ArticlePloS one2018
The effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia: A cross sectional study.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.
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Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis.Global health action · 2023Pooled it
- Impact of community-based health insurance in low- and middle-income countries: A systematic review and meta-analysis.PloS one · 2023Pooled it
- The burden of household out-of-pocket healthcare expenditures in Ethiopia: a systematic review and meta-analysis.International journal for equity in health · 2022Pooled it
- Does community-based health insurance protect women from financial catastrophe after cesarean section? A prospective study from a rural hospital in Rwanda.BMC health services research · 2022Trial
- Article
- The effect of community-based health insurance on out-of-pocket expenditure among diabetic patients at hawassa university comprehensive specialized hospital: facility-based comparative cross-sectional study.BMC health services research · 2026Article
- Drivers of community-based health insurance enrolment in post-war Tigray, Ethiopia.BMJ global health · 2026Article
- Determinants, challenges, and opportunities of the community-based health insurance scheme in Tigray Regional State, Ethiopia: A mixed method study.Journal of public health research · 2025Article
- Machine learning based classification of catastrophic health expenditures: a cross-sectional study of Korean low-income households.BMC health services research · 2025Article
- What influences the impact of health financing reforms? Using qualitative comparative analysis to identify patterns in health financing systems and their effects on financial protection.SSM - health systems · 2025Review
- Socioeconomic impacts of community-based health insurance: evidence from Gondar Zuria District, Amhara Regional State, Ethiopia.Health research policy and systems · 2025Article
- Health insurance policy enforcement and catastrophic health expenditure: a case study in Sichuan province, China.Frontiers in public health · 2025Article
- Exploring disparities in satisfaction with obstetric-gynecological care among insured and uninsured women in Almaty, Kazakhstan: a comparative cross-sectional study.Frontiers in global women's health · 2025Article
- Out-of-pocket and indirect expenditure of spina bifida and hydrocephalus patients admitted for inpatient treatment and follow-up at two university-affiliated hospitals in Ethiopia.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Catastrophic Health Expenditures for In-State and Out-of-State Abortion Care.JAMA network open · 2024Article
- Beneficiaries' satisfaction with community-based health insurance services and associated factors in Ethiopia: a systematic review and meta-analysis.Cost effectiveness and resource allocation : C/E · 2024Review
- Assessment of the Effect of Community-Based Health Insurance Scheme on Health-Related Outcomes in Ethiopia: A Systematic Review.Iranian journal of public health · 2024Review
- Catastrophic out-of-pocket payments related to non-communicable disease multimorbidity and associated factors, evidence from a public referral hospital in Addis Ababa Ethiopia.BMC health services research · 2024Article
- Insured-non-insured disparity of catastrophic health expenditure in Northwest Ethiopia: a multivariate decomposition analysis.Health economics review · 2024Article
- Disparities in satisfaction among insured and uninsured adult outpatient department service users in Southern Ethiopia, 2022: a comparative cross-sectional study.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMoving towards the goal of universal health coverage requires strengthening service delivery and overcoming significant financial barriers. The Government of Ethiopia is rolling out community based health insurance to protect the rural community from high out of pocket health expenditure and improve health service utilization. We investigated the effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia.
methodsA community based cross sectional study was conducted. A Multi stage sampling technique was used to get a total of 454 (224 insured and 230 uninsured) households. The data were entered using EPI info version 7 and analyzed using SPSS version 20 and STATA version 13 for binary logistic regression analysis and propensity score matching analysis respectively. Wealth status of the households was computed by Principal Component Analysis (PCA). A multivariable logistic regression analysis was done to identify the predictors of catastrophic health expenditure. Propensity score matching analysis was used to determine the effect of community based health insurance on catastrophic health expenditure. The average treatment effect on the treated (ATT) was calculated to compare the means of outcomes across insured and uninsured households.
resultsA total of 454 household heads were included in the study, making a response rate of 91.2%.The total level of catastrophic health expenditure was found to be 20%. Among the households with catastrophic health expenditure, 4.41% were insured, whereas the remaining 15.64% were noninsured. Insured households (AOR = 0.19, 95% CI: 0.11-0.34), rich households (AOR = 1.98; 95% CI: 1.07-3.66), having member with chronic illness (AOR = 2.13, 95% CI: 1.01-4.51) and having member encountered any illness during the past 3 months (AOR = 2.44, 95% CI: 1.35-4.40) were statistically associated with catastrophic health expenditure. Community based health insurance contributed to 23.2% (t = -5.94) (95% CI: -0.31_-0.15) reduction of catastrophic health expenditure.
conclusionThe overall level of catastrophic health expenditure was high among noninsured households. Community based health insurance has significant financial protection from catastrophic health expenditure in northeast Ethiopia. Thus, the government need to scale up community based health insurance to protect the noninsured households from catastrophic health expenditure.
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