Client Satisfaction and Associated Factors Among Insured and Uninsured Adult Clients Visiting Public Health Institution in Enrage Enawga Woreda, Amhara Regional State North West Ethiopia, 2021: Institution Based Comparative Cross Sectional Study

Background: Community-Based Health Insurance is an emerging concept for providing financial protection against the cost of illness and improving access to quality health services for rural and urban populations. Knowing the factors for patient satisfaction is an important and direct indicator of quality of health care which is essential for providers to fill their gaps. Although few studies have been conducted on patient satisfaction in Ethiopia; but this study aimed to assess patient satisfaction and associated factors in the insured and uninsured clients under Community-based health insurance. Methods: Institution-based comparative cross-sectional study was conducted from March 15 th2021 to April 30th, 2021. Over all 770 clients were selected from the health center by using simple random sampling techniques. The data were coded and entered into Epi-data3.1 and exported to SPSS Version 25 for analysis. Descriptive statistics and bivariate and multivariable logistic regression analyses were performed to identify the factors that affect client satisfaction with of p values less than 0.05. Results: Out of 753 respondents with a response rate of 97.8% the insured and non-insured patient satisfaction was 215 (56.6%) and 171(45.8%) respectively. The mean score with Standard Deviation of the satisfaction score was 3.6± 0.37 among insured and 3.5± 0.38 among non-insured under the CBHI scheme. The Pearson chi-square test showed a statistically significant difference between insured patients with a higher mean satisfaction score than their counterpart noninsured with x2= 8.67, df =1, P=0.003. Conclusions: The result shows that insured clients have a higher satisfaction score than non-insured clients. Therefore, to improve patient experiences at health centers and achieve financial risk protection through CBHI, program managers and healthcare providers should increase the satisfaction at the health facility to insured and non-insured community members.