Nursing & Primary Care
Open AccessStudy of Associated Factors with Payment for Health Services in Public Hospitals of Northern Health District of Bujumbura
Authors: Edouard Niyongabo, Yakine Niyukuri, Jackson Ntakirutimana.
Abstract
Background: This study examined the factors influencing out-of-pocket payments for healthcare services in public hospitals in the northern health district of Bujumbura, despite efforts to improve access to care. A descriptive and analytical survey was conducted with 124 patients using structured questionnaires. Descriptive analyses were supplemented with multinomial logistic regression.
Purpose: The overall objective of this study is to analyze the factors associated with direct payment of health services in public hospitals; While, Specific objectives include: - Identify the associated factors with the use of out-of-pocket payments. - Evaluate reasons for non-enrollment in health insurance. - Identify the disadvantages of out-of-pocket payments for patients.
Results: The results showed that 57.26% of patients paid directly for their care, 38.71% used health insurance, and 3.23% received free care. The main reasons for non-enrollment in health insurance included lack of information (38.81%), non-civil servant status (32.84%), and lack of funds for contributions (26.87%). As a result, 56.45% of patients experienced catastrophic out-of-pocket expenses, 30.65% had limited access to care, and 12.90% delayed treatment.
Conclusion: The study highlighted the predominance of out-of-pocket payments, revealing financial challenges and inequalities in access to care. To reduce this dependency and improve equity, reforms were needed to make health insurance more accessible, increase awareness, and extend coverage to all Burundian citizens.
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