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Global health
Research
Community-based health insurance and healthcare service utilisation, North-West, Ethiopia: a comparative, cross-sectional study
  1. Desta Debalkie Atnafu1,
  2. Hiwot Tilahun2,
  3. Yihun Mulugeta Alemu1
  1. 1 School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
  2. 2 Curative and Rehabilitative Core Process, Amhara Regional Health Bureau, Bahir Dar, Ethiopia
  1. Correspondence to Mr. Desta Debalkie Atnafu; destad2a{at}gmail.com

Abstract

Objectives The objective of this study was to compare differences in healthcare utilisation between community-based health insurance member households and non-member households and to identify factors for community-based health insurance enrolment in South Achefer District.

Design Comparative, cross-sectional study.

Settings Community-based.

Participants A total of 652 selected households (326 insured and 326 uninsured households) participated in the study.

Methods A two-sample t-test (for proportions) and χ2 (for categorical data) were computed.

Main outcome measure Utilisation of healthcare.

Results There was a significant difference in the rate of healthcare utilisation between insured (50.5%) and uninsured (29.3%) households (χ2=27.864, p<0.001). Significant variations of enrolment status in community-based health insurance were observed in the following variables: educational status, family size, occupation, marital status, travel time to the nearest health institution, perceived quality of care, first choice of place for treatment during illness and expected healthcare cost of a recent treatment.

Conclusions Utilisation of health services among insured households with community-based health insurance was higher. Educational status, family size, occupation, marital status, travel time to the nearest health institution, perceived quality of care, first choice of place for treatment during illness and expected healthcare cost of a recent treatment should be emphasised to enhance community health insurance enrolment.

  • health economics
  • health policy
  • human resource management

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2017-019613

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    Footnotes

    • Contributors All the authors (DDA, HT, YMA) conceived and designed the experiments, performed the experiments, analysed the data, contributed materials/analysis tools and wrote the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Ethical approval from the University of Gondar ethics committee was obtained. In addition, ethical approval from Amhara Regional Health Bureau was granted.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Collaborators Geta Asrade.