Abstract:
Background:Out-of-pocket medical payments are expenditures stood directly by a patient where
insurance does not cover the full cost of the health good or service. This expenditure includes
any payment related to medical fees, purchases of medicines (prescribed or not), user fees for
care and payments for equipment and diagnostic tests. Significant out of pocket payment create
financial barrier to access health care services and puts people at risk of poverty.
Objective: To investigate the magnitude and associated factors of out-of-pocketmedical
expenditure among outpatients visiting public hospitals in Jigjiga town Somali region, Eastern
Ethiopia from November 15 to November 30, 2023.
Methods:A facility-based cross-sectional study was design conducted among406 randomly
selected outpatient clients visiting at public hospitals in Jigjiga town, Eastern Ethiopia. Pretested
and structured questionnaires were used to collect data using face-to-face interviews. Data was
entered into Epi data version 4.6 and exported to Statistical package for social science (SPSS)
version 21for data cleaning and analysis. Descriptive statistics were used to analyze information
aboutclient’s characteristics and the out-of-pocket medical expenditure they faced. After
checking all assumption linear regression analysis were performed to see the association of each
variable with the outcome variables. A statistical significance were declared at 95% CI and P value <5%.
Results: A total of 400 study participants interviewed with a response rate of 98.5%. Annual
mean out of pocket health expenditure of the participant was $ 6.03 ± 3.08 with a 95% CI =
(5.71, 6.33) per patient.Being female (β=0.83$,95% CI = 0.27, 1.3),having health insurance
(β=5.77$, 95% CI = 4.66, 6.88) and distance from hospital(β=0.93$, 95% CI = (0.21, 1.64)were
factors significantly associated to out-of-pocket expenditure.
Conclusion and Recommendation:This study showed that out-of-pocket health expenditure
among outpatients was found to be low.Sex, health insurance, and distance from a health facility
were statistically significant associations with medical expenses paid out-of-pocket. We
recommend strengtheningimplementation of Urban Community-based health insurance scheme,
which guarantees urban communities to access quality health services without facing financial
hardship.
