MAGNITUDE AND ASSOCIATED FACTORS OF OUT-OF-POCKET MEDICAL EXPENDITURE AMONG OUTPATIENTS VISITING PUBLIC HOSPITALS IN JIGJIGA TOWN SOMALI REGION, EASTERN ETHIOPIA

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.