access to health services to those who are unable to pay. The utilization health services among fee waiver beneficiaries remain low and unevenly distributed. This study aimed to assess the utilization of health services and associated factors among fee waiver beneficiaries in Dessie City, Northeast Ethiopia. Methods A community-based cross-sectional study design was employed in Dessie City from March 23 to April 23, 2021. The study was conducted among 407 fee waiver beneficiaries. A structured, interviewer-administered questionnaire was used to collect data. Participants were selected using a simple random sampling technique. Both bi-variable and multi-variable binary logistic regressions were performed. Significant factors for the outcome variable were identified at 95% CI with a p-value < 0.05. Results The overall health service utilization among fee waiver beneficiaries was found to be 62.4% (95% CI: 58.1–67.2). Being an urban resident [AOR:2.83, 95% CI:1.26–6.32], having a merchant occupation [AOR:0.20, 95% CI:0.05–0.80], having an average monthly income of 500–1000 birr [AOR:3.22, 95% CI:1.06–6.90], having a chronic disease [AOR:8.36, 95% CI:4.47–15.62], and perceiving the severity of illness as mild [AOR: 0.24, 95% CI: 0.07–0.81] were found to be statistically associated factors with health service utilization. Conclusions The fee waiver beneficiaries were not fully utilizing health services at public health facilities. Being an urban resident, being a merchant, having an average monthly income of 500–1000 birr, having a chronic disease, and perceived severity of illness were significantly associated with health service utilization. As a result, boosting income-generating strategies and urbanizing rural parts of the city may improve health service utilization among fee waiver beneficiaries.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Health services utilization and associated factors among fee waiver beneficiaries’ in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

Tadesse

Feleke

Chanie

et al. 2022

BMC Health Serv Res

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“…Access to health services is not only determined by the health status of individuals but is also a consequence of demand generated by socio-economic factors. [ 7 , 8 ]. Many patients cannot afford the care they need and often forgo medical care altogether for uninsurance or inadequate health insurance [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

Ren

2023

BMC Public Health

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Objective The Andersen’ s Behavioral Model was used to explore the impact of various factors on the utilization of health services. The purpose of this study is to establish a provincial-level proxy framework for the utilization of health services from a spatial perspective, based on the influencing factors of the Andersen’ s Behavioral Model. Method Provincial-level health service utilization was estimated by the annual hospitalization rate of residents and the average number of outpatient visits per year from China Statistical Yearbook 2010–2021. Exploring the relevant influencing factors of health service utilization using the spatial panel Durbin model. Spatial spillover effects were introduced to interpret the direct and indirect effects influenced by the proxy framework for predisposing, enabling, and need factors on health services utilization. Results From 2010 − 2020, the resident hospitalization rate increased from 6.39% ± 1.23% to 15.57% ± 2.61%, and the average number of outpatient visits per year increased from 1.53 ± 0.86 to 5.30 ± 1.54 in China. For different provinces, the utilization of health services is uneven. The results of the Durbin model show that locally influencing factors were statistically significantly related to an increase in the resident hospitalization rate, including the proportion of 65-year-olds, GDP per capita, percentage of medical insurance participants, and health resources index, while statistically related to the average number of outpatient visits per year, including the illiteracy rate and GDP per capita. Direct and indirect effects decomposition of resident hospitalization rate associated influencing factors demonstrated that proportion of 65-year-olds, GDP per capita, percentage of medical insurance participants, and health resources index not only affected local resident hospitalization rate but also exerted spatial spillover effects toward geographical neighbors. The illiteracy rate and GDP per capita have significant local and neighbor impacts on the average number of outpatient visits. Conclusion Health services utilization was a variable varied by region and should be considered in a geographic context with spatial attributes. From the spatial perspective, this study identified the local and neighbor impacts of predisposing factors, enabling factors, and need factors that contributed to disparities in local health services utilization.

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Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study

Gu,

Wang,

Qiu

et al. 2024

BMC Public Health

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Background The burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents. Methods Data were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization. Results According to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently. Conclusions Given the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents’ access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.

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Utilization of health services and associated factors among fee waiver beneficiaries in Dawunt district, North Wollo zone, Ethiopia

Cited by 3 publications

References 9 publications

Health services utilization and associated factors among fee waiver beneficiaries’ in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

Health services utilization and associated factors among fee waiver beneficiaries’ in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study

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