Browsing by Author "HaileMariam, Damen(professor)"

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    Health care services utilization and its determinant factors among health professionals, Addis Ababa, Ethiopia, 2018 G.C: Health facility based mixed study.
    (Addis Ababa University, 2018-10) Cheru, Miraj; HaileMariam, Damen(professor); Tassew, Berhan(MPH)
    Background: The main function of health system is ensuring the availability and accessibility of health service. Service provision is an immediate output of the health system, but health service utilization in sub Saharan Africa is very low. Similar to that the health service utilization in Ethiopia also is low. Dimensions that are barrier for health service utilization are geographic accessibility; availability of health workers, drugs and equipment; affordability and acceptability. Objective: To explore pattern of health service utilization and its determinant factors among health professionals in Addis Ababa, Ethiopia, 2018 G.C. Methods: Institutional-based cross-sectional study supplemented with a qualitative study was conducted to explore patterns of health service utilization and its determinant factors among health professionals by using stratified sampling technique. The total sample size for the study was 634 using single population sampling technique methods with 10% non-response rate. Data was collected using structured questionnaire for quantitative data and in depth interview was conducted on 12 respondents for qualitative data. To increase the quality of data training was provided to the data collectors to familiarize with the questionnaire, at the time of data collection data was checked for completeness and consistency by principal investigator and data was transcribed in full text and response in all interview sessions was reviewed and combined. EPI- info version 7 and SPSS version 20 for quantitative and open code version 3.6.2.0 for qualitative data was employed for analysis. Logistic regression was used and odds ratio was calculated to ascertain association between dependent and independent variable at p values of less than 0.05. The result had presented in tables, graphs, words and charts. Result: The final multivariate logistic regression model has shown that satisfaction on skill and competency of health care provider, having unhealthy perceived health status and having known chronic illness were found to have a statistically significant association with utilization of health care service. While participants who were satisfied with skill and competency of health care provider were 2.265 more likely utilize health service than not satisfied (AOR=2.265, 95% CI: 1.112, 5.627). Also respondents who perceived that their health status was healthy were 0.035 times less likely utilized health service than unhealthy (AOR=0.035, 95% CI: 0.009, 0.132). the xi | P a g e final multinomial regression shows that respondent that perceived that high cost of health care service are 7.902 more likely preferred health center than private clinics(AOR=7.902, 95% CI:2.301,27.141) ) The qualitative part of this study shown that majority of the respondents first they had observed within their health facility. But, they preferred advanced health facility in order to get advanced health care service. And also shown that there is free health care service for health care providers within government health facility but there is specific of amount of money planned annually to get health care service for staffs that are worked within non-governmental for non-profit health facility. Conclusion: In conclusion the level of health services utilization rate was found to be low. There is no uniform payment trend to utilize health care service employees among private, governmental and NGOs. Efforts have to be made to increase utilization of modern health services through establishing uniform payment trend among health facilities for health work forces.
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    Unit cost analysis and assessment of the pay back of service provision at Tikur Anbessa Specialized Teaching Hospital, Ethiopia
    (Addis Ababa University, 2019-10) Abdulwehab, Remziya; HaileMariam, Damen(professor)
    Background: Health care expenditure is increasing worldwide. Determining the unit cost of medical services is one part of economic analysis which helps to improve efficient use of scarce resource. It is also a vital indicator needed by managers and policy makers. Most of the health institutions in our country have not yet properly established clear methods to calculate unit cost and set the service price. Objective: This study is conducted to explore the unit cost of health services provision and assess the payback at Tikur Anbessa Specialized Teaching Hospital(TASTH), Addis Ababa Ethiopia. The study has been conducted for the period of July 2017 to June 2018. Methods: Afacility based cross-sectional unit cost analysis has been conducted in order to identify the unit cost and compare it with the price. The top-down costing method wasapplied to calculate and allocate the overhead and intermediate cost centers to the final cost centers of TASTH for the year 2017/18GC (2010 EFY) froma provider perspective. Micro-costing method was applied to calculate unit cost of each service inthe final cost centers and, thecost was compared with the current hospital service charge. The average and range of different serviceunitscost, priceand Cost to recovery ratio (CRR)was calculated for further analysis. The study covered 273(22%)selected services out of the total 1,212services in the hospital. The costs data were calculated using Microsoft Excel 2010. Results:The average unit cost of different diagnostic services is 276.03ETB (range24.55-800.4), whereas the average unit price is 108 ETB with (MIN-MAX) that is (4-800). The average unit cost for different inpatient services is 813 ETB (range 51.4-3676.6) and the average unit price is 104ETB with a (MIN-MAX) that is(10-350). The average unit cost for outpatient services is 124.99, but the average price is 11.13 with (MIN-MAX) that is (5,30). From the total services analyzed 57(21%) of them have a no price sated, 157(58%) of them have CRRbetween(1% to25%), 27(10%) of them have CRR between 26% to 50% and 14(5%) of themhave CRR between(51% to 100%). Conclusion:The current study implies that costs of service provisions are considerably higher as compared to the corresponding services especially for Outpatient and inpatient services the CRR is only 9% and 13% respectively. The hospital administrative bodies and other concerned bodies should take measures in order to reduce the gaps between cost anduser fees so as to maintain financial sustainability of the hospital without compromising access to services for the poorest segment of the population.