Impact of non-communicable disease multi morbidity on health care utilization and out-of-pocket health expenditure at Tikur Anbessa specialized hospital Addis Ababa, Ethiopia, 2020.
| dc.contributor.advisor | Molla, Meseret(PHD) | |
| dc.contributor.advisor | Tassew, Berhan(MPH) | |
| dc.contributor.author | Habtemichael, Mizan | |
| dc.date.accessioned | 2021-01-24T10:32:29Z | |
| dc.date.accessioned | 2023-11-05T14:40:15Z | |
| dc.date.available | 2021-01-24T10:32:29Z | |
| dc.date.available | 2023-11-05T14:40:15Z | |
| dc.date.issued | 2020-12 | |
| dc.description.abstract | Background:Out-of- pocket (OOP) health payment is the least efficient and most inequitable means of financing health care. In Ethiopia from the total health expenditure, OOP payment by household accounts 31 % which is more than the recommended 20%. Even though there are studies conducted on burden of OOP due to deferent NCDs like, cardiovascular disease, Cancer, diabetes mellitus and mental illness, there is no figure regarding the financial burden of OOP expenditure due to having more than one NCD (Multimorbidity). Objective: The study assessed the impact of NCD multimorbidity on health care utilization and OOP expenditure at Tikur Anbesa Specialized hospital, Addis Ababa in 2020. Method: Facility-based cross-sectional study was conducted at Tikur Anbesa Specialized Hospital from May 2020 to July 2020. Data was collected using pre-tested, structured intervieweradministered questionnaire. Data were entered using epi data version 3.1 and analyzed using STATAV 14. Binary logistic regressions, multivariable logistic regressions and negative binomial regression was used to examine the association between variables. Result: A total of 392 respondents were participated in this study and prevalence of NCD multimorbidity was 67 % (95%CI 62.2-71.5). The frequency of OPD visits was associated with the number of NCD (IRR= 1.2, 95%CI; 1.15-1.25, P-value < 0.001) and an increased number of NCDs was also associated with a higher likelihood of having hospitalization (AOR= 1.5, 95%CI; 1.19- 2.00, P-value < 0.001). We found 30.7% and 12.9% of households incurred catastrophic health expenditure (CHE) at 25% and 40% threshold of total household expenditure respectively. At a threshold level of 25% and 40% of household non-food expenditure, the level of catastrophic payments was 61.2% and 38.7% respectively. Conclusion and Recommendation: Multimorbid patients came to health facilities more frequently and they were exposed to increase financial problems. CHE mostly affected those households with older member, unemployed member, family member who came from outside of Addis Ababa to get health care services. Respondents who were in the poorest wealth quintile, those who have increased number of NCD conditions, those households with a hospitalized member, household who was not a member of an insurance system, those who use both public and private health facilities, and patients who visit a health facility frequently were affected by CHE.NCD multimorbid patients should be prioritized in the implementation of financial risk protection mechanisms. | en_US |
| dc.identifier.uri | http://etd.aau.edu.et/handle/123456789/24806 | |
| dc.language.iso | en_US | en_US |
| dc.publisher | Addis Abeba University | en_US |
| dc.subject | Non-communicable disease ,multi morbidity,health care utilization | en_US |
| dc.title | Impact of non-communicable disease multi morbidity on health care utilization and out-of-pocket health expenditure at Tikur Anbessa specialized hospital Addis Ababa, Ethiopia, 2020. | en_US |
| dc.type | Thesis | en_US |