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  6. The Burden Of Out-of-pocket Expenditure For Emergency Health Care Service In St. Paul Hospital Millennium Medical College, Addis Ababa Ethiopia

The Burden of Out-of-Pocket Expenditure for Emergency Health Care Service in St. Paul Hospital Millennium Medical College, Addis Ababa Ethiopia

Woldesenbet Waganew1

  • 1St Paul hospital millennium medical college.

Ethiopian Journal of Health Sciences|June 13, 2025

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View abstract on PubMed

Summary

Out-of-pocket payments are the primary financial burden for acutely ill patients in emergency departments, exceeding other methods like community-based health insurance and government waivers across all demographics.

Area of Science:

  • Health Economics
  • Public Health
  • Healthcare Management

Background:

  • High out-of-pocket (OOP) healthcare expenditure significantly hinders universal healthcare access, particularly for acute care.
  • OOP payments pose a substantial financial burden on patients seeking emergency medical services.

Purpose of the Study:

  • To assess the prevalence and burden of out-of-pocket payments among acutely ill patients presenting to an emergency department.
  • To identify the primary payment methods utilized by patients in acute care settings.

Main Methods:

  • A cross-sectional study design was employed, analyzing patient records from St. Paul Hospital Millennium Medical College in Addis Ababa, Ethiopia.
  • Descriptive statistics were utilized to summarize findings from 388 eligible patient charts out of 22,982 total clients.

Main Results:

  • Out-of-pocket payments represented the most common payment method at 35.8%, followed by community-based health insurance (15.5%) and government fee waivers (13.7%).
  • OOP spending was consistently higher than other payment methods across diverse demographic groups (age, gender, region) and clinical factors (referral source, comorbidities).

Conclusions:

  • Out-of-pocket payments are the predominant financial mechanism for acute care in the studied emergency department.
  • The findings highlight a significant financial barrier for patients, underscoring the need for improved healthcare financing strategies to reduce OOP burdens.
Keywords:
emergency servicehealth care expenditureout of pocket payment

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