Free health care provision and its financial implications in Gondar town, northwest Ethiopia

Abstract

Abstract Background: In Ethiopia based on government regulation; there is provision of free health service for the poor. However users’ characteristics and the financial burden on health care provision has not been well investigated. Objective: To find out if free health care provision really protects the poorest from the burden of payment and to estimate the service cost and financial impact of the above on Gondar College of Medical Sciences (GCMS) referral hospital. Methods: Records of patients who received free health service at the GCMS hospital between December 1996 and December 2000 were retrieved from the hospital register book. Using a pre-tested uniform questionnaire, data were collected on 1021 patients whose address could be traced in Gondar town. Results: Among the respondents, 836 (81.9%) were in the economically active age group (15-64 years) and more than half, 646 (63.3%) were females. Outpatients were 642 (62.9%) with an average cost of birr 34.60 per patient/year, while 379 (37.1%) were inpatients with average hospitalization duration of 28.7 days and average cost of birr 86.10 per patient/year. A significant number of respondents, 631 (61.8%) were real poor. The majority, 999 (97.8%) think poverty certificate to be an appropriate means to help the poor and 728 (70.2%) had no problem of acquiring one. More than half of the respondents, 642 (63.3%) were also satisfied with the service given free of charge. Conclusion: Poverty certificate from Kebele does not exclude those who can afford to pay and creates unnecessary burden on government health service financing. Therefore, more effective screening technique by the concerned authorities is recommended. [Ethiop.J.Health Dev. 2004;18(2):125-129]