Date of Award

12-5-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr Muhammad Ashar Malik

Second Advisor

Dr Aziz Ullah Dhiloo

Third Advisor

Dr Nazima Zain

Department

Community Health Sciences

Abstract

Introduction: Out-Of-Pocket (OOP) payments are considered a regnant means of financing healthcare. Pakistan's health financing is primarily financed through OOP payments. The government's share in healthcare financing is < 40%. Government hospitals are affected by inadequate funding and often lack health supplies. Consequently, patients visiting government facilities independently arrange such services and supplies while being treated.
Objectives: This study aims to estimate the extent of Unofficial Out Of Pocket payments (UOOP) of patients seeking treatment in a public hospital.
Methodology: Using a cross-sectional design, this study was conducted in a tertiary public hospital, Dr Ruth K. M. Pfau Civil Hospital, Karachi (CHK); data were collected on UOOP payments from 315 patients who stayed >2 days in the three departments; gynae, medicine, and surgery.
Results: Of the 298 study participants, most were female ( 59%), young ( 50%), unemployed ( 65%), non-educated (41%), married (81%), and belonging to urban areas (82%). Only seven participants received free healthcare services; the remaining were paid from their pockets. Mean (PKR) UOOP was highest on food (PRK 3102), followed by laboratory tests (PKR 2880), blood bags (PKR 1769), surgical items (PKR 1293), medicines (PKR 1227), and radiology tests (PKR 1104). In univariate analysis, the relation between the stay and place of residence with UOOP payments was statistically significant. In multivariate regression analysis, UOOP in the medicine department was significantly higher than in the surgery department at a 10% level of significance.
Conclusion: Our findings indicate a high incidence of UOOP in a tertiary care hospital. Hinting at a shortage of resources to cater for the healthcare need of the patients, more research is required on the causes of the unavailability of such services that are supposed to be provided free of cost.

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1

Last Page

44

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