The Impact of Community‐Based Health Insurance Scheme on Patient Satisfaction in Debresina, Primary Hospital, North Shewa Zone, Ethiopia: A Comparative Cross‐Sectional Study

Abstract

ABSTRACT Background and Aims In developing countries, the impact of Community‐based health insurance on patient satisfaction has not well assessed. This study aimed to assess the impact of community‐based health insurance on patient satisfaction with outpatient services at Debresina Primary Hospital, North Shewa Zone, Ethiopia. Method A facility‐based comparative cross‐sectional study was conducted from May to June 2023 at Debresina Primary Hospital. Data were collected from 538 (282 CBHI members and 256 non‐members) selected patients attending outpatient care using systematic random sampling. Data were entered into Epi‐Info version 7.2 and analyzed using STATA version 17. A multivariable logistic regression analysis was conducted to identify predictors of patient satisfaction. A propensity score matching model was used to determine the impact of community‐based health insurance on patient satisfaction by reducing selection bias and enhancing group comparability. Result A total of 538 (282 insured and 256 non‐insured) patients were enrolled in the study. Half of the study participants were satisfied with the outpatient care and among those satisfied, 56.4% were insured and 42.2% were non‐insured respondents. Insured patients (AOR = 2.1; 95% CI = 1.38–3.1), married patients (AOR = 2.13; 95% CI = 1.1–4.16), and patients who visited the hospital five or more times per year (AOR = 1.67; 95% CI = 1.04–2.68) were more likely to be satisfied with outpatient services. A community‐based health insurance scheme raises patients' satisfaction with outpatient care by 18% (ATT = 0.175, t = 2.94). Conclusion The community‐based health insurance scheme has a favorable impact on patient satisfaction with outpatient services. Expanding coverage will significantly contribute to improving patient satisfaction and healthcare experiences, ultimately helping Ethiopia achieve universal health coverage.