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The impact of out-of-pocket expenditures on missed appointments at HIV r care and treatment centers in Northern Tanzania

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Global Health Journal 2021年第2期5卷 90-96页

作者： carl mhina Hayden Bosworth John A.Bartlett Helene Vilme Joyce H.Mosha Deborah F.Shoo Tom J.Kakumbi Glory Jacob Charles Muiruri Department of Population Health Sciences School of MedicineDuke University215 Morris StreetDurhamNC 27701USA Kilimanjaro Christian Medical University College Box 2240Moshi KilimanjaroTanzania Health Economics Unit School of Public Health and Family MedicineFaculty of Health SciencesUniversity of Cape TownOBSERVATORY 7925South Africa Duke Global Health Institute Duke UniversityDurhamNC 27708USA Durham Center of Innovation to Accelerate Discovery and Practice Transformation Durham Veterans Affairs Health Care System508 Fulton StreetHSRD 152DurhamNC 27705USA Muhimbili University of Health and Allied Sciences P.0.Box 65001Dar-es-SalaamTanzania

Background:Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV(PLHIV).PLHIV likelihood of missing clinic appointments is associated with direct and indirect expenditures made while accessing HIV *** objective of this study was to examine the relationship between out-of-pocket(OOP)health expenditures and the likelihood of missing ***:Totally 618 PLHIV older than 18 years attending two HIV care and treatment centres(CTC)in Northern Tanzania were enrolled in the *** attendance and clinical characteristics were abstracted from medical *** on OOP health expenditures,demographics,and socio-economic factors were self-reported by the *** used a hurdle *** first part of the hurdle model assessed the marginal effect of a one Tanzanian Shillings(TZS)increase in OOP health expenditure on the probability of having a missed appointment and the second part assessed the probability of having missed appointments for those who had missed an appointment over the study ***:Among these 618 participants,242(39%)had at least one missed clinic appointment in the past *** expenditure was not significantly associated with the number of missed clinic *** median amount of OOP paid was 5100 TZS per visit,about 7%of the median monthly *** who were separated from their partners(adjusted odds ratio[AOR]=1.83,95%confidence interval[CZ]:1.11-8.03)and those aged above 50 years(AOR=2.85,95%CI:1.01-8.03)were significantly associated with missing an *** those who had at least one missed appointment over the study period,the probability of missing a clinic appointment was significantly associated with seeking care in a public CTC(P=0.49,95%CI:0.88-0.09)and aged between>25-35 years(P=0.90,95%CI:0.11-1.69).Conclusion:Interventions focused on improving compliance to clinic appointments should target public CTCs,PLHIV aged between>

关键词： Missed clinic appointments Out-of-pocket expenditure HIV Tanzania

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