Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting
In Ethiopia, Community-Based Health Insurance (CBHI) schemes aim to enhance healthcare accessibility and reduce financial barriers to health care access by providing protection against out-of-pocket (OOP) expenses. However, evidence on the institutional experience of insured patients remains limited...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-04-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/00469580251333636 |
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| author | Bereket Alemayehu Admasu MD Mahlet Yigeramu Gebremariam MD |
| author_facet | Bereket Alemayehu Admasu MD Mahlet Yigeramu Gebremariam MD |
| author_sort | Bereket Alemayehu Admasu MD |
| collection | DOAJ |
| description | In Ethiopia, Community-Based Health Insurance (CBHI) schemes aim to enhance healthcare accessibility and reduce financial barriers to health care access by providing protection against out-of-pocket (OOP) expenses. However, evidence on the institutional experience of insured patients remains limited. This study explores the financial implications of CBHI membership among inpatients at St. Paul’s Hospital Millenium Medical College. A cross-sectional study was conducted in St. Paul’s Hospital Millenium Medical College Inpatient Departments. After stratifying across different wards, the study participants were chosen by systematic random sampling. Data on socio-demographics and payment related factors were collected with a structured questionnaire. Ethical approval and informed consent were obtained. About 260 respondents, of whom 168 (64.6%) were CBHI members and 92 (35.4%) were non-members, had participated in the study. The result reveals that both CBHI members and non-members continue to bear OOP expenses, undermining the financial protection intended by the scheme. Among CBHI members, self-sponsored out-of-pocket payments along with health insurance (65, 38.7%) were the major source of financing. The significant reduction in reported difficulty in paying for basic necessities among CBHI members compared to non-members ( P = .034) does suggest that the insurance offers some level of financial relief. While CBHI provides some financial relief, gaps in coverage need more in-depth exploration. |
| format | Article |
| id | doaj-art-c1b6f6485ea9426a84c88e2d3663a7df |
| institution | OA Journals |
| issn | 0046-9580 1945-7243 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj-art-c1b6f6485ea9426a84c88e2d3663a7df2025-08-20T01:48:29ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432025-04-016210.1177/00469580251333636Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited SettingBereket Alemayehu Admasu MD0Mahlet Yigeramu Gebremariam MD1St. Paul’s Hospital Millennium Medical College, Addis Ababa, EthiopiaTikur Anbessa Hospital, Addis Ababa, EthiopiaIn Ethiopia, Community-Based Health Insurance (CBHI) schemes aim to enhance healthcare accessibility and reduce financial barriers to health care access by providing protection against out-of-pocket (OOP) expenses. However, evidence on the institutional experience of insured patients remains limited. This study explores the financial implications of CBHI membership among inpatients at St. Paul’s Hospital Millenium Medical College. A cross-sectional study was conducted in St. Paul’s Hospital Millenium Medical College Inpatient Departments. After stratifying across different wards, the study participants were chosen by systematic random sampling. Data on socio-demographics and payment related factors were collected with a structured questionnaire. Ethical approval and informed consent were obtained. About 260 respondents, of whom 168 (64.6%) were CBHI members and 92 (35.4%) were non-members, had participated in the study. The result reveals that both CBHI members and non-members continue to bear OOP expenses, undermining the financial protection intended by the scheme. Among CBHI members, self-sponsored out-of-pocket payments along with health insurance (65, 38.7%) were the major source of financing. The significant reduction in reported difficulty in paying for basic necessities among CBHI members compared to non-members ( P = .034) does suggest that the insurance offers some level of financial relief. While CBHI provides some financial relief, gaps in coverage need more in-depth exploration.https://doi.org/10.1177/00469580251333636 |
| spellingShingle | Bereket Alemayehu Admasu MD Mahlet Yigeramu Gebremariam MD Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting |
| title_full | Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting |
| title_fullStr | Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting |
| title_full_unstemmed | Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting |
| title_short | Assessment of Health Insurance’s Role in Reducing Financial Barriers to Health Service Access: Perspective from a Resource Limited Setting |
| title_sort | assessment of health insurance s role in reducing financial barriers to health service access perspective from a resource limited setting |
| url | https://doi.org/10.1177/00469580251333636 |
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