Community Based Health Insurance Scheme as a New Healthcare Financing Approach in Rural Ethiopia: Role on Access, Use and Quality of Healthcare Services, the Case of Tehuledere District, South Wollo Zone, Northeast Ethiopia

Molla Yismaw Jembere
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引用次数: 9

Abstract

Community based health insurance scheme is an emerging and promising concept to access affordable and effective healthcare, to protect households from out of pocket expenditure and impoverishment. Accordingly, this study examined access, use and quality of services after the introduction of the scheme in Ethiopia. To conduct this study, mixed research approach, descriptive, inferential and thematic analysis employed concurrently to collect data from participants. The study finding disclosed that by avoiding out of pocket payment, community based health insurance improve access and overall quality of service. Moreover, health services utilization improved from 0.33 visits of individual per year in 2011 to 1.44 visits in 2016. However, there were limitations in some quality indicator, moral hazards (miss utilizations) and adverse selections (inclusion of chronically ill, poor and indigents) during enrolment. Generally, the purpose of the scheme is threefold: increase access and use by making healthcare services more affordable and equitable, improve health status of population, and mitigate the out of pocket financial consequences of ill health by distributing the costs of healthcare across all members of a risk pool within the scheme.
以社区为基础的健康保险计划是埃塞俄比亚农村一种新的医疗保健融资方式:对医疗保健服务的获取、使用和质量的作用,以埃塞俄比亚东北部南沃罗区Tehuledere县为例
以社区为基础的健康保险计划是一个新兴的、有希望的概念,可以获得负担得起和有效的医疗保健,保护家庭免于自付费用和贫困。因此,本研究审查了埃塞俄比亚实行该计划后服务的获取、使用和质量。本研究采用混合研究方法,同时采用描述性、推理性和专题性分析来收集研究对象的数据。研究发现,通过避免自掏腰包,社区医疗保险改善了获得服务的机会和整体质量。此外,卫生服务使用率从2011年的每年0.33次提高到2016年的1.44次。然而,在登记期间,在某些质量指标、道德风险(错过利用)和不利选择(包括慢性病患者、穷人和贫困人口)方面存在局限性。总的来说,该计划的目的有三个:通过使保健服务更加负担得起和公平来增加获得和使用,改善人口的健康状况,以及通过在计划内的风险池中将保健费用分摊给所有成员来减轻健康状况不佳的自付财务后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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