ArticleInquiry : a journal of medical care organization, provision and financing
Postwar Decline in Healthcare Services Utilization With Rising Disparities: A Repeated Cross-Sectional Study Using Count Data Models.
Article in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
IntroductionTigray experienced a devastating armed conflict in November 2020 that systematically dismantled one of the country's best-performing health systems, with only 30% of hospitals and 17% of health centers remaining functional six months into the war. This study aimed to compare several count data models in analyzing postwar healthcare services utilization disparity and associated factors in Eastern Tigray, Ethiopia.MethodsRepeated cross-sectional analytical study design employed secondary data from 20 facilities across 18 districts of Eastern Tigray comprising 2,040 observations. We compared many models and ZINB-GLMM was selected to handle the healthcare utilization with substantially excess zeros, unmeasured heterogeneity of facility, and potential period-specific interaction. The model considered demographic, service-related, geographic, and conflict-period factors. Model performance was compared using AIC and BIC.ResultsMean utilization declined from 335 recipients prewar to 41 postwar, an 87.8% reduction. The prewar period was significantly associated with higher rate of utilization compared with the postwar period (
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