Publications by authors named "Amare Minyihun"

12 Publications

  • Page 1 of 1

Cost of Illness of Epilepsy and Associated Factors in Patients Attending Adult Outpatient Department of University of Gondar Referral Hospital, Northwest Ethiopia.

Risk Manag Healthc Policy 2021 4;14:2385-2394. Epub 2021 Jun 4.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Epilepsy has significant economic implications on health care needs, premature death, and lost work productivity. Therefore, this study aimed to assess the cost of illness of epilepsy and its associated factors in the Outpatient Department of University of Gondar Referral Hospital, Northwest Ethiopia.

Methods: We conducted an institution-based cross-sectional study from March 2018 to April 2018. A total of 442 adult epileptic patients were selected from the chronic follow-up clinic using a systematic sampling technique. We fitted binary logistic regression to identify the associated factors, and significant variables in the multivariable logistic regression analysis were determined using P-value <0.05 and 95% CI.

Results: The study revealed that the mean total cost illness of epilepsy per patient per year was US$ 166±61.6, and 30.3% of patients incurred high cost. Age (AOR = 1.06; 95% CI: 1.03, 1.09), sex (AOR = 3.66; 95% CI: 1.94, 6.89), educational (AOR = 0.15; 95% CI: 0.005, 0.047), polytherapy (AOR = 4.66; 95% CI: 2.29, 9.46), seizure frequency (AOR = 4.48; 95% CI: 1.56, 12.8), place where AEDs were bought (AOR = 6.23; 95% CI: 2.7, 14.03) and disease duration (AOR = 0.11; 95% CI: 0.05, 0.25) were predictors of the cost of illness of epilepsy.

Conclusion: The total annual cost of illness of epilepsy was high, taking into account the per capita income of the individuals. The age, sex, and educational status of the patients, and the number of AED, seizure frequency, places where patients buy drugs, and disease duration were factors significantly associated with the cost of illness of epilepsy. Hence, creating an alternative source of income, socio-economic support, and affordable health care service for patients, especially for female and elderly patients, and strengthening and equipping nearby clinics, increasing drug availability in governmental pharmacies.
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http://dx.doi.org/10.2147/RMHP.S289113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187097PMC
June 2021

Willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia.

PLoS One 2021 24;16(3):e0248618. Epub 2021 Mar 24.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.

Introduction: In Ethiopia, cataract surgery is mainly provided by donors free of charge through outreach programs. Assessing willingness to pay for patients for cataract surgery will help explain how the service is valued by the beneficiaries and design a domestic source of finance to sustain a program. Although knowledge concerning willingness to pay for cataract surgery is substantive for developing a cost-recovery model, the existed knowledge is limited and not well-addressed. Therefore, the study aimed to assess willingness to pay for cataract surgery and associated factors among cataract patients in Outreach Site, North West Ethiopia.

Methods: A cross-sectional outreach-based study was conducted on 827 cataract patients selected through a simple random sampling method in Tebebe Gion Specialized Hospital, North West Ethiopia, from 10/11/2018 to 14/11/2018. The data were collected using a contingent valuation elicitation approach to elicit the participants' maximum willingness to pay through face to face questionnaire interviews. The descriptive data were organized and presented using summary statistics, frequency distribution tables, and figures accordingly. Factors assumed to be associate with a willingness to pay were identified using a Tobit regression model with a p-value of <0.05 and confidence interval (CI ≠ 0).

Results: The study involved 827 cataract patients, and their median age was 65years. About 55% of the participants were willing to pay for the surgery. The average amount of money willing to pay was 17.5USD (95% CI; 10.5, 35.00) and It was significantly associated with being still worker (β = 26.66, 95% CI: 13.03, 40.29), being educated (β = 29.16, 95% CI: 2.35, 55.97), free from ocular morbidity (β = 28.48, 95% CI: 1.08, 55.90), duration with the condition, (β = -1.69, 95% CI: -3.32, -0.07), admission laterality (β = 21.21, 95% CI: 3.65, 38.77) and remained visual ability (β = -0.29, 95% CI (-0.55, -0.04).

Conclusions: Participants' willingness to pay for cataract surgery in outreach Sites is much lower than the surgery's actual cost. Early intervention and developing a cost-recovery model with multi-tiered packages attributed to the neediest people as in retired, less educated, severely disabled is strategic to increase the demand for service uptake and service accessibility.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248618PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990211PMC
March 2021

Health-related quality of life and associated factors among patients with epilepsy at the University of Gondar comprehensive specialized hospital, northwest Ethiopia.

Qual Life Res 2021 Mar 18;30(3):729-736. Epub 2020 Oct 18.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Purpose: Epilepsy is a global public health problem that causes a profound physical, psychological and social consequences. However, as such evidence in our country is limited, this study aimed to assess the health-related quality of life (HRQOL) and associated factors among patients with epilepsy.

Methods: An institution-based cross-sectional study was conducted on 370 patients with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31) was used to measure HRQOL. Multiple linear regression was fitted to assess the association between HRQOL and the independent variables, and a P-value < 0.05 and a 95% confidence interval were used to declare statistical significance.

Results: More than 55% of the participants were male, and the mean age of the participants was 29.64 (11.09) years. The overall HRQOL score was 55.81 (14.00). The scale scores ranged from 46.50 (15.55) to 64.98 (19.43). Out of the seven scales, the energy scale score was the lowest. Frequency of seizure, anxiety, depression, perceived stigma and adverse drug event were negatively associated with HRQOL, whereas social support had a significant positive association.

Conclusion: This study revealed that the HRQOL of patients was low and that its energy and emotional scales were the most affected. The presence of depression, anxiety and stigma adversely affected patient HRQOL. Therefore, healthcare professionals should be aware of the emotional state of the role it plays for HRQOL. Interventions aimed at reducing psychosocial problems and stigmatization are also needed to improve the patient HRQOL.
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http://dx.doi.org/10.1007/s11136-020-02666-4DOI Listing
March 2021

Determinants of Access to Health Care Among Women in East African Countries: A Multilevel Analysis of Recent Demographic and Health Surveys from 2008 to 2017.

Risk Manag Healthc Policy 2020 30;13:1803-1813. Epub 2020 Sep 30.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Access to essential health care is one of the major factors associated with maternal mortality. In developing countries, improving women's access to health care has significantly reduced maternal death. Therefore, this study aimed to identify the determinants of access to health care among women in East African countries based on 2008 to 2017 Demographic and Health Surveys (DHSs).

Methods: This study used secondary data from 2008 to 2017 DHSs of 12 East African countries. A two-level mixed-effects logistic regression analysis was employed to determine the variables associated with women's access to maternal health care. The adjusted odds ratios (AORs), 95% CI, and P-value were computed. Variables with P<0.05 were considered as determinants of access to maternal health care.

Results: A total of 148,483 study participants were included in this study. Women who accessed health care were 64,218 (42.91%) in the region. The study revealed that access to women's health care was positively associated with factors; being educated women, having an educated husband, being from households with middle and richest wealth status, and living in different countries compared to Comoros. The study also revealed that living in a rural setting and having unplanned pregnancy were barriers to access to health care.

Conclusion And Recommendation: Women in East Africa countries have poor access to maternal health care. Residence, maternal education, husband education, income, and planned pregnancy were the predictors of access to health care. Therefore, there should be a common strategy to enhance the accessibility of health service utilization among women in the region and financial support for the poor that enables women to use health services. For better health care access, increasing the awareness of women and their partners about the significance of utilization of healthcare service focusing on uneducated persons are crucial activities.
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http://dx.doi.org/10.2147/RMHP.S263132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533273PMC
September 2020

Acceptance of Human Papillomavirus Vaccination and Associated Factors Among Parents of Daughters in Gondar Town, Northwest Ethiopia.

Cancer Manag Res 2020 16;12:8519-8526. Epub 2020 Sep 16.

Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Cervical cancer is one of the profound threats to women's lives and the fourth most common cancer among women. Ethiopia launched the human papilloma vaccination for the first time, with the support of the Global Alliance for Vaccine and Immunization (GAVI) in 2018. Therefore, the aim of this study was to assess the acceptability of the human papillomavirus vaccine and associated factors among parents of daughters in Gondar town, Northwest Ethiopia.

Methods: A community-based cross-sectional study with a total sample of 946 study participants was conducted in Gondar town from April to May 2019. The study participants were selected using a multistage sampling technique from parents having a daughter of 9-17 years age. Data were collected using an interviewer-administered questionnaire. The data were entered into EpiData version 4.2 and exported to STATA version 14 for analysis. Variables having a p-value of <0.2 and <0.05 in the bivariable and multivariable logistic regression were considered as a statistically significant factor for the acceptance of HPV vaccination.

Results: A total of 899 study participants with a response rate of 95% were included in the study. Among participants in this study, 81.3% with 95% CI (78.6, 83.7) accepted to vaccinate their daughters for HPV vaccination. The acceptance to vaccinate daughters for HPV vaccination was affected by being from the richest household [AOR= 3.44, 95% CI = (1.97, 6.01)], good knowledge about cervical cancer [AOR=5.49, 95% CI= (2.62, 11.52)], and positive attitude towards HPV vaccination [AOR=21.53, 95% CI= (11.60, 39.96)].

Conclusion: The study revealed that the acceptance to human papillomavirus vaccination is high and was significantly associated with the level of knowledge about cervical cancer, the attitude towards HPV vaccination, and the wealth status of the households. Therefore, community education on cervical cancer and its prevention is crucial to increase awareness and acceptance as well.
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http://dx.doi.org/10.2147/CMAR.S275038DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7502398PMC
September 2020

Self-reported fall and associated factors among adult people with visual impairment in Gondar, Ethiopia: a cross-sectional study.

BMC Public Health 2020 Apr 15;20(1):498. Epub 2020 Apr 15.

Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar comprehensive specialized hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.

Background: Fall is a major public health problem and potentially disabling issue. A vast burden of visually impaired live in low-middle income countries particularly in Sub-Saharan Africa. Limited ability to detect environmental hazards puts visually impaired at a greater risk of falls and unintentional injuries. Falls among visually impaired is associated with considerable disability, health care cost, loss of independence, and socio-economic consequences. Ethiopia lacked estimates of fall among any vulnerable population, particularly among visually impaired people. Therefore, this study aimed to estimate the prevalence of falls and factors associated among adult people with medically diagnosed visual impairment in Ethiopia.

Methods: An institutional-based cross-sectional study was conducted among visually impaired adults who attended the ophthalmology clinic at the University of Gondar comprehensive specialized hospital during the study period. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Bivariate and multivariable binary logistic regression model analysis was used to identify factors associated with falls. Adjusted odds ratio with corresponding 95% confidence intervals were computed to show the strength of association.

Results: A total of 328 adults medically diagnosed with visual impairment participated in the study (97.3% response rate). The age of the participants ranged from 25 to 89 years with a mean age of (56.46 ± 14.2 years). The overall cumulative prevalence of self-reported falls among adults with visual impairment was 26.8% with 95%CI (22.7, 32.4%). The major associated factors of fall identified by multivariate analysis were; visual impairment in both eye (AOR 3.21, 95% CI 1.11, 9.29), fear of falling: some concerned: (AOR, 4.12; 95%CI, 1.44, 11.76), very concerned fear (AOR 10.03; 95% CI, 3.03, 33.21), medications: (AOR 4.63; 95% CI 2.14, 10.00) and self-reported depression: (AOR 3.46; 95% CI 1.11, 10.79).

Conclusion: The result of this study indicates a moderate self-reported prevalence of fall among adult people with medically diagnosed visual impairment. Identifying sub-groups at risk of falls among visually impaired, modifiable risk factors, implementation of precaution measures to avoid fall and fall-related injuries, and most importantly measures that would reduce the fear of falls in visually impaired people deserves immediate attention.
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http://dx.doi.org/10.1186/s12889-020-08628-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161228PMC
April 2020

Health-related quality of life and associated factors among patients with diabetes mellitus at the University of Gondar referral hospital.

Health Qual Life Outcomes 2020 Mar 10;18(1):62. Epub 2020 Mar 10.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Diabetes mellitus, which has a wide range of effects on the physical, social and psychological aspects of the well-being of a person, is a common and challenging chronic disease that causes a significant rate of morbidity and mortality. However, studies in our country, by and large, focused on the impact of the disease in terms of mortality and morbidity alone. Therefore, the objective of this study was to assess the health-related quality of life (HRQOL) and associated factors of diabetic patients at the University of Gondar referral hospital, Ethiopia.

Methods: A facility-based cross-sectional study was conducted at the University of Gondar referral hospital from April to May 2017. A generic World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to measure the HRQOL. The data were analyzed by Stata version 12. Multiple Linear Regression analysis with P-value 0.05 was used to measure the degree of association between HRQOL and independent variables.

Results: A total of 408 patients with Diabetes Mellitus were included in the study. The HRQOL scores for physical, psychological, social and environmental domains were 50.9, 54.5, 55.8 and 47.3, respectively. Diabetes-related complications had a significant association with all except the psychological domain. Higher HRQOL was associated with exercising, following the recommended diet, foot care, sensible drinking and the absence of co-morbidities. However, old age, unemployment and being single and widower had a significant association with lower HRQOL.

Conclusion: The environmental and physical domains of HRQOL scores were the lowest compared to the social and psychological domains. Old age and living in rural area had a significant association with a lower HRQOL, whereas the absence of diabetes-related complications, exercising, general diet and foot care had a significant association with better HRQOL of patients. Therefore, strong advice on the recommended lifestyle is important, and old patients and rural dwellers should get due attention. In addition, the prevention of diabetes-related complications is important to improve the patient HRQOL which is an important outcome measurement from the patient's perspective related to the impact of the disease. Therefore, including HRQOL assessment as part of routine management is necessary.
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http://dx.doi.org/10.1186/s12955-020-01311-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063813PMC
March 2020

Fertility Desire And Associated Factors Among HIV Positive Women Attending ART Clinics In Amhara Region Referral Hospitals In Northwest Ethiopia, 2017.

HIV AIDS (Auckl) 2019 17;11:247-254. Epub 2019 Oct 17.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: "Fertility desire" is the intention of people to have more children despite being diagnosed with HIV, whereas intentions denote a commitment to implement that desire. Despite the overwhelming effects of HIV on a fetus, there is a desire for fertility among people positive for the virus/disease worldwide.  Therefore, this study aimed to assess fertility desires and factors associated with sexually active HIV positive reproductive-age women attending ART clinics at Amhara region referral hospitals, Northwest Ethiopia.

Methods: An institution-based cross-sectional study was conducted on reproductive-age women attending the clinics at the hospitals. A total of 427 eligible women were systematically included in the study. A semi-structured questionnaire was used to collect data via interviewer-administered techniques. EpiInfo7 and STATA 14 software was used for data entry and analysis, respectively. The logistic regression analysis method was used to identify factors associated with fertility desire. Factors that had p-values of ≤0.05 were considered statistically significant.

Results: The findings indicated that 40.3% (95% CI; 35.7%, 45.0%) of the participants reported they had the desire to have children in the future. Variables such as women in the age group of 25-34 years (AOR= 2.80, 95% CI; 1.68, 4.68), participating with their sexual partner (AOR=3.52, 95% CI; 1.36, 9.13) and married women (AOR=2.32, 95% CI; 1.05, 5.10) had a positive association with the outcome variable, whereas having one or more live children (AOR=0.19, 95% CI; 0.09, 0.39) and having no formal education (AOR= 0.51, 95% CI; 0.29, 0.89) had a negative association with fertility desire.

Conclusion: The proportion of sexually active HIV-positive women with desire for children was high among women visiting referral hospitals. Therefore, programmers and policymakers need to expand new PMTCT services throughout the region and consider the effects of these factors on HIV-positive women, as they develop interventions.
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http://dx.doi.org/10.2147/HIV.S221941DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6802556PMC
October 2019

Self-care practice and associated factors among patients with diabetes mellitus on follow up at University of Gondar Referral Hospital, Gondar, Northwest Ethiopia.

BMC Res Notes 2019 Sep 18;12(1):591. Epub 2019 Sep 18.

Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Objective: Diabetes, a rising global health problem, requires continuous self-care practice. There are limited studies about self-care practice, and most of the studies conducted in Ethiopia focused on some parts of the recommended self-care practices. Therefore, this study aimed to assess diabetes self-care practice and associated factors among diabetic patients attending at University of Gondar Referral Hospital, Gondar, Northwest Ethiopia.

Results: The study revealed that 51.86% (95% CI 46.95-56.72%) of the patients have poor self-care practice. Unable to read and write (AOR = 3.36; 95% CI 1.42-7.90), primary level of education (AOR = 2.62; 95% CI 1.20-5.70), living in rural area (AOR = 3.33; 95% CI 1.61-6.88), having strong social support (AOR = 0.31; 95% CI 0.15-0.62), having diabetes related complication (AOR = 2.20; 95% CI 1.12-4.30), and poor socio-economic status (AOR = 2.16; 95% CI 1.17-3.98) were factors significantly associated with poor self-care practice of patients with diabetes. The study indicates that the prevalence of poor self-care practice was high. Education, residence, socio-economic status, complication and social support were significantly associated with poor self-care practice. Therefore, strategies should be developed to support patients with information, glucometer, and enhance patient's social support.
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http://dx.doi.org/10.1186/s13104-019-4630-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751591PMC
September 2019

Willingness to pay for improved solid waste management and associated factors among households in Injibara town, Northwest Ethiopia.

BMC Res Notes 2019 Jul 12;12(1):401. Epub 2019 Jul 12.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.o. Box:196, Gondar, Ethiopia.

Objective: Globally, cities generate 1.3 billion tons of solid waste per year, amounting to a rate of 1.2 kg per person per day. Solid waste management is an important challenge to both the developed and developing countries. This study aimed to assess the willingness to pay for the improved solid waste management and associated factors among households in Injibara town, Ethiopia.

Results: A total of 903 household heads participated in the study. The finding indicated that 81.06% were willing to pay for the service. The average amount of money the participants would be willing to pay per month was 29.7 ETB ($1.07)). The study revealed that sex (β = 3.24, (95% CI 1.98, 4.50)), age (β = - 0.09: 95% CI - 0.19, - 0.01), educational status (β = 6.19: 95% CI 3.54, 8.84), occupation (β = 2.43: 95% CI 1.009, 3.86), amount of solid waste generated (β = 1.74: 95% CI 0.19, 3.29), distance from dump site (β = 1.58: 95% CI 0.45, 2.72), satisfaction with the existing service (β = 3.89, (95% CI 2.75, 5.06) and wealth status (β = 2.43: 95% CI 1.0, 3.86) were statistically significant. Therefore, the level of premium load should consider the amount of waste generated, wealth status and the distance from the dump site.
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http://dx.doi.org/10.1186/s13104-019-4433-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626345PMC
July 2019

Willingness to pay for community-based health insurance and associated factors among rural households of Bugna District, Northeast Ethiopia.

BMC Res Notes 2019 Jan 24;12(1):55. Epub 2019 Jan 24.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Objective: Community based health insurance schemes are becoming recognized as powerful method to achieve universal health coverage and reducing the financial catastrophic shock of the community. Therefore, this study aimed to assess willingness to pay for community-based health insurance and associated factors among rural households of Bugna District, Ethiopia.

Results: A total of 532 study participants were included in the study. The finding indicated that 77.8% of the households were willing to pay for the community-based health insurance. The average amount of money the households were willing to pay per household per annum was 233 ETB ($11.12 USD). The result of the study also revealed that attending formal education[ß = 3.20; 95% CI = 1.87, 4.53], history of illness [ß = 2.52; 95% CI = 1.29, 3.75], household size [ß = 0.408; 95% CI = 0.092, 0.724], awareness about the scheme [ß = 2.96; 95% CI = 1.61, 4.30], and wealth status [ß = 5.55; 95% CI = 4.19, 6.90] were factors significantly associated with willingness to pay. Therefore, enhancing awareness of the community about the scheme, considering the amount of premium as per household family size and wealth status might increase household's willingness to pay for community-based health insurance.
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http://dx.doi.org/10.1186/s13104-019-4091-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346545PMC
January 2019

Factors for healthcare utilization and effect of mutual health insurance on healthcare utilization in rural communities of South Achefer Woreda, North West, Ethiopia.

Health Econ Rev 2018 Aug 22;8(1):15. Epub 2018 Aug 22.

School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia.

Objective: To identify factors for healthcare utilization and to describe effect of Mutual Health Insurance on health service utilization in rural community in South Achefer, North West Ethiopia.

Methods: Across-sectional study was conducted. A total of 652 households consented to participate in the study (326 insured and 326 uninsured households). Propensity score matching was used to explain possible differences in the baseline variables between enrolled and un-enrolled households. Logistic regression analysis was used to identify factors for healthcare utilization.

Results: Healthcare utilization among insured households was 50.5% (95% CI: 44.8%, 56.2%). Whilst among uninsured households, healthcare utilization was 29.3% (95% CI: 24.11, 34.47). In general, the overall healthcare utilization was 39.89% (95% CI: 35.7, 43.8). The overall increase in patient-attendance given illness among insured households was 25.2% higher compared with uninsured (t = 4.94, 95% CI: 0.145, 0.359). Educated (primary and above) (AOR = 1.84; 95% CI: 1.14, 2.98), chronic patient (AOR = 1.86; 95% CI: 1.13, 3.06), first choice was health facilities at the point of illness (AOR = 6.33; 95% CI: 2.97-13.51), rich (AOR = 2.1; 95%CI: 1.29, 3.43), and insured (AOR = 2.16; 95% CI: 1.45, 3.23) were independently associated with increased healthcare utilization.

Conclusion: Enrolment to mutual health insurance increases healthcare utilization. Presence of illness in the households, household earnings, educational status, first choice of treatment at point of illness, and membership to Mutual Health Insurance scheme should be targeted during escalating of healthcare utilization.
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http://dx.doi.org/10.1186/s13561-018-0200-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104411PMC
August 2018
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