ArticleClinicoEconomics and outcomes research : CEOR2021
Inequality and Inequity in Outpatient Care Utilization in Ethiopia: A Decomposition Analysis of Ethiopian National Health Accounts.
Article in ClinicoEconomics and outcomes research : CEOR, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Is context considered in health inequity research and why? An examination of current trends in Ethiopia.Philosophy, ethics, and humanities in medicine : PEHM · 2026Pooled it
- Financial protection and healthcare utilization for low-income populations under China's multi-tiered health financing system: a cross-sectional study in an Eastern city.BMC health services research · 2026Article
- Equity considerations for the implementation of health insurance benefit package in Ethiopia: result of expert Delphi exercise.International journal for equity in health · 2024Article
- Rural-urban inequalities in health care utilization in Bhutan: a decomposition analysis.International journal for equity in health · 2024Article
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6 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundInequity in healthcare use is avoidable inequality, and it exists when there are differences in the use of healthcare after standardization of different needs among the population. In Ethiopia, wide variation and lower achievement exists in outpatient visit per person per year against the target to reach by 2020. Therefore, this study is aimed at measuring inequalities and inequities in outpatient care utilization in Ethiopia.
methodsThe study utilized data from 2015/16 Ethiopian National Health Account survey. The analysis included a weighted sample of 42,460 individuals. Concentration curve and indices were used to measure inequality in outpatient care utilization. Deviations in the degree to which outpatient care was distributed according to need were measured by the horizontal inequity index. All statistical analyses were done using STATA version 14. In all analyses statistical significance was declared at a
resultsThe outpatient care utilizations were found to be concentrated among the rich. The actual (C = 0.0335, 95% CI: 0.0298, 0.0431) and need predicted (C = 0.0157, 95% CI: 0.0117, 0.0413) utilizations were concentrated among the rich. The distributions of outpatient care in Ethiopians were pro-rich (rich-favoring). The decomposition analysis revealed that need factors were the main positive contributors to the inequality (23.6%) and non-need factors were among the negative contributors to the inequality (-48.4%).
conclusionThis study evidenced the presence of rich-favoring inequality and inequity in outpatient care utilization in Ethiopia. Therefore, there is a need to consider implementation strategies that focus on fairness in healthcare utilization.
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