Cost–related unmet need for healthcare services in Kenya
| العنوان: | Cost–related unmet need for healthcare services in Kenya |
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| المؤلفون: | Wim Groot, Jelena Arsenijevic, Purity Njagi |
| المساهمون: | Health Services Research, Maastricht Graduate School of Governance, RS: FSE TA-TIER, RS: GSBE MGSoG, RS: CAPHRI - R2 - Creating Value-Based Health Care |
| المصدر: | BMC Health Services Research BMC Health Services Research, 20(1):322. BioMed Central Ltd BMC Health Services Research, Vol 20, Iss 1, Pp 1-12 (2020) |
| بيانات النشر: | BioMed Central, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | health care delivery, poverty, DETERMINANTS, Health informatics, Health Services Accessibility, Health administration, 0302 clinical medicine, Universal Health Insurance, Health care, Medicine, Healthcare Financing, 030212 general & internal medicine, Cost-related, health service, outpatient care, health care economics and organizations, education, education.field_of_study, Family Characteristics, lcsh:Public aspects of medicine, 030503 health policy & services, Nursing research, Health Policy, Healthcare, article, health care cost, Equity, hospital patient, health care policy, Analysis of Health Care Markets, Regression Analysis, Female, ACCESS, 0305 other medical science, scale up, BEHAVIOR, Research Article, Unmet need, COUNTRIES, Adult, medicine.medical_specialty, Population, health care financing, Multilevel analysis, 03 medical and health sciences, Young Adult, Environmental health, cross-sectional study, Humans, human, i11 - Analysis of Health Care Markets, correlation coefficient, Health Services Needs and Demand, Poverty, business.industry, Public health, Equity (finance), family size, lcsh:RA1-1270, economics, Kenya, household, Cross-Sectional Studies, money, Self Report, Health Expenditures, business |
| الوصف: | Background The assessment of unmet need is one way to gauge inequities in access to healthcare services. While there are multiple reasons for unmet need, financial barriers are a major reason particularly in low- and middle-income countries where healthcare systems do not offer financial protection. Moreover, accessibility and affordability are paramount in achieving universal health coverage. This study examines the extent of unmet need in Kenya due to financial barriers, the associated determinants, and the influence of regional variations. Methods We use data from the 2013 Kenya household health expenditure and utilization (KHHEUS) cross sectional survey. Self-reported unmet need due to lack of money and high costs of care is used to compute the outcome of interest. A multilevel regression model is employed to assess the determinants of cost-related unmet need, confounding for the effect of variations at the regional level. Results Cost-related barriers are the main cause of unmet need for outpatient and inpatient services, with wide variations across the counties. A positive association between county poverty rates and cost-related unmet is noted. Results reveal a higher intraclass correlation coefficient (ICC) of 0.359(35.9%) for inpatient services relative to 0.091(9.1%) for outpatient services. Overall, differences between counties accounted for 9.4% (ICC ~ 0.094) of the total variance in cost-related unmet need. Factors that positively influence cost-related unmet need include older household heads, inpatient services, and urban residence. Education of household head, good self-rated health, larger household size, insured households, and higher wealth quintiles are negatively associated with cost-related unmet need. Conclusion The findings underscore the important role of cost in enabling access to healthcare services. The county level is seen to have a significant influence on cost-related unmet need. The variations noted in cost-related unmet need across the counties signify the existence of wide disparities within and between counties. Scaling up of health financing mechanisms would fundamentally require a multi-layered approach with a focus on the relatively poor counties to address the variations in access. Further segmentation of the population for better targeting of health financing policies is paramount, to address equity in access for the most vulnerable and marginalized populations. |
| اللغة: | English |
| تدمد: | 1472-6963 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d79f063c0248801698b167d77b6e6b10Test http://europepmc.org/articles/PMC7164162Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d79f063c0248801698b167d77b6e6b10 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14726963 |
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